E.g. let's say my PPO plan has a 5,000 in network OOP max and 8,000 out of network OOP. max
The following out of pocket coinsurance costs occurs in this order
I realized today I have no reason to believe this, but I always assumed the "out of network OOP max" implied (in or out of network), which would mean #2.
Semi related question in the same example , is it possible for you to hit your out of network OOP maximum without hitting your in network OOP? E.g. after #3 it would appear you are in an odd situation where you are better off avoiding in network doctors.
The following out of pocket coinsurance costs occurs in this order
- 4,000 spent in network
- 4,000 spent out of network
- 4,000 spent out of network
I realized today I have no reason to believe this, but I always assumed the "out of network OOP max" implied (in or out of network), which would mean #2.
Semi related question in the same example , is it possible for you to hit your out of network OOP maximum without hitting your in network OOP? E.g. after #3 it would appear you are in an odd situation where you are better off avoiding in network doctors.