Will insurance deny my procedure if I buy a plan off marketplace for the sole purpose of having surgery out of state (TX) and move back home? Is this a thing? For some reason I feel this practice is frowned upon.
I’m hoping to hit my out of pocket maximum with my surgery and hospital stay, then return to my home state for recovery. I have been hit with a rare and very debilitating condition for the past 2 years and have tried many treatments including 8 months of PT, chiro, acupuncture, and injections so surgery is in the picture. Because my state does not have any surgeons trained for this type of surgery I will need to get it done out of state. But despite having all the documentation and advocacy from my surgeon, I’m afraid insurance will make me do 6 more months of physical therapy first or something like that.
More detail:
My current plan has 0 out of network benefits but approves procedures and visits out of state that are deemed necessary. I was able to get my initial consultation out of state approved this way, but I found out that the hospital they operate in doesn’t want to do that type of paperwork. So moving states and purchasing a plan is the option I’m exploring right now.
I will be checking with my surgeon and the hospital once I get more details during open enrollment, but I feel like insurance companies catch onto these type of situations and look for ways to get people to pay more premiums.
Thanks
submitted by /u/velvaetine
[link] [comments]Will insurance deny my procedure if I buy a plan off marketplace for the sole purpose of having surgery out of state (TX) and move back home? Is this a thing? For some reason I feel this practice is frowned upon. I’m hoping to hit my out of pocket maximum with my surgery and hospital stay, then return to my home state for recovery. I have been hit with a rare and very debilitating condition for the past 2 years and have tried many treatments including 8 months of PT, chiro, acupuncture, and injections so surgery is in the picture. Because my state does not have any surgeons trained for this type of surgery I will need to get it done out of state. But despite having all the documentation and advocacy from my surgeon, I’m afraid insurance will make me do 6 more months of physical therapy first or something like that. More detail: My current plan has 0 out of network benefits but approves procedures and visits out of state that are deemed necessary. I was able to get my initial consultation out of state approved this way, but I found out that the hospital they operate in doesn’t want to do that type of paperwork. So moving states and purchasing a plan is the option I’m exploring right now. I will be checking with my surgeon and the hospital once I get more details during open enrollment, but I feel like insurance companies catch onto these type of situations and look for ways to get people to pay more premiums. Thanks submitted by /u/velvaetine [link] [comments]Read Morer/HealthInsurance