Could an individual currently on the BCBS traditional plan lose their doctor if they move to the BCBS PPO plan?
No one would be required to change doctors under the PPO plan. In fact, 98% of physicians and 100% of hospitals used in 2005 under the traditional plan are also PPO participating providers. Of the 271 total providers used in 2005 under the traditional plan, only 15 providers — 3 physicians, 5 x-ray and lab providers, 2 anesthesiologists, 2 orthopedics, 1 physical therapist, 1 vision provider and 1 oxygen supplier were not included in the PPO plan. If an individual’s doctor or hospital does not belong to the PPO, the employee can still go to that physician and pay a co-insurance percentage for going to an out-of-network provider (20% under Option #1 and 30% under Option #2) which is capped by the co-insurance maximum for the Option plan selected.
Related Questions
- How do the coverages under the Aetna Medicare Open Plan compare to the coverages Aetna retirees currently receive under the Traditional Choice® Indemnity Plan?
- Could an individual currently on the BCBS traditional plan lose their doctor if they move to the BCBS PPO plan?
- What actually happens to my healthcare costs when I switch from a traditional PPO plan to a CDH Plan?
