30 Second Insurance Tips©

Tip #315- What Is Your Out Of Network Coverage?

Most health plans negotiate discounted fees from providers. Think of the statements you get from your insurer following a health care encounter; they’re called EOBs, which stands for Explanation of Benefits.
On an EOB, you might see a routine doctor visit discounted from $185 to $120. Or, an outpatient surgery, from $13,500 to $7,488. One more example; repair of a brain aneurysm, from $94,000 to $50,567.
If services are performed by an out of network provider, in most cases your health plan will only pay the in network discounted amount.
This week I spoke with a client who is frustrated with the level of care she is getting locally. She wants to go to an out of state (i.e., out of network) provider.
I just wanted her – and you – to understand how much that could cost.
Note. There are exceptions to every rule. Those are best pursuedbefore the horse is out of the barn!
Want more Tips on health care? Come see us at the Potawatomi Hotel & Casino on Wednesday May 24th at the BizExpo, Booth 411.  Parking and access to the Exhibit Hall are fast and free. Learn more and register here.