by Guest » Fri Aug 05, 2011 05:57 pm
Is it generally possible to have surgery performed at a hospital that is in my plan network but use a surgeon that is out of my network? The doctor regularly performs surgery at this hospital, it's just that he is not in my network. As I understand it the hospital bill would be fully covered by my insurance while I would pay the deductible and coinsurance fees for my doctor. Is this interpretation correct? Are there any possible costs I am not considering or might the insurance company give me a hard time? Any guidance is much appreciated.
Posted: Thu Aug 18, 2011 11:46 am Post Subject:
You may opt for your preferred doctor to perform the surgery in the network hospital. You have not mentioned the kind of health policy you have.
Is it a HMO or a PPO ?
Whether your policy allows you to choose your doctor or not, that fact is important. If it does allow you to choose any doctor then, you might even get a part payment on the doctor’s fee, even if he’s out of the network. Thus, as far as I understand, if your policy restricts you to stay within the network doctors, it should not cover your doctor’s fee and you need to cough it up along with the deductibles.
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