Insurance Question

elise24601

I'm thinking of going out-of-network for my plastic surgeon, for a variety of reasons. This means I will have to pay 20 percent of his fees plus my deductible. BUT someone told me that the "out of pocket maximum" on my plan means that I don't have to pay OVER a certain dollar amount per year. Can anyone clarify this a bit for me?

cubbieblue

Hi Elise I think you would have to check your plan benefits. My plan for instance has a separate out-of-network out-of-pocket max which is double my in-network out-of-pocket max. But there is a ceiling on what I would have to pay if I chose to go out-of-network, although a much higher one when not using network providers. Good luck!.