We have a similar concern as the OP. I am covered by Medicare and a supplement but my wife is a few years younger and is covered by a bronze level ACA plan from Anthem Blue Cross and Blue Shield. Healthcare.gov says that the plan is an EPO and does not have a national provider network. Except for emergency and urgent care there is no out-of-network coverage. The plan does include Blue Card PPO Basic but we're not sure what this actually means in terms of coverage outside of our immediate (St. Louis, Mo.) area. Does that mean as suggested in earlier posts that we would get the BCBS negotiated rates if we use a provider in the BCBS PPO Basic network but we would be responsible for the full amount?
Note: As far as we can tell, all of the Anthem plans available through the exchange in our area use the same network and if you shop off network, you are directed either to short term plans with lesser coverage or to plans that are identical to the ACA plans. According to healthcare.gov, there are no plans in our area that include a national network. We would have considered a higher level plan if it included a broader or national network but going to a gold plan in our area got a lower deductible and out-of-pocket max but didn't broaden the network or provide additional out-of-area coverage.
Note: As far as we can tell, all of the Anthem plans available through the exchange in our area use the same network and if you shop off network, you are directed either to short term plans with lesser coverage or to plans that are identical to the ACA plans. According to healthcare.gov, there are no plans in our area that include a national network. We would have considered a higher level plan if it included a broader or national network but going to a gold plan in our area got a lower deductible and out-of-pocket max but didn't broaden the network or provide additional out-of-area coverage.
Statistics: Posted by TomBH — Thu Apr 11, 2024 4:58 pm — Replies 40 — Views 2587