(Closed) Please help out of state doctor question!

posted 7 years ago in Wellness
Post # 3
Member
661 posts
Busy bee
  • Wedding: April 2012

I’m pretty sure it just depends on your insurance.  You can probably call the customer service number on your card and they can tell you.  Hope you feel better!

Post # 5
Member
1940 posts
Buzzing bee
  • Wedding: July 2010

I second calling the number on the back of the card.  Some insurance companies also have websites set up where you can see who is covered.  If you call, ask if there is anyone near where you are at that is “in network.”  Some insurances will say things like “oh, you can go anywhere” but they fail to mention that some places are preferred (i.e. you pay a lot less) and some places are not preferred (i.e. you may pay 80% of the cost).

Edit: Just saw your second post… any luck if they have a website?  Is the insurance through an employer?  If so, can you call the company’s HR department and see if they can help?

Post # 6
Member
1940 posts
Buzzing bee
  • Wedding: July 2010

Also, if you need to be seen today or this weekend, you may have a difficult time finding a regular physician to see, especially with the holidays.  You may want to see if there is an urgent care center near where you are at.

Also, does your insurance have a 24-hour nurse liine?  If so, they may be able to point you in the right direction.

Post # 7
Member
442 posts
Helper bee
  • Wedding: August 2015

If you go through the emergency you should be fine. Don’t schedule an appointment. 

Post # 9
Member
1940 posts
Buzzing bee
  • Wedding: July 2010

This is just my personal opinion, and not medical advice, but if it were me and I needed to see a doctor, I would go.  Your health is more important than anything.  The worst scenario would be that your insurance company denies the claim.  You can then go through the steps of filing an appeal, especially because you were out of the area and they were closed. 

 

Post # 11
Member
541 posts
Busy bee
  • Wedding: September 2011

You should be fine with an urgent care. Most insurances will pay them at the “in network” benefit level regardless of where you are or who you go see. And I think (99%) sure that with health care reform it’s law starting tomorrow that any type of urgent situation needs to be covered that way.

Post # 12
Member
1161 posts
Bumble bee
  • Wedding: March 2011

Actually, a UTI IS urgent, and delaying treatment can lead to the infection moving to your kidneys, which is something you want to avoid.

Most insurances have a provision for urgent medical care received when out of town, and I would suspect you will be fine (you will possibly be billed for an out of network visit).  Does you plan have a memeber website?  The information may be on that website.  Otherwise, document that you tried to call the number on the back of your card and go get  yourself checked out.

Post # 13
Member
1111 posts
Bumble bee

If you have a Blue Cross/Blue Shield PPO, usually if an out of area provider is in the PPO network, then you’re usually covered.

If you have a BCBS EPO, and the provider is in the PPO network, you’re also usually covered.

What they do is file it to the local BCBS, and the state BCBS will send it to the BCBS in your home state.

Post # 14
Member
2767 posts
Sugar bee
  • Wedding: September 2009

it depends if the place you go would be considered in-network or out of network.  And a UTI is urgent.  It will only get worse if you don’t go.  Trust me you don’t want that to happen.  I avoided going to the doctor on my honeymoon because I didn’t know what I had.  I waited too late and then I was in a whole heap of pain.  You can destroy your urinary tract and other organs if you wait too long.  Go and get some medicine for it.

Post # 15
Hostess
18646 posts
Honey Beekeeper
  • Wedding: June 2009

Does your insurance company have a website?  Usually you can go online and look for covered doctors.  If your plan is a local plan, they might not cover out of state doctors but some plans are nationwide plans so they cover all over the country.

Post # 16
Member
620 posts
Busy bee

@MacFaniam24:

I agree that UTI is urgent but usually if a woman has had UTIs before and it is the exact same symptoms, you can call whoever is on call for your physician and he/she can call you in a prescription without you even needing to be seen. It is that common.

If on the other hand, you are a woman who says you never had a UTI, this feels different, etc. etc. then you need to be seen. 

ETA: Have the number of a local pharmacy when you call the on call doc…please…lol

The topic ‘Please help out of state doctor question!’ is closed to new replies.

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