Question:
will bc/bs ppo cover out of state doctors?

   — Michelle A. (posted on May 31, 2000)

May 30, 2000
It is my understanding that bc/bs approve the operation not the surgeon. I have bc/bs of illinois and I went to GA to have my operation. They covered for me. Usually you can call and ask and get lots of info if you ask the right questions. Hope this helps. Tammy
   — Tamilyn12

May 31, 2000
Michelle... I dont know a lot about the insurance game. However, I do know that due to availability of services can get you covered out of state. For example, with the DS surgery, we all know that there arent many DS surgeons out there (but the number is growing) and several people I know have gotten approval due to the availability of services and their out-of-state surgeon going to bat for them. Good luck to you.
   — Kris S.

May 31, 2000
Michelle, If your policy is a PPO, and you go out of state, BC/BS will cover that like you went out of network. In other words, they should cover a percentage , but not usually 100% (mine is 90% of reasonable costs). If you stay in network, they should cover 100%. I know this because I am in Illinois and have BC/BS PPO and went to an Illinois PPO Dr. However the billing came from Michigan and BC/BS mistakenly thought I had surgery in Michigan! I was billed as though my Dr. was out of network. They have since resovled this error (thankfully!!) but I got a look at what the cost would have been had I had to go out of the PPO network of Drs. If you have more specific questions, I would call BC/BS as the policies are so varied. Good Luck!
   — M B.

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