Will "maximum allowable amount" for out of network therapy be the same on Blue Shield’s Silver & Gold PPOs?
I'm currently in the market for new health insurance after leaving my job. My biggest healthcare expense is out of network therapy.
I've been using a Blue Shield Gold 80 PPO plan through my work which reimburses 50% of their mysterious "maximum allowable amount" for my therapy, which turns out to be about $90. It looks like the Silver PPO also reimburses 50%. Will this be 50% of the same number?
Edit: I am 29 years old and located in California. My gross income this year should be about $63K.
Here is the Summary of Benefits for the Bronze 60 PPO, Silver 70 PPO, and Gold 80 PPO. The only difference I'm noticing for reimbursements for mental health office visits for non-participating providers is that the deductible does not apply on the Gold 80 plan. (As a side note, I find it extremely gross and misleading that these all advertise reimbursing 50% without any mention of the existence of a maximum allowable amount…)
submitted by /u/sasha_feroz
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