TargaDave
Full time employment: Posting here.
- Joined
- Jul 22, 2005
- Messages
- 588
Curious what people’s experience has been with out-of-network coverage, especially as it relates to “customary and allowable” expenses, and going to one of the big name clinics (Mayo, Cleveland, Johns-Hopkins, etc)?
Short story: DW goes for post cancer surgery checkups at Mayo 1-2 times per year, about $7k/visit. Our PPO plan (Health Assurance) advertised 70% out-of-network coverage but the typical “allowables” are way below what Mayo charges (i.e., something like $300 for a cat-scan versus Mayo’s $1200 fee and so on). So far this year we have $12k out-of-pocket med expense excluding deductibles. I know she could get certain tests done in-network but she feels far more confident in Mayo’s overall competency (uncommon condition).
Insurance agent told us to try and “negotiate” with Mayo ahead of time for her next visit. Can’t believe that’s gonna do much good. Anyone ever do that?
T-Dave
Short story: DW goes for post cancer surgery checkups at Mayo 1-2 times per year, about $7k/visit. Our PPO plan (Health Assurance) advertised 70% out-of-network coverage but the typical “allowables” are way below what Mayo charges (i.e., something like $300 for a cat-scan versus Mayo’s $1200 fee and so on). So far this year we have $12k out-of-pocket med expense excluding deductibles. I know she could get certain tests done in-network but she feels far more confident in Mayo’s overall competency (uncommon condition).
Insurance agent told us to try and “negotiate” with Mayo ahead of time for her next visit. Can’t believe that’s gonna do much good. Anyone ever do that?
T-Dave