Health insurance with or without out of network coverage?

Question

I have a choice between two insurance plans, one that pays for almost everything if you stay within only the network and one that pays 80% and has a deductible of $300, but has out-of-network coverage at 60%.... so my question is: in the event that i fall down the stairs/my apendix breaks/i nearly drown and 911 is called, can someone ask for a specific hospital to stay in network or do they just take you to the nearest place and try to save your life? Because i'm thinking, if there's a true emergency, i don't want to worry about being covered or not... if i happen to land in a hospital that's not in the network, then i have an entire bill to pay even though i have insurance.... so what's your input in this? Should i take the insurance with the deductible or no out of network coverage?

Answer 1

There is no absolutely right answer for your question.Nonetheless,explorer the information here might give you some ideas.HOpe it helps.http://health-insurance.expert-tip.info/...

Answer 2

Tough call.  I've had at least one client who needed care out of network and could not get the insurance company to cover it as if were in network.  It turned out to be a large bill.

My thought is to shop around for indemnity plans.  These are health insurance plans with no network at all.  This would avoid the situation your are worried about.

Anthem and UHC both offer such plans, but do not advertise them much.

http://www.ohioinsureplan.com/index.php/...

Answer 3

Emergency care is generally covered worldwide.  The biggest difference is that your deductible and co-insurance doubles if you are out of network. If you travel much, choose one of the bigger carriers with a multi-state network. If you stay pretty local, see if your local hospitals are in the network.

Hope this helps.

Don

http://mtnhealthinsurance.com

Answer 4

Emergencies should be treated in network.  AND, they don't have to be so drastic.  I broke my wrist while skiing...well snowboarding really just 3 months ago and I got it X-rayed at the urgent care center right by the mountain.

When I got the bill it was billed out of network so I called the insurance company and told them my arm was broken so it wasn't like I could open up a directory and they immediately fixed it.

The other item to consider is it's not 60% out-of-network.  It's 60% of the amount they deem reasonable.  So, if the doctor bills $200 and they believe $120 is the usual rate, they cover $72 and leave you with the $128.  Make sense?

Jeff