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Author Topic: Switching HMO to PPO  (Read 3486 times)

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john2465

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Switching HMO to PPO
« on: September 02, 2008, 08:44:21 PM »
i currently have insurance coverage with an HMO.  I would like to go out of area to get the best possible surgeon.  Can I switch from HMO to PPO with same company and have surgery covered if i have had no interruption in my coverage?

obxpelican

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Re: Switching HMO to PPO
« Reply #1 on: September 02, 2008, 09:06:32 PM »
It's all dependent on your insurance company.  You are heading the right direction because an HMO will make you go to their doctors and if none of them have any experience you are in deep do do.

Even if your insurance company won't allow the change without pulling the "pre-existing condition" bs check with your state insurance commission and see how long an insurance company can say it was pre-existing, I think in PA it's 18 months.
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

sroberts

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Re: Switching HMO to PPO
« Reply #2 on: September 02, 2008, 11:57:43 PM »
John,


If you have insurance from your employer then you usually have to wait for open enrollment
to make any changes. I changed from an HMO to a PPO this year for the same reason.


spencer

john2465

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Re: Switching HMO to PPO
« Reply #3 on: September 14, 2008, 09:41:21 PM »
If you change during open enrollment, do you avoid the pre-existing condition  period?  In N.J. it is usually 1 year.

Thanks

John

sroberts

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  • rbhr Dr Rogerson 6/26/08
Re: Switching HMO to PPO
« Reply #4 on: September 14, 2008, 09:56:38 PM »
I would think it would be covered regardless. We switched at the beginning of this year and didn't have any problems.

 

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