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Old 07-28-2009, 03:09 PM   #21
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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.
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Old 07-29-2009, 12:00 AM   #22
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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).
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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.
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