I'm traveling the US, what health care plan is best (PPO, HMO)?
December 17, 2013 6:52 PM   Subscribe

Hello! After getting laid-off from a job and having a job to look forward to in June, I have decided to spend the next 6 months traveling, WWOOF-ing around the US and overseas, living off of my savings and picking up odd jobs. In terms of health care, and the marketplace, what health insurance plans cover multiple states for things other than emergencies (i.e. mental health, a foot fracture, etc)? Would a PPO do that or an HMO? I've spent a ton of time talking to the Maryland Health Exchange people, and after being told something different by each person I spoke to, I wanted to ask you all. Thank you kindly!
posted by Kombucha3452 to Health & Fitness (5 answers total)
Every carrier structures their plan networks differently (and many companies are limiting their individual exchange region & provider networks to keep costs down), so you'd really have to examine each individual plan summary to see if it covers stuff on a national level. In general, PPOs give you more freedom to go where you want, but that does not necessarily mean all PPOs offered on the exchange will offer nationwide coverage. Shop carefully!
posted by ThePinkSuperhero at 7:01 PM on December 17, 2013 [1 favorite]

In our search in Michigan we were told by Blue Cross that staying with other state's Blue Cross providers would keep us in network -we were looking particularly in terms of college kids going to school out of state. I don't know if that will apply for you but the Blues are the largest set of providers I believe. You're going to have to see what you can get in writing on this I think. And read the fine print very carefully about emergency room visits and out of network stuff since reimbursement on both of those issues is typically different than your regular providers.
posted by leslies at 7:15 PM on December 17, 2013 [1 favorite]

In our search in Michigan we were told by Blue Cross that staying with other state's Blue Cross providers would keep us in network

WIth the BC/BS PPO plans, we've generally seen that to be true in our office- any state's BC/BS card with a PPO in the suitcase is probably going to be in-network from one state to another. But again, I cannot emphasize enough, every carrier is different, every sub-plan is different, shop carefully! You might want to call individual carriers to ask questions about individual plans you're finding on the exchange if things are unclear.
posted by ThePinkSuperhero at 7:21 PM on December 17, 2013 [1 favorite]

Speaking very generally, HMOs tend to be cheaper (both in terms of monthly premium payments as well as in how much you pay out-of-pocket when you get care) but they tend to not cover at all any care received from a provider that is out-of-network. In contrast, PPOs are more expensive, but they are always going to give you some coverage if you go out-of-network. Could be kind of crappy coverage - for instance, the PPO plan may only pay for half of the cost of a doctor's visit out-of-network, as opposed to paying 80% if you went to an in-network doctor - but it will be some coverage.

So, if you were looking at a hypothetical HMO and PPO that both had an identical national network of providers, it would be hard to say which one was "better"--depends on what you value more, keeping your costs low or having protection in case you went out-of-network. (This might be the case if you were choosing between two BCBS plans, an HMO and a PPO, that both had the same national network.) If you're looking at plans where the network is all within a single state or region, which is likely to be many of the plans you're checking out, you'd almost certainly be better with a PPO if you know you'll be traveling extensively and expect to actually use care out-of-network.
posted by iminurmefi at 8:34 PM on December 17, 2013 [2 favorites]

You may have more luck looking for international health insurance provided by your own country.
posted by AlexiaSky at 6:36 AM on December 18, 2013 [1 favorite]

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