I'm still helping my daughter shop for insurance through Obamacare in Massachusetts.
Most of the plans only cover in-network doctors.
If she pays out of pocket for an out-of-network doctor, will the insurance still pay for lab tests, prescriptions drugs, and other studies ordered by the out-of-network doctor. She would be using in-network labs.
Thanks for any help. She's near Boston and sees Dr. H.
Posted by Maia_Azure (Member # 44330) on :
Hello,
I have a massachusetts based plan. It covers ls work at all the major labs (quest, labcorps, etc) regardless of what state I get th blood drawn in.
My plan would not cover my igenx test, fry labs, a parasitology test or a few labcorp tests that were specific.
My doctor is out of state, and most don't accept insurance, I will only get office visits paid for if I pass the $5,000 deductable.
Pay attention to what kind of plan, if it's an HMO you likely won't get out of network converage and they may be restrictive on labs.
I have a PPO so in-network is cheap, then there are nom-preferred where I pay slightly more, anything else is only covered once deductible is met. (any out of network charge)
Posted by marypart (Member # 27012) on :
So your doctor is out of network, and he/she writes the order for an in-network lab, and the insurance will pay for the lab tests? Even if the doctor that ordered them is out-of-network?
My husband and I have Aetna and they pay for the tests, even if they are ordered by an out-of-network doctor. I'm just wondering if any of the insurance companies deny payment for tests at in-network labs because the order came from an out-of-network doctor.
Yeah, I'm looking for a PPO, not an HMO, on the Massachusetts Health Connector website.
Posted by Maia_Azure (Member # 44330) on :
My doctor just gives me a lab slip, I can go to any location that is convenient for me. Ive been to labcorp in MA and New Hampshire. I always go to a lab near home, but I am not sure if that matters.
I've never tried to go to a lab outside of new england, but from my past experience insurance pays as long as they work with that lab.