Questions about direct primary care

Hello,

I have Anthem PPO. 29M, live in Indiana but work in Kentucky, this new doctor would be in Kentucky.

I've been having health problems for about 8 months or so. My current primary care doctor has not been very helpful and I'm looking to try someone else.

I was told about a direct primary care doctor that will work with you more directly and give you the required attention. I have no problem paying their monthly fees and such. What I'm concerned about is the stuff I would need outside of them: referrals, prescriptions, bigger tests.

Will insurance typically cover a prescription if it's written by an out-of-network doctor? Will they cover my referral to an in-network doctor if it's made by an out-of-network doctor? What if they want me to get some kind of scan, will insurance cover it if it's ordered by an out-of-network doctor?

I've been trying to find the answer to these things in my plan but I don't know where to look.

submitted by /u/tigersbowling
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