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Old 07-28-2009, 02:09 PM   #21
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Join Date: Oct 2005
Location: Texas
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Originally Posted by Martha View Post
But as you work through your deductible the extra cost you pay by using non-network providers will not apply to the deductible.
Usually, but not necessarily. I have an HDHP and HSA through my employer, and the deductible and out of pocket maximums are the same for both in-network and out-of-network.

Individual services may cost more out of network, but you'd hit the same ceiling either way.

I think that's pretty unusual, but in my plan, once you've hit the out of pocket maximums in a year there is no incentive to stay in-network. And yes, I did confirm that.

"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)
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Old 07-28-2009, 11:00 PM   #22
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Join Date: Mar 2005
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Originally Posted by Martha View Post
Even when you are sick, worried, and pressed for time.
I'm also in a PPO with limited choices for preferred providers and I agree not knowing where to go after you are sick is a pita. When you're sick, worried or pressed for time is not when you want to first be concerned about who your local preferred providers are. But rather than just give up (internet, paper lists, 800 numbers too complicated so give up and shoot yourself type of thing) DW and I always work hard up front to identify specialists, labs, drugs stores, etc. We also study each others plans (totally different insurers) so that if the other is incapacitated we can easily handle the paperwork, after the initial emergency is under control. Being on top of the coverage and network associated with your health insurance policy was especially important while we were raising the family, both working full time jobs and caring for a son with serious health issues (Arnold-Chiari Malformation).

I have to use network providers or take a big hit.
Me too. That's why you have to get on it and not just throw up your hands and give up. As I said in my earlier post, you have to actively work to know the providers in your insurer's network and it's best to do that apriori.

"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
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