4 ms·
Please understand what "out of pocket maximum" actually means. It only applies to "covered" procedures. If that experimental surgery isn't covered your OOP max
by patryn20 9y ago
Please understand what "out of pocket maximum" actually means. It only applies to "covered" procedures.
If that experimental surgery isn't covered your OOP maximum doesn't apply.
Also please understand that insurance companies like to consider thirty year old tests/procedures/treatments as experimental/unproven and will consistently use that as an excuse to deny coverage and not apply them to your OOP maximum.
Hope you can afford an attorney if that happens.
Will this likely happen to you? Not at all. Can it happen to you? Absolutely.
- ceejayoz 9y agoAll of these things apply to group insurance, as well. Pre-ACA many plans didn't have an out-of-pocket maximum even for covered stuff, and most had lifetime limits on coverage as well.