Question about in plan vs. out of plan
So I've been going back and forth with my health insurance company (it's United Healthcare) with some confusion about bills and why I haven't met my deductible yet and why some bills looked the way they did.
(For some background story, I got diagnosed with Lymphoma and have had a lot of doctors visits, ct scans, mris, pet scans, chemotherapy, biopsies, bloodwork, etc)
After months of back and forth, I finally talked to a competent rep who told me that some of the bills were for things that were out of network. The way my plan is structured, I am liable for up to $16,000 out of pocket for out of plan. I have 60% coinsurance until I reach that number. (For in plan, I have 80% coinsurance until I reach 7,000).
The original doctors I went to were all found through my insurance's website. The doctors for the biopsies who I was referred to were apparently out of plan. No one ever indicated that I was being referred to someone out of plan, and actually the person who sold me the plan never even mentioned the $16,000 out of pocket max, only the $7000 (maybe he only mentioned in plan and I didn't realize the other was an option, I don't remember the specifics).
People always asked for my insurance before every appointment and always said the insurance was fine and I was never warned about this. All the doctors were in the same building/ hospital. When I brought this up to the customer support rep, she said that "my plan has out of network benefits" but my thoughts are if it ends up costing 20% more (which on some of these bills is $1,000, I should have been notified).
So my question is, just so I know for the future, how can I avoid this situation? With the many doctors appointments and faster timeline, I didn't really have time to think things through and just went to who I was referred to. Should the doctor's be warning us that they are out of plan? Is that something that they know?
submitted by /u/Crafty_Scientist_667
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