SC Blue Cross/Blue Shield accepting out of state plans? (Rock Hill: health insurance, how much)

[rothbear]

I will be moving down to our home in Sun City soon, but hubby is staying here until we sell the house and he finds a job down there.

Here's our question.......If hubby gets BC/BS health insurance for us through his work in PA, can I use the plan with no problem in SC at participating docs for routine stuff? Anyone done this down there? I did check through the SC site for participating docs in PA and it brought up a bunch, I just don't know happy they would be accepting an out of state plan for an indeterminate amount of time.

Unfortunately, we have UPMC now and they do not have any participating down there and told me they would only pay for emergency stuff. But DH office will probably help pay for a BC/BS shield plan that we get directly. And why is health insurance in SC so much more expensive than up here in PA???? The same plans costs about $200-300 MORE down there????

[Jeff in Indian Land]

I would expect that you shouldn't have any problem with any medical provider that is part of the BCBS network, but you should probably confirm that when scheduling an appointment.

Many large companies contract with a BCBS affiliate to provide coverage for their employees nationwide, without regard to where the employee actually lives. I work for the American Red Cross, and our program is contracted with the BCBS affiliate in Maryland.

Keep in mind that, depending on your choice of providers, you may actually be dealing with providers in Charlotte more-often than in York or Lancaster County.

No matter where you seek assistance, the primary concerns will be whether you have a plan that limits you to in-network care only, and if the provider is part of the BCBS network.

I believe all the major hospitals in this area are part of the network, as well as many of the larger doctors groups.

I'm not a health care expert, but wonder whether the price difference you noted in insurance coverage is simply a reflection of how much the coverage would cost when an employer is not bearing a portion of the costs.

[rothbear]

No actually, the difference in price was from a search on the PA site for individual paid plans and the same search on the SC site. So basically it should be the same. Also, where prescriptions are covered in all the PA plans, you have to add it to the SC plans and that's an extra $89/month! Wow, not sure it would be worth it at that rate.

Thanks for your input!

Anyone else????

[greenvillesc]

I live and work in SC and am a state employee (schools). I am able to use providers in North Carolina with no problem. I was told to check the ID card and see if there is a little "suitcase" printed on the card, which indicates that the program can be used nationwide. I was able to locate and use providers that are out-of-state for me with no problem. The Presbyterian Health Care system was on our Blue Cross/Blue Shield list and I have been extremely pleased with everyone so far. However, I would definitely advise you to call BC/BS: there should be an 800 # on the back of your card. There are many types of BC/BS plans, and what is true for one person's plan may not be for another. They should be able to answer any questions for you.

[Lindsey_Mcfarren]

When I moved from Texas to Florida I had a BC BS PPO plan from Texas. They took it here just fine and gave me the in network benefits for it as well.

Usually among the different BC BS plans there is reciprocity. I would check it out to make sure however. That is one of the perks of having BC BS plans.

[rothbear]

I finally found a toll free number to call BC/BS for non-members today and was told the same thing that greenvillesc mentioned. The guy said to check for the little suitcase with PPO in it and that means that it will be accepted as in network for any network providers in any state.

We don't have them yet as we are just checking in on it for right now. But we'll have to see about the costs as the guy also told me that what I was quoted on the website may or may not be the actual cost as they have to do a medical underwriting on all applicants. They could probably use this to charge us more because we are both over 55.

Thanks for all the input!

[groove1]

I have BC BS of NC and use it in SC with no problem. You can see any doctor in any state.

[grannynancy]

I live in SC, work for a company based in DC have BC/BS of Maryland and the ONLY trouble is they have to file through the SC office and when there was a coding problem [hint avoid Peidmont Hospital in Rock Hill like the plague -- bad rep and they always miscode something] you may have some delays. The problem was delays with the SC office transferring info to the MD office

But I have had this plan for 3 years and that is the ONLY problem. The good thing is my BC/BS MD EPO is MUCH better coverage than BC/BS SC!!!!!!!

[rothbear]

grannynancy.........I agree! The PA BC/BS coverage is MUCH better than SC, and cheaper as well. PA includes coverage for prescriptions in their base rate, and in SC it costs $89 extra on top of the base rate! Plus I think there were other better items as well.

We haven't looked into it yet as I'm probably not moving down until the beginning of September. I am trying to get appointments with all my docs up here before I move down so that I am not rushed to find someone.