Health Insurance Discovery for Out of Network

[JuliaFaith]

Talking to my insurance company today (almost a daily occurrence) they mentioned that if we have long-term treatment with an out-of-network provider we may be eligible for a "GAP exception". For some plans, the Dr. office has to call in, and others the insured has to call. This 'exception' apparently allows them to reimburse at in-network costs which, from what I can tell, are much higher amounts. Will see what, if anything, happens.

[mdmom]

Would you be willing to tell me what insurance company you are dealing with? I'm intrigued by the idea.....

[JuliaFaith]

Would you be willing to tell me what insurance company you are dealing with? I'm intrigued by the idea.....

It depends on your insurance company, but mine right now is UHC and I do not know if they are actually willing to do this. Will see. The best thing to do is call and talk to a representative for your insurance company and ask them if they allow this kind of thing. My insurance told me it would only cover visits in the future if it will cover them at all. Thought it would not hurt to check. Will post if I find out more.