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Health Insurance (Expert Forum)
How often have you wanted to use out-of-network doctors?
Answered by
Amir Mostafaie - health insurance, insurance
eHealthInsurance
Gold River - CA
This forum is for questions and support regarding health insurance issues such as Medicare, Medicaid, Long-term health insurance, COBRA, insurance portability.
How often have you wanted to use out-of-network doctors?
by nonnet, Aug 29, 2009 01:33PM
I'm considering switching to a health plan that's less expensive to buy. It will make me pay more money out-of-pocket if I use doctors who aren't in my insurer's network of preferred providers.
So I'm wondering, "What's the likelihood that I'll want an out-of-network specialist?"
Does that happen a lot when you get a less common disease, and you want to have a recognized expert to treat you? Does it only happen when an emergency prevents you from taking time to check if the ER people are in-network?
I'm especially hoping to hear from Blue Shield of California policyholders, and medical pros who have dealt with Blue Shield of California. That's my insurer.
Thanks!
So I'm wondering, "What's the likelihood that I'll want an out-of-network specialist?"
Does that happen a lot when you get a less common disease, and you want to have a recognized expert to treat you? Does it only happen when an emergency prevents you from taking time to check if the ER people are in-network?
I'm especially hoping to hear from Blue Shield of California policyholders, and medical pros who have dealt with Blue Shield of California. That's my insurer.
Thanks!
Doctor's Answer
by Amir Mostafaie, Aug 31, 2009 12:42PM
, Aug 31, 2009 12:42PM
Dear nonnet,
There is always a chance that we may find ourselves in need of treatment from a well known expert who doesn’t take our insurance, but strange as it may sound that is more pronounced in some areas than others. That is because in some areas, most practicing physicians don’t accept ANY type of insurance because they don’t agree with insurance companies' contracted rates! So you may have to spend some time researching to see if you live in one of those areas.
As for if an emergency can prevent you from taking time to check if the ER people are in-network, you might feel better knowing that in an emergency situation most plans cover you at the same rate out of network as they do in-network.
I highly recommend that you not only read the fine prints in the plan brochure that you are considering, but if you plan on switching coverage, take time & read the actual policy. Blue Shield of CA offers a 30-day free look period from the date of their acceptance letter to cancel a policy as never effective & give you a full refund.
Sincerely,
Amir Mostafaie
There is always a chance that we may find ourselves in need of treatment from a well known expert who doesn’t take our insurance, but strange as it may sound that is more pronounced in some areas than others. That is because in some areas, most practicing physicians don’t accept ANY type of insurance because they don’t agree with insurance companies' contracted rates! So you may have to spend some time researching to see if you live in one of those areas.
As for if an emergency can prevent you from taking time to check if the ER people are in-network, you might feel better knowing that in an emergency situation most plans cover you at the same rate out of network as they do in-network.
I highly recommend that you not only read the fine prints in the plan brochure that you are considering, but if you plan on switching coverage, take time & read the actual policy. Blue Shield of CA offers a 30-day free look period from the date of their acceptance letter to cancel a policy as never effective & give you a full refund.
Sincerely,
Amir Mostafaie
