Reply to Insurance with $20,000 Deductible?!

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]What's the in network deductible?

I thought the point of PPO plans was you had to stay in network. Our PPO has a really high out if network deductible as well.  We have to pay cash for our child's psychiatrist and psychologist, neither of whom take insurance at all.[/quote]

+1. Complaining that a PPO has poor out-of-network benefits is like complaining that you have pay out of pocket if you go outside your network on an HMO. It reflects a fundamental misunderstanding of insurance programs that has nothing to do with Obamacare.[/quote]
The point is that they are saying they are a PPO with out-of-network benefits, but the deductible is so sky-high that you're "encouraged" to stay in-network. The problem comes about when they don't have a specialist and you are forced out of network.[/quote]

I think we're still waiting for OP to come back and show us where it says they don't have anyone in-network in a particular specialty. Even if it's the case, though, typically PPOs will have an appeals process by which you may be able to get coverage for out-of-network providers at the in-network rate if they truly have no specialists available in-network that could treat the insured.[/quote]
I'm the OP and I am back. No....it doesn't say on that form that they are missing specialists. But I know from experience that many plans - including this one - do. Congress knows as well, as there have been numerous complaints from exchange customers that the specialist they need is not in network. It actually pretty commonplace, and a REAL problem, but Obama is burying it. Still trying to hide how much damage he's done.
http://khn.org/morning-breakout/in-network-access-to-specialists-not-always-available-on-some-obamacare-plans-study-finds/
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