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You know what? I take this back. I just shopped in my state (NJ) directly with two carriers to compare individual plans. Even the highest-priced plan didn't offer any out-of-network coverage. It DID offer access to a national network of doctors, so for someone who travels a lot it might make sense.
But no out-of-network coverage can really be a problem in some places. In NY/NJ/CT the networks are so densely populated it's highly unlikely anyone would have trouble finding a specialist in-net, but the same isn't true everywhere. Sigh, another thing that Obamacare fails to fix.
Low-income and low-information patients will typically do whatever their in-network physician tells them to do. ****I hope those plans put the onus on the referring physician to send patients to in-network specialists and facilities. One of the biggest problems people face is not making sure a facility is in-network before getting a big treatment, which can easily happen when someone is making stressed decisions after being handed a serious diagnosis.*****
Every doctor I've seen in the last decade has verified that my insurance will pay him/her BEFORE I can even schedule an appointment. Same for out/in patient procedures in a hospital.
I've never had a health insurance policy with no out of network coverage.More misinformation from Bots living in their mom's basement.
I did when I lived in NY and NJ. At the time, my then employer used to switch large group insurers and plans on an almost annual basis. More often than not, the networks, MDs and hospitals within networks changed. It was the annual shuffling of medical records, especially for the kids.
Nothing new. When I had employer provided insurance, if I went out of network, my insurance did not pay anything.
Same here. My take is this is very state specific, dependent on the laws created by the state's politically appointed insurance commissions.50 states and no two have identical laws.
Every doctor I've seen in the last decade has verified that my insurance will pay him/her BEFORE I can even schedule an appointment. Same for out/in patient procedures in a hospital.
Please, that's ridiculous. Do you go to a doctor for routine treatment while you're on vacation? Of course not. Emergency treatment is always covered. For decades people have been faced with the in- and out-of-network issue. It's been a problem since HMOs were invented.
We've gone to the doctor plenty of times on vacations. Ear infections, jelly fish stings, wounds that might need stitches. None of those required an ER, so not emergency treatment.
The most popular option within Medicare are the Advantage plans which are generally HMOs. They will NOT pay outside their networks (with the few exceptions previously mentioned).
This isn't an unknown concept in health insurance (and not just Medicare). But if you don't like it don't sign up.
The most popular option within Medicare are the Advantage plans which are generally HMOs. They will NOT pay outside their networks (with the few exceptions previously mentioned).
This isn't an unknown concept in health insurance (and not just Medicare). But if you don't like it don't sign up.
When I reached Medicare age, for the first time 30 years, I could go to any doctor, anywhere. I have traditional Medicare with the best supplement available - no more PPOs/HMOs for me.
Same here. My take is this is very state specific, dependent on the laws created by the state's politically appointed insurance commissions.50 states and no two have identical laws. Same here.
As usual, the opposition is making mountains out of very flat mole hills....
People don't have to buy a plan from the Exchange, they can buy any number of Gold Star, Cadillac, Rolls Royce plans they want. As long as it at least meets the basic requirements of the Law, there would be no fine. The Exchanges are for several options of a basic level of Ins plans that will be ..... affordable.
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