@DUnreal - We’ve had a number of members who’ve had the same situation you’re in w/ insurance that won’t pay for out of state doctors’ visits/surgeries. Some insurance companies employ a patient advocate who will go to bat for you w/ the insurance company. If yours doesn’t have someone like that, then there are patient advocates who work independently & can help you appeal the need for specialized surgery since there are no doctors in your state who are capable of doing the surgery you need.
Another option is to contact your insurance company & ask what their appeals process is then do what they request. This doesn’t always provide a positive result. We had one member who threatened to file a complaint w/ the medical insurance board in his state if his insurance didn’t approve his out of state ES surgery. He got the approval he needed after he proposed that to them as his next step.