Arizona Blue Cross Forcing Some Into Smaller Provider Networks

As ObamaCare was becoming the law of the land, President Obama stated “If you like your doctor you can keep your doctor. If you like your hospital you can keep your hospital.” But since ObamaCare plans came into existence on January 1, 2014, many health insurance companies offering plans here in Arizona limited the providers you could visit. Some large nationwide health insurance company’s networks were literally decimated and people found that the doctors they had been seeing for many years were no longer available under their new ObamaCare plan. This was not the case with Blue Cross Blue Shield of Arizona. You could see just about any Blue Cross provider anywhere in the USA.

Lehrman Group brokers encouraged our clients into Arizona Blue Cross plans because Blue Cross did not make the decision to limit their impressive provider network to their existing and new customers. But this will change for all Blue Cross policyholders living in Maricopa and Pima counties beginning January 1, 2016. Maricopa county residents will be required to select from one of two smaller networks. It’s a little different for Pima county residents (see below).

Each Maricopa county network has a rather large selection of providers and hospitals. One of the two networks, the Alliance network, includes the Banner hospitals but not Phoenix Children’s Hospital. If you want the Banner hospitals in your network, you cannot use Phoenix Children’s Hospital for any reason except an emergency. The other Maricopa network, the Select network, does include Phoenix Children’s Hospital, but not the Banner hospitals. You’ll need to think carefully before you select the network you end up with. Investigate which network your current medical providers accept, and see which hospitals you’d want to be admitted to should the need arise. If you don’t have a doctor and are never admitted to a hospital, then deciding which network to choose may not be an issue for you.

Pima county residents have access to two networks: the Secure HMO network and the Statewide HMO network. The Secure HMO network includes two hospitals — St. Joseph’s and St. Mary’s. The Statewide HMO network offers the wide choice and value of a large network. According to BCBSAZ’s internal data, it includes 90% of doctors and hospitals across the state.

All Arizona residents who currently live in Maricopa and Pima counties will soon receive a letter from Blue Cross which will inform them that they must select a new network. None of the Maricopa or Pima county plans available from Arizona Blue Cross for the 2016 policy year will provide any out-of-network benefit at all unless the visit was due to an emergency. If you have a child attending college out of state, your child will have no health insurance coverage whatsoever unless the visit is due to a medical emergency. If you live in Maricopa or Pima county and have an Arizona Blue Cross policy and your children attend out-of-state schools, Lehrman Group has an excellent solution for you. Call us and we’ll explain it to you.

It is now more important than ever to speak with a professional health insurance broker before applying for any health insurance plan. You may not be able to get both the doctors AND the hospitals you want. Make sure your broker knows who all of your providers are so that you can be assured your health care bills will be covered in the event you need medical care. The last thing you need is to find that your expensive hospital stay is not covered. The hospital you went to last year, which was covered then, may not be covered now.

From anywhere in Arizona, call Lehrman Group at (800) 600-9663. We will help you make smart decisions about your health insurance for the 2016 policy year. To get a quote for health insurance rates, click here.