Out of network insurance – how does it work?

I’m on Blue Cross Blue Shield TX Marketplace insurance (Blue Advantage Silver HMO 205) that does not have an OON option, but am considering changing to a plan that does (Blue Advantage Plus Silver 605). It says out of network is 50% covered. Both plans have a $0 deductible and similar out of pocket costs.

Before changing, I want to make sure I would actually get what I want from this plan. Any insight for any part of this would be helpful.

– Can you see an OON specialist as easily as getting a referral from your PCP, or does it have to be a special circumstance to get access to OON care? Do you have to see a covered specialist first? MY PCP won’t be a problem here – they are very helpful.

For example, I’ve seen a specialist that neither my PCP or I were happy with, and would like to see someone else. I also would like to see a neurologist for another issue, but have not seen one yet because I’m having trouble finding one that takes my insurance in my area. Would both of these examples be applicable for an OON specialist?

– Are costs significantly higher for seeing an OON specialist? If a covered visit is $150 full price, is it likely that without the contracted rate, it could be $500, for example?

– Do OON costs count towards your out of pocket maximum, or are they considered separate costs that don’t count towards this total?

Anything else I should know?