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View Diary: Insurers widen profits by narrowing choice of doctors (96 comments)

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  •  Be Careful (0+ / 0-)

    What will likely happen is that your insurance company will pay 50% of the "reasonable and customary charges" -- which does not equate to 50% of the bill charged by your out of network doctor, who is then free to balance bill you for the amount not paid by the insurance company. This is exactly what has been happening for years in states such as NY with very high-priced specialists. The insurance company uses zip codes or their own formulation to come up with "reasonable and customary charges" and it never equates to one-half of the physician or medical facility charge - leaving consumers with huge, unexpected bills.


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