gordonpc Posted January 11, 2016 Report Share Posted January 11, 2016 We've only made it 10 days into 2016 and the restrictions imposed by BCBS's HMO have us pulling our hair out. We are full-timers and use the Escapees mail forwarding service and thus have a Livingston address. When we signed up for health insurance through the marketplace, we only had 7 options, all BCBS HMO's. Since we are new Texas residents, we didn't have an established Primary Care Physician (PCP) so BCBS assigned us one in Livingston. However, we are now in Kerrville, 5 hours away, and DW needs to have some tests performed. BCBS told us we would have to a referral from our PCP before they would pay for us to see another doctor in the network. Our PCP's office told us they won't do a referral when they've never seen us first. BCBS allows us to switch our PCP but only effective the first of the next month (after they approve the change). We've contacted physicians in the Kerrville area to see if they are accepting new patients with BCBS HMO insurance and, although they are listed on the BCBS website, they no longer belong to the HMO. Our second issue has to do with out-of-state medical treatment. We knew when we signed up for the HMO that the HMO insurance would only pay for emergency room treatment when out of state. Now we see in the BCBS handbook that even this is only true if you are traveling outside of Texas for short periods of time (less than 90 consecutive days). We entered the full-timer lifestyle with the expectation that we would travel throughout the US. Now, the limitations caused by the HMO are causing us to fear leaving the Livingston area. I'm curious how other Texas full-timers under the age of 65 are dealing with these issues. Link to comment Share on other sites More sharing options...
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