3 ms·
Noteable here: Out of network. What did she expect to happen?
by LorenPechtel 2y ago
Noteable here: Out of network. What did she expect to happen?
- ceejayoz 2y agoMy insurance has a separate deductible and max out-of-pocket for out-of-network providers. When I reach those, I’d expect them to pay the remainder. As agreed. As implied by a prior authorization.
- LorenPechtel 2y agoI've never seen a max out of pocket for out of network.
- ceejayoz 2y agoYou have now! https://imgur.com/a/Qw62Vhl https://imgur.com/a/Qw62Vhl That's via Aetna.
- jjav 2y ago> When I reach those, I’d expect them to pay the remainder. They won't. "Out of pocket maximum" means something completely different to the insurance company than it does to any normal person. Out of every dollar you pay out of pocket, the insurance company will decide how much they feel like counting it. Might be the full dollar, or some pennies, or nothing. You might have paid $20K out of pocket in a year, but the insurance company will say you've only paid $1000 because just because. Good luck reaching that "out of pocket maximum". Source: I've been there.
- ceejayoz 2y agoI reach my out-of-pocket maximum, every year. The rest of the year, we pay no more copays.
- antisthenes 2y agoNo sane healthcare system that puts ordinary citizens first should ever have this distinction.