You will want to review the benefits covered by any plan you are considering to see if your children’s out-of-State providers are included in the plan’s network. Services provided by health care providers outside of a plan’s network typically cost more than services delivered by in-network providers.
All plans cover emergency services at any hospital in the United States, regardless of what state plan was purchased from, with the exception of Hawaii. As long an emergency is considered life-threatening, it will be covered as in-network, regardless if the hospital is in your plan’s network. Most plans offer benefits in other states and internationally.
Of course, there are some limitations. Every health plan has a “network” of healthcare providers. Whenever you visit a provider outside of your network, you will pay a larger share of the cost. If you choose an HMO plan, your physician network is local, so you may find it harder to use your benefits in another state. If you choose a PPO plan, you will generally have access to a larger network of out-of-state providers.
If you have a BCBS PPO Plan, you have access to the BlueCard Program offered through the BCBS Association.
If you have a BCBS HMO Plan, you may have access to the Away From Home Care Program that gives HMO members who are temporarily residing away from home access to care.
What Providers Offer Multi-state Plans?
In 2015, multi-state plans are offered through the Blue Cross Blue Shield Association and by Consumer Operated and Oriented Plans (CO-OPs).
How Do Networks Work with Multi-state Plans?
Some multi-state plans offer regional or national provider networks and will reimburse as “in-network” care rendered by providers in other states, but others may not. This information should be provided in the description of the multi-state plan’s features on your state’s health insurance Marketplace.
It’s very important to understand your plans network, you should not expect care options to be consistent between states. Be aware of out-of-network coverage cost sharing and limits.
Are Multi-state Plans More Expensive?
In general a multi-state plan isn’t more expensive. However, the cheapest marketplace plans will often be local HMOs (without multi-state options. In this way, the cheapest multi-state option will often cost more than the cheapest marketplace plan. Comparing one PPO to it’s similar MSP, you may find the multi-state options to have a lower price-tag due to competition of the large network.
Specific cost sharing will very for each covered benefit depending upon your plan and network.
Can I get cost Assistance on a Multi-State Plan?
These plans work just like regular Marketplace plans and are eligible for cost assistance.
Multi-State or PPO?
In some states PPO’s cover you out of state, in others only a multi-state plan will. Again it’s important to check networks and coverage limits of any plan you buy.