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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]This thread had me very worried, since our first OON reimbursement claim was submitted on 4/20.  They processed it on 4/24 and I received a check in the mail today. [/quote]

From our experience it seems that as of mid April Carefirst is back to processing newly submitted OON claims efficiently, but still severely delayed on processing backlogged OON claims filed January through March 2026. With those earlier claims, there seems to be no pattern on how Carefirst is addressing them (chronologically, by family member, by provider, etc.). This seems in line with reports of Carefirst having a claim processing platform transition integration malfunction that is being addressed with manual entry. [/quote]

Who are all these fancy rich people seeing doctors Out Of Network? I don't get it. How much money do you have?[/quote]

I only have a $750 OON deductible. The calculation of the allowed amount is more generous than I thought. My out-of-pocket for my OON psychiatrist is only $55 vs $40 in network. I’m not rich, but I can swing the $15 difference.[/quote]

+1 it really depends on your specific plan and health needs. Our plan reimburses OON pretty well (80% of the full cost) and we have a neurodivergent child. At one point there were actually zero providers that took insurance that were qualified to treat the specific issue our child had. Don't judge PP. You never know what people's situations are.[/quote]

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