Filing Claims to Track Out-of-Pocket Expenses (plan, coverage, benefits, deductible)

[Nene817]

I have a healthcare provider who is out of network, and whose services are not covered by insurance. This particular provider will not file an insurance claim since they know it will not be reimbursed, and it is left on me to file the claim if I wish. Now, I know the insurance won't cover anything, but I was thinking I should still file a claim in order to show that I paid the bill and have that count towards my annual Out-of-Pocket Max. Is that how that works? Would I still file a claim I know is ineligible for reimbursement, in order to make sure the amount I paid counts towards my OOP Max?

[Angie682]

If a service is excluded from coverage under your plan the denied amounts do not track toward your out of pocket maximum.

Only "eligible" charges (covered expenses) track toward the out of pocket maximum (your deductible and coinsurance amounts).

[Nene817]

Thanks Angie. It seems I made a mistake. This is my chiropractor I'm talking about, and on my old insurance chiropractic care was only covered if it was in-network. I did double check my new benefits that went into effect in January, and see my out of network chiropractor would now be partly covered by co-insurance if my deductible was met. I don't anticipate ever meeting this deductible, but thought it would be smart to make sure my visits are counting towards it "just incase."