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@penny65 The prices are so inflated to make up for Medicare, Medicaid, Tricare, and people like this whose payment doesn't even cover the coat of providing care to the patient. That $75 is meant to cover the expense of all the admin staff who scheduled, checked in, and worked any billing; the MA...

@enoob57 The majority of plans on the marketplace are HMO's, and also have significantly stricter rules about referrals than plans through an employer or Medadvantage. At least in my state, that's been my observation.

@durgha Something to consider that you don't mention. Do any of the plans offer an FSA or HSA? Especially if an HSA is available, that's often the best choice because you can put away money pre-tax. This lowers your taxable income and can be treated as a secondary retirement fund, or used to pay...

@resjudicata It depends on the location. If it's not in the hospital facility it most likely won't be, but it's still good to ask if the location bills hospital fees. I believe they're now required to have signage in the office about it as well. I even get an email before all my appointments...