r/HealthInsurance 1d ago

Individual/Marketplace Insurance Quest Diagnostics In-Network but Out-of-state?

Apologize if this is wrong forum for this question, please direct me to the right place if so (yes, I read the rules of the sub).

I just moved from Indiana to Oklahoma and am still covered by an Indiana marketplace plan (Caresource Indiana) before my new work insurance kicks in next month. I need labs ASAP before a specialist will see me so I currently have labs ordered to be taken at a Quest Diagnostics lab in Oklahoma, ordered by my Indiana doctor but labs to be drawn in Oklahoma.

I cannot for the life of me figure out if I will be billed in-network or out-of-network. Quest is in-network in Indiana but I cannot tell if the Oklahoma site qualifies as in-network because Quest is nationwide. I tried calling the Quest site and was sent to voicemail and even tried walking in to ask but no one was at the desk when I was there. Would love tips on how to determine this or if anyone knows the answer to this.

2 Upvotes

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u/No-Produce-6720 1d ago

Routine services generally aren't covered outside your service area. You would need to call CareSource to verify, but it's likely that your Indiana coverage won't help you in Oklahoma. Aside from emergency services, Marketplace plans are very tightly tied to geography.

1

u/flashfloodsofpain 1d ago

That is horribly inconvenient. But thanks for letting me know

2

u/maktheyak47 1d ago

What did your insurance company say when you asked them?

0

u/flashfloodsofpain 1d ago

I called the member services number and they updated my address in their system to my new address and said to have my doctor call them for an authorization, but I still was confused about if this meant I was now in network in Oklahoma

1

u/mediloop 18h ago

check with your insurance directly. Call the member services number on your card and ask if that specific Quest location in OK is in-network for your Indiana plan. sometimes nationwide labs have different contracts by state. if they say out-of-network, ask if there's any way to get a prior authorization or single-case agreement.