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Really dumb BCBS Basic question

slukd79slukd79 member
in D.C. Area Babies

HMO or PPO?

For some reason, my H doesn't know the answer to this and I am trying to find a new pediatrician for my LO in IL. The practice that was recommended to me only accepts PPO. My insurance card does not say.

(I said this was a dumb question... Embarrassed)

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Re: Really dumb BCBS Basic question

  • cecilyandgautamcecilyandgautam member
    I have BCBS Basic federal employees program and it's a PPO. Your insurance card should say also.
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  • slukd79slukd79 member

    The docs I am trying to make an appointment with all come up on the list online-- but the front desk wants to know PPO or HMO.

    Thanks for your answer. I appreciate the non judgment!

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  • jess08200jess08200
    The upper right hand corner of your card will tell you PPO or HMO.
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  • slukd79slukd79 member

    imagejess08200:
    The upper right hand corner of your card will tell you PPO or HMO.

    Nope. I have searched the card and it doesn't indicate either way! The more I find out, the more I think PPO. Thanks!

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  • belizeitornotbelizeitornot

    I tried to reply to this earlier from my phone but I see it didn't work. :(

    I have BCBS Basic and mine does not list HMO or PPO anywhere on the card. The upper right just has the word "basic" in some shape that i'm blanking on without it in front of me.

    I'm on the HMO which is an "open access" plan which means you don't need referrals (like a PPO) but it's an HMO mentality as far as dealing with copays and percentage payments (ie, i pay a $25 copay for my pcp, $35 for specialist for visits, well care for my daughter are no co-pay visits). Does that sound like what you have? if so, you have the HMO.

    You can probably also call BCBS and ask them flat out "do i have an open-access HMO or a PPO" and they ought to be able to give you the answer. (?!)

    ETA: well now i'm totally confused. I just went to opm's website and looked at the plan brochure and it says PPO. but i feel like the basic option works just like an HMO (you have to use an in-network provider, no percentage payment -just a copay) but no need for referrals. So maybe don't trust what I said. LOL.

    https://www.opm.gov/insure/health/planinfo/2012/states/dc.asp

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  • brea311brea311 member
    Not a dumb question - I have BCBS Basic as well and my card does not say. When my doctor's office asks I always say "ummm, PPO".
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