Please help explain my coverage
Hello all,
I am a 24-year-old female currently residing in Pennsylvania. I was originally born in New Jersey, but when I was very young (around 3), myself and the rest of my family moved to Pennsylvania, and have been here ever since. After moving to Pennsylvania, my dad continued to work for the state of New Jersey and was insured by them through Blue Cross Blue Shield.
I have been having some horrendously bad tooth pain in my back molar and recently went to a dentist in my network who referred me to an endodontist to get a root canal. However, the endodontist I was referred to was out of my network, so I have been attempting to find one that is within my network. The issue I'm encountering is that the only endodontist within my network doesn't have an available appointment until June 24th and is rated quite low. On the other hand, the dentist I was referred to has available appointments within the next few days and is also rated significantly higher.
I am having trouble understanding my benefits and have included a table below of an overview listed on my provider's website. It appears to me that in and out of network dentists would ostensibly cost me the same amount of money, but I also have no clue how insurance works and am scared to risk paying a ton out of pocket by going somewhere out of network. If anyone would be willing to explain the table below I would appreciate you so much!
Thank you!
PLAN PROVISON IN NETWORK OUT OF NETWORK Annual Deductible $25.00 individual $25.00 individual Restorative You pay 20% after deductible PPO You pay 20% after deductible MAC You pay 20% after deductible Endodontics You pay 20% after deductible MAC You pay 20% after deductible PPO You pay 20% after deductible Plan Provision Combined In and Out of Network Dental Annual Maximum $1,250.00 Individual INN & OON Benefit Period Maximum (Excluding Ortho) $1,250.00 Individual combined In and Out of Network Benefits submitted by /u/BriefAccurate9059
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