Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

This is frustrating. I'm trying to choose a health insurance plan for the coming year. We're under Empire BCBS. We have a choice of two plans..... the first one requires deductibles & coinsurance for both in-network & out-of-network care, but the yearly deductibles aren't too extreme for either. The second plan has no deductible & coinsurance for in-network, but has a HUGE deductible & coinsurance for out-of-network care. Both plans require the same copayment amounts for network doctor visits, and the premiums are about the same.

What would you pick?? Is out-of-network coverage very important????? I'm so confused. If we only use in-network coverage, it seems like we'd save a lot of money on the second plan... but if we were to do something out-of-network, we'd get huge bills. It's just me & DH, no kids now, if it makes a difference.

Re: Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

I have a plan that requries a copayment for in network coverage and a $3000 deductable for out of network coverage. I'm not sure how high yours will be, but I am pleased with my plan. The only time I have ever went out of network was when I needed an emergency appendectomy and the anesthesiologist was out of network. Otherwise, the Blue Cross plan is huge and you can always find a great doctor in network, so to me it is more important to have a copayment and not a deductable for in network.

Re: Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

I have united healthcare, we have something similar to the first plan you mentioned. I have never used a doctor out of the network except for the exact same scenario the poster above mentioned lol. I would probably go with the 2nd one, but I would call the doctors I regularly see just to make sure they take the new insurance just so i don't run into a problem...

Re: Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

Ive never had to use out of network benefits so i would go with the 2nd plan. Not to say you wont ever, but with bcbs most drs (so it seems) take it.

I know a lot of psychologists do not take insurance so if that is a need of yours, you may want to consider the other plan.

Ive known some people who have had trouble with drs in emergency situations (hospital) and thembeing out of network and not told until after

Re: Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

I have never gone out of network and either as my DH and he had a major surgery 2 years ago and had to see many doctors. I would never use an out-of-network doctor unless it was for something life threatening and the best of the best was out-of-network. I have had BCBS since I was a kid!

My DH had an out of network provider run tests on him when he was in the hospital and we did get billed but did not have to pay because it was beyond our control. I have also had my dr send lab results to out-of-network labs and I didnt pay either because that wasnt my fault!!

Re: Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

I personally go to a lot of out-of-network doctors (some that I've seen for years and didn't want to switch for my new plan) and some doctors that don't accept insurance at all. I would personally perfer the first plan. But if you are okay with NEVER going to out of network doctors (you may need to change some of your doctors if they aren't in the new network), then go for the second one.

Re: Need advice! In-network vs. out-of-network for health insurance? I'm clueless.

It really depends on the scope of the network. I have an Empire BCBS plan that doesn't have out of network coverage & it has been fine. I didn't have specific drs I wanted to stick with at the time, but since then I have needed specialists & and a specific hospital and everything was covered.

The only issue i had had was that the insurance network was having contract disputes with a network of hospitals in my area & they threatened to drop then, but they worked it out. That made me nervous b.c then my 3 out my 4 closest hospitals would have been out of network, but it is still ok to go to an out of network ER, I think.