In network vs. Out of network

[Guest guest]

For anyone that has chosen to go out of network, I was wondering if

you could tell me about what it cost to go out of network. I know all

insurances are different, but I am trying to get an idea of about how

much it could be. The doctor I have been seeing this whole time is

out of network and I really rather not change and look for a new

surgeon. I already feel comfortable with the one I have. It looks

like I will be having surgery in about November or December, so I

guess I need to make a decision. If anyone could give me an idea of

what it may cost, I would appreciate it. Thanks!

[Guest guest]

> For anyone that has chosen to go out of network, I was wondering if

> you could tell me about what it cost to go out of network. I know

all

> insurances are different, but I am trying to get an idea of about

how

> much it could be. The doctor I have been seeing this whole time is

> out of network and I really rather not change and look for a new

> surgeon. I already feel comfortable with the one I have. It looks

> like I will be having surgery in about November or December, so I

> guess I need to make a decision. If anyone could give me an idea of

> what it may cost, I would appreciate it. Thanks!

>

>

I had top and bottom done, and the cost was $18,000 for EACH. My

insurance covered approx $28,000 of the $36,000 total.

Granted I am in Manhattan so these prices are inflated from what

you'll find elsewhere.

[Guest guest]

My doc, mercifully, was in-network. My ortho was not, but it was well

worth the convenience -- the only in-network ortho guy was about 60 or

more miles away, and mine, in addition to being a wonderful guy, was

just beside my path to work five days a week. That was worth a lot back

in 2002, and probably is worth a lot more now that gas is $2.50 a

gallon, or more, hereabouts.

Try the in-network docs, and see if you can be comfortable with him,

I'd suggest. But do not let that overwhelm your choices.

For me: The surgery was completely covered, because my doc was in

network. I paid about $48 for the suction machine he insisted on, and

that I never needed. (He was right to insist, and I am grateful that I

did not need it.!)

C.

> For anyone that has chosen to go out of network, I was wondering if

> you could tell me about what it cost to go out of network. I know

all

> insurances are different, but I am trying to get an idea of about how

> much it could be. The doctor I have been seeing this whole time is

> out of network and I really rather not change and look for a new

> surgeon. I already feel comfortable with the one I have. It looks

> like I will be having surgery in about November or December, so I

> guess I need to make a decision. If anyone could give me an idea of

> what it may cost, I would appreciate it. Thanks!

>

>

[Guest guest]

I met with 2 surgeons, one in network and one out of network. Be very

carefull when budgeting an out of network surgeon. Usually they have a

out of network deductible (mine is $3,000) and then they cover a

portion of the procedure (mine is 80%). But they do not cover 80% of

the entire procedure, they cover that % of what they

consider " reasonable and customary " . So if the surgeon you are seeing

charges $45,000 (to be billed to the insurance) and the insurance

thinks $20,000 is reasonable and customary, you have to pay 20% of the

20,000 and the difference between the two (total $19,000).

I considered going out of network, but it was going to cost me about

$15,000 of money I do not have.

Either way, most surgeons are experienced enough not to have many

concerns about their performance. Just feel comfortable with your

decision.

> For anyone that has chosen to go out of network, I was wondering if

> you could tell me about what it cost to go out of network. I know

all

> insurances are different, but I am trying to get an idea of about how

> much it could be. The doctor I have been seeing this whole time is

> out of network and I really rather not change and look for a new

> surgeon. I already feel comfortable with the one I have. It looks

> like I will be having surgery in about November or December, so I

> guess I need to make a decision. If anyone could give me an idea of

> what it may cost, I would appreciate it. Thanks!

>

>