The Benefits of Using an Out-of-State Provider Network

Do you live near the border of California and Nevada with a PPO health insurance policy? An out of state provider network may be a better option.

If so, you may want to reconsider how as well as where you use your medical coverage. Most insurance companies will offer a stronger out of state provider network, in addition, to more options for healthcare. For example, most individual Anthem plans will use the “Pathway Network” within the state the policy was issued and allow members access to the “Blue Card PPO” network list outside of the state. When you compare these two provider networks, the Pathway Network contracts with significantly fewer doctors and facilities when compared to the Blue Card PPO list.

Larger out-of-state provider networks are standard with most PPO insurance companies.

Insurance carriers will offer more in-network doctors outside of your state of residency. This is because they assume that members are more likely to use local in-state providers for healthcare.

For residents of Tahoe and other towns on the border of California and Nevada, members have a unique option for accessing health care nearby. Since the state border divides the Lake Tahoe area, California residents may have access to more doctors on the Nevada side. There might be more doctors in the Reno area as well. Vice Versa, Nevada residents in the Tahoe Area may want to consider out-of-state provider options. These options might be better on the other side of the state border.

California residents living in Tahoe do not have many options for available insurance companies. Leveraging your insurance policy’s out-of-state network list may increase your options for provider availability. In today’s insurance market, it is crucial to understand these subtle nuances of your coverage. If you’d like an experienced broker to assess your policy’s inclusions and limitations, please give Matt Law a call. The phone number to reach him is (775) 828-1216. Matt Law is licensed in both California and Nevada. He will analyze your policy, free of charge. Health Benefits Associates’ office is located in Reno and is open 12 months a year to assist consumers with claims, benefit questions, and policy maintenance.