How do I Switch HMO to PPO Anthem Blue Cross Blue Shield in California?

Preferred Provider Organization plans offer flexibility not offered in Health Maintenance Organization plans. In PPO plans, patients can visit doctors in and out of the provider network, while HMO plans only allow visits to in-network doctors.



HMOs require that a doctor refer patients to specialists, but PPOs do not. Many people switch from an HMO to a PPO, even though the second option is more expensive. Anthem Blue Cross of California is an insurer that allows patients to switch plans from an HMO to a PPO.

Instructions

• 1

  Review your current paperwork from Anthem Blue Cross or call the number on the back of your ID card to confirm when you can change insurance plans. For example, if you are participating in an employer-sponsored health plan, you can only switch plans once a year during the open enrollment period.

• 2

  Switch plans during your company's open enrollment period. Your human resources department will guide you through the process. Complete the online enrollment forms or written paperwork and select the PPO health plan option. Submit the forms to your human resources department or directly to Anthem Blue Cross.

• 3

  Contact Anthem Blue Cross at the number listed on the back of your ID card for information about the different PPO plans. A representative will discuss your health care needs, match you with a PPO plan and explain the process for switching coverage.

• 4

  Download the individual enrollment application from the Anthem Blue Cross website. On the form, select the check box "Change your current plan/policy." Complete the form and mail it to the address or fax it to the number listed on the application. If you have an insurance broker, ask him to submit the forms and obtain quotes. This process can also be completed online.

• 5

  Receive your new Anthem Blue Cross identification cards through the mail upon approval. You may get the cards after the new plan starts, but you can still visit a doctor by asking office staff to verify your coverage with Anthem Blue Cross before submitting any claims.