What is a point of service health insurance plan? Can I still have coverage when I go without a referral ?

Question

I have Blue Cross Blue Shield Healthselect with State of Texas and I have a plan that requires me to have a primary care physician and requires me to have a referral when I go see a specialist. However, I thought I can go to a specialist dr. without a referral under my plan and dr still be paid for services rendered but the specialist drs office says no. -no benefits paid out at all. I know I have 60% /40% on out of network dr but that is if the dr is not accepting bc/bs healthselect at all -it does not mean 60% of bill will be paid out by bc/bs. and i pay 40% of bill. anyone out there has gone through this ?

Answer 1

you have a deductible before the 60/40. Call healthselect, they can tell you what to do next.

Answer 2

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Answer 3

Your assumption is a direct contradiction to your explanation of a point of service plan.  Why would a point of service plan, which requires a referral to see a specialist, pay the preferred rate if you DO NOT GET A REFERRAL?  

Call your primary care physician and ask them for the referral, give them the name of the specialist you want to see and they should take care of the rest for you.