Originally Posted by
gloopy
Another overlooked thing is that the main purpose of insurance is to cover the unexpected. While DPMP is better for known out of network, many may think that can't apply to them because they're in network. Until they're not...even when you think you're in network you can be out of network. We've all heard the horror stories of stereotypical out of network anesthesiologists slamming people with life wrecking bills. Medical billing is a swamp so murky people go to school just to learn how to do it.
Us thinking we can always navigate all that by reading a leaflet once a year and then trusting "the system" to be honest, forthright and transparent is like flying VFR solo cross country with foggles on. It always works out. Until that one time it doesn't.
Not to mention that we pick once a year. The Mayo Clinic in JAX will vacillate (sometimes in the same year) as to wether they will accept TRICARE (which is really medicare rates) for insurance. So I've had reasons in the past to have a family member seen there and once they took it, then they didn't and lately since the pandemic, it's back on. It all amounts to the patient load they can keep that pay full freight or much closer to it than the govt does.