[dbussone]

Originally Posted by golfing eagles

I guess the big question that people, including myself, would like to know is whether the UHC MA plan $4400(option 1) or $1900(option 2) maximum annual out of pocket expense still applies if the costs were incurred as a result of an approved out of network referral. (I assume if you just go without approval, you're on your own)

I believe you are correct. The key, as you note, is that the out of network referral is approved by the insurer and/or referring practice. It should work just as it would in a similar circumstance if an HMO referred a patient to a non network provider.


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