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Asked: Apr 28, 2010

Out-of-State Hospital Benefits, please help

If I am a Pennsylvania resident and may end up needing medical attention while vacationing in Florida, how is my health insurance affected if my insurance is based in PA? Is there any FL law that requires the FL hospital to fully recognize my coverage?

Categories: In California
Plan Types: In Other

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No, there is no such law in any state that requires a hospital to fully recognize' the insurance coverage from any insurance company, even if it is an insurance company operating in the same state where you are receiving medical treatment. How a hospital will recognize your health insurance coverage is based on the type of health insurance coverage you have, and what insurance carrier is issuing your policy. Many insurance companies contract with nationwide networks of physicians and hospitals. If you use a hospital that is on the network of facilities contracting with your health insurance company, that hospital is obligated to provide you with services under the terms and agreements of their contract with your insurance company. If you are on an HMO plan, your out-of-state benefits may be limited to emergency medical services only. This is because HMO networks are restricted to much smaller geographical boundaries and rarely cross state lines. When traveling outside of your home state, it is important to know the limitations of your health insurance policy. If they work with a nationwide network of hospitals, they can provide you with a list of medical facilities in Florida that will fully recognize your health plan.'

Answered: May 01, 2010

 

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