The no surprises act has been AMAZING, particularly in states (such as NY) that have additional protections. There are still some gotchas, though.I don't know why things would work out better with a LDHP PPO, but perhaps there's a reason or the plans are different. However, the No Surprises Act has made a big difference in how these things are handled. Essentially all emergency care (except ground ambulances) will cost you the in-network rate and for other subsequent care, they have to give you notice of how much things are going to cost and a list of available in-network providers.This adds a great deal of uncertainty if you, say, have a major incident on vacation, or can't find a hospital that accepts the "allowed" amount. Are your losses unlimited in that case, and is a PPO any better?
My personal experience with PPOs is that out-of-network stuff tends to work itself out (no idea how). But with HDHP, it seems like I could lose unlimited money if injured on vacation?
My current insurance does not provide any out of network care. And all our main physicians are out of network. Our negotiated cash rates are competitive with insurance company rates. So while our payments don't count towards the deductible, our savings on premiums more than makes up for fact that we pay out of pocket for our doctors. However, every facility (imaging for example), emergency room, and hospital in the area is in-network for such care. So it's only office visits where we have to make a decision whether to go out of network, and we choose to do so for convenience.
Statistics: Posted by neurosphere — Sun Jun 09, 2024 3:41 am — Replies 118 — Views 7320