Question about Anthem blue cross insurance?

So my dad switched from blue shield of california hmo to anthem blue cross hmo and he said everything was pretty much the same except they're just different companies. I just want to ask on here if there are any differences because there has to be. Also, also with the in and out of network thing. Can somebody explain exactly how that works? I know HMO only allows you to find services within your network so that would mean I'd only be able to see doctors within the Central Valley where I live in California. Does that mean I'd be able to see any doctor I want to within the central valley? Meaning from Sacramento all the way down to bakersfield? 

3 Answers

  • Eva
    Lv 7
    1 month ago

    Look on the insurance company website.  There will be a list of in-network providers. Hopefully your doctor(s) will be on that list.  In an hmo, you need a primary care physician that belongs to the network. Anything you need outside of that doctor's office needs a referral from that doctor and needs pre-approval from the insurance company.  Always check the website to make sure the doctor or hospital you're going to is in network.  Most medical offices do participate with blue cross/blue shield.  Your dad should have a book from them about what is and isn't covered under the policy.

  • 1 month ago

    A "network" is not a physical place.  Each insurance company has its own list of each doctors are in its network.  It is not any doctor you want in the Central Valley.  It is only some of them.

  • 1 month ago

    Your specific network list is on the Anthem website.

    Typically, an HMO has a gate keeper doctor.  You have to go through that doctor and they will refer you on to specialists as necessary.

    The HMO network likely only allows you to see doctors outside the network for true emergencies and on a referral basis from an in-network doctor. 

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