In-Network vs Out-of-Network

[mona832 20]

Okay so I got a call from Dr. Mirza's office and they told me that my insurance will cover the procedure, but that they are considered out of network for my provider. Now I am sure that they will answer all my questions when I have my first visit with them on the 10th, but I am curious to know what this means for me. I have a higher deductible for out of network providers, so I am not sure at this point if I want to go in for my appointment with the office. I did some research and found that he is a great doctor, but I don't want to spend thousands of dollars on something that my insurance has agreed to cover. So does anyone further along in the insurance process know what this means? Will the hospital charge me more as well? Do you know of any great UHC network doctors in Houston? I would love to keep Dr. Mirza, but I just can't see myself paying thousand's of dollars more than what I would already have to pay.

[mooncat 106]

I am not familiar with your insurance, but typically that does mean that you will pay significantly more. If I were in your situation, I would try to research some doctors that are in network to see if you feel you would be happy with them. If so, why pay more than you have to. If you can't find anyone else that you feel comfortable with, it may be worth it to pay the out of pocket expense. As you will see on these forums, not everyone has a great experience. Putting yourself into the hands of a doctor you are comfortable with is a great start.

Good luck!

[myfutureme 13]

Hey! With my insurance the dr was out of network and the hospital was in. So I fit know. My out of network cost out of pocket was 7000 in network was 5000. Depends how it works

[work2do 15]

I have UHC myself. Not sure of course which plan you have, but UHC is very strict. I would call UHC directly if I were you. For bariatric services UHC requires that you go thru United Resource Networks. They will also tell you your requirements, like if you need a 6 month diet, Bmi, etc.

also, out network is not cheap, call UHC!!!