Question:
Only one physician in my state that performs surgery? What can I do for coverage?

I am currently with Prudential Healthcare HMO from Oklahoma. I have found out that their is only one doctor in the state that performs the surgery and he does not honor Prudential insurance. I was told by my insurance company that I could not be covered if I travel out of state to a physician that would probably be "in network" because this company is so large. I can change to the POS plan under the insurance but not until next July. And even then I am not sure that the insurance will cover my surgery. I really want this surgery and without insurance I will not be able to have it. What are my rights in finding out if the insurance company will help me with this surgery? Basically, What are my options. If anyone has had any experience with this please educate me.    — Holly B. (posted on October 5, 1999)

October 5, 1999
I too had Prudential Insurance but it was a POS . There was no doctors of this specialty in the network of my insurance. So I ask for them to pay do to the special feild that this takes and they agreed and paid him in network at 90%. This is not just a run of the mill surgery and not just any doctor can do it right . So please beware. They do not have these kind of doctors on the list do to not just anyone needs this special type of doctor. Good Luck.
   — [Anonymous]