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Questions about Health Insurance

Posted: Tue Aug 13, 2019 5:42 pm
by Rikimaroo
So I currently have Myblue HMO with BCBS...Through Healthcare.gov as I own my own business and its more cheaper, but a hell of a good plan, myblue Silver, i pay $200 a month for it. It's actually really great. The only downfall is that it doesn't cover out of state, it doesn't have the bluecard option.

My surgeon after reviewing my MRI this week, suggested I go to Cleveland Clinic in OH to see Dr. Scott Steele to get surgery and IORT (intraoperative radiation) and this is the best chance for cure. I currently go to Cleveland Clinic Weston, FL....I live in Florida. I am waiting for the CC OH people to call me to see if we can work something out with the insurance giving the nature of the situation being a medical emergency and see if they will work with them.

Anyone ever dealt with this and have any tips to tip the scale in my direction on going out of state and getting in network coverage?

Here is a link to the plan

http://www.bcbsfl.com/DocumentLibrary/COC/2016/IU65ACA/ONX%5C/Plan_1603C_ONEX_01JAN16.pdf


Rikimaroo

Re: Questions about Health Insurance

Posted: Tue Aug 13, 2019 7:41 pm
by margiej
I, too, have insurance with healthcare.gov. While looking for some other info on my insurer's website, I found that if a certain critical treatment weren't offered in my network, I could go another clinic and still be covered. In my case, they would allow me to go to Mayo Clinic for specialized treatment. Otherwise, I generally have no coverage out of network. Perhaps, the place to start is with your Florida insurer and see if something is available to you for specialized treatment.
Wishing you all the best,
Margie

Re: Questions about Health Insurance

Posted: Sat Aug 17, 2019 11:42 pm
by retiredteacher
Hi - not out of state, but out of network here in Northern California. My oncologist spoke with a review physician to get the approval for out of network coverage. Took some time. Try to get a nurse case manager to help walk things through.