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Politics : View from the Center and Left
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To: Cogito who wrote (63412)5/4/2008 9:38:50 PM
From: epicure  Read Replies (1) of 542068
 
I'm so sorry.

Are these not preferred providers you are dealing with? I know that with preferred providers the customary fee is the only fee they can charge- and the whole thing is written down to that level.

I think I have mentioned that we have the most expensive insurance my husband's company offers. That insurance changed in January- and now there is no copayment- but they only pay 80% of all bills, when you go to preferred providers. When you go out of network they pay 80% of customary fees. There is a cap on the amount you need to pay in one year- it's 5k for in network, and 9k for out of network- and then the bills are paid at 100%, but still, that could really hurt some families- if they even had this kind of insurance.

The company has set up an HRA (Health Reserve Account) to cover the first 1k of 20% payments, so it's only your next 4k (in network) or 8k (out of network) that you must pay 20% of. But still- after being covered at 100%, it doesn't seem like such a great deal, considering how much it costs.
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