[dbussone]

Originally Posted by golfing eagles

Now IF there is no provider in network that does the same procedure, and IF it is considered medically necessary to have that specific procedure, don't they cover it as though it were in network?

Yes, but the patient typically is still expected to pay a larger out of pocket fee by the insurer, since the insurer will almost always pay the out of network providers more than in-network providers. The former has no contract and the latter does, hence the difference in treatment.


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