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if I understand correctly, the out of pocket maximum might only apply to in network providers. I think if you end up getting a non-covered procedure or get serv
by leetcrew 8y ago
if I understand correctly, the out of pocket maximum might only apply to in network providers. I think if you end up getting a non-covered procedure or get service from an out of network provider, you can be on the hook for way more than the out of pocket maximum. if so, it would be hard to ensure that this doesn't happen in an emergency.
- ummonk 8y agoThat was fixed long ago by ACA. Emergency services are treated as in-network regardless of whether they were actually in-network.
- jjeaff 8y agoWell yes, but you make it sound so easy. You'll have to go multiple rounds with the insurance and aca reps in many cases to get it approved after the fact.
- ummonk 8y agoYes, and that is the biggest issue. Hospitals and insurance companies playing hot potato with each other while the hospital tries to pin whatever the insurance company doesn't pay for on the consumer. We need more punitive regulatory action for such situations.