Questions about Out of Pocket Maximum
I have supposedly met my OOP maximum for the year but I am still getting bills from medical providers. Looking at my insurance claims, I believe these are delayed bills that I should have gotten months ago, but I did not realize that at first so I was thinking I was still being charged for services after reaching my OOP max. I looked online and apparently the OOP max covers "100% of the costs of covered benefits" EXCEPT "Costs above the allowed amount for a service that a provider may charge" which to me sounds like the OOP maximum does absolutely nothing at all because I will continue to get bills from providers for services that my insurance doesn't fully cover even though insurance is supposed to cover everything.
Please tell me that means something other than I am reading it to mean because I am super frustrated and scared. I am having serious medical issues right now and I am about ready to decide to just live with it because I can't afford care, especially if the OOP max means absolutely nothing.
I am super careful to stay in network, it was a huge deal trying to get a scan done because they kept sending the order to places that don't accept my insurance.
I have a marketplace plan and the quoted sections above are pulled directly from the HCM website.
Please help clarify things for me
submitted by /u/lost_addendum
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