Stay in Your Insurer’s Network
It’s essential to stay in-network if you have an HMO, which generally doesn’t cover out-of-network care except for emergencies. But even if you have a PPO, which includes some coverage for out-of-network providers, it can still be expensive to leave your insurer’s network. You’ll generally have to pay a higher deductible (sometimes double the in-network deductible), and you’ll have a higher out-of-pocket spending limit. Plus, you’ll usually be charged a larger percentage of the costs — perhaps 20% for in-network care and 40% for out-of-network care. Use your insurer’s tools to find in-network providers, and make sure the facility, doctor and anesthesiologist are all in-network before you schedule a procedure.