Surgery costs (after insurance)

[Guest guest]

Hello again, all.

Does anyone know how the 'maximum out of pocket expenses' works? For

example, if I go out of network, I am supposed to be capped at $5000 a

year maximum for me ($2000 if in network). However, out of network

stuff is also just paid at 60% of whatever the insurance companies

considers 'reasonable'. So, how does this work? Is the doctor still

going to make me pay what he wants, or does this mean the insurance

pays for it all (even in this 60/40 situation) once I've done my $5000.

Thanks...I'm confused.

Cassie