Question:
Ins. pays -0- for out of network Dr, but will pay for in-network

My insurance, United Healthcare will pay for surgery if I use a network Doctor, but nothing if I go out of network. I aked them if they would pay for the doctor of my choice, but at the rate of the in-network doctors. They did not know - any ideas or is it a lost cause? I also asked about only covering the hospital charge and they said not if the doctor is out of network - Help!!!    — Melissa T. (posted on September 19, 2001)

September 19, 2001
Sounds like it's time to find an in-network Doc. I'm sure there is one available. Better coverage than none at all. Several other people here are getting full blown denials and would probably be happy to have *some* covg. Good luck!
   — Kimberly L.

September 19, 2001
I agree, look for a doctor in network who will most likely use a Hospital in-network and you'll only end up paying you co-payment.That's what I did after finding out that BTC is out of network,went to the surgeons section in this web site read the names available in my area, then when on line in my Insurers web page and see if any of the doctors were included;sure enough one of them was and I end up paying ONLY $97 dollars for my surgery.Good Luck.
   — Monica J.

September 19, 2001
I also have United Health Care. When I called them, they said they would pay 70% of the out-of-network costs. I did have to pay the consultation fees but they said the required tests, surgeon, hospital would be covered at 70%. I read on one of the web sites that if there are no in-network surgeons the insurance company has to cover it at the "usual" rate. The website to try is www,obesitylaw.com Hope this helps. I'm pre-op so may have ins. trouble but so far all is going well. Good luck. Carol
   — grammie5

September 19, 2001
I really don't mean to sound flip...but, what's the problem? Use an in-network provider. Why put yourself through added stress and why pay out money if it isn't necessary.
   — [Anonymous]