Scan Medical Insurance

Can my medical insurance deny a claim because they are based outside the state where I work?

I work for a hotel chain in one of their Georgia locations. The company has contracted our health insurance with Blue Cross Blue Shield (BCBS) of Alabama. The doctor ordered a series of blood tests, and after having them done in Atlanta, BCBS denied the claim because according to them, they only cover diagnostic tests carried out in Alabama. Is this legal? Does this mean I have to travel to Alabama every time I require a diagnostic procedure?

Public Comments

1. what type of plan do you have? do you know what your plan limits are?
2. No, they cannot deny a claim merely because you work in a different state than where they are based. Yes, they can deny a claim because you had the procedure done out of their network. As you have correctly noted, you can have the procedure covered by going to a place where they cover it.
3. Your policy is going to have a local network. If it's out of network, they can cover however they cover out of network charges. If your employer bought a plan that only has coverage in Alabama, this is legal. But most likely, you need to change your coverage area, so you can get coverage where you are located. Call the number on the back of your card, and ask how you can get switched to a local area. It's not about where you work - it's about where you live.