I totally understand what the thread writer's son is going through. My husband is considered overweight and isn't eligible for private health insurance either. My husband is a truck driver with a rather large company and we were lucky to even get the crappy health insurance that they offered.
This insurance plan has a managable deductible and we pay 20% co-insurance instead of a copay. And even though its a PPO it seems to run like an HMO being that if you see someone outside of the coverage area they change their coverage level to 65%. Again this didn't seem like a problem until I had to go to the ER because I was physically assalted when I was 5 months pregnant. While they were working on making sure my baby would survive it never crossed my mind to ask if the doctor was contracted. When in the ER you get what ever doctor happens to be there. Well, this doctor turned out to be a "non contracted" doctor and now is demanding his own rather high fee ($500)in addition to the other bills we recieved during that visit, our out of pocket expense was around $1000, the cost of the entire visit was way more.
This seems like a scam to us because because when in emergency situations does anyone really have time to check if the health care provider is contracted? I contacted my insurance company about this and posed the scenario that when I go to have my baby (I'm now 9 months pregnant) if we need to do an emergency c-section will I again have this higher patient responsiblity? I was told "yes" and that the only way to avoid paying more money would be to ensure that all the doctors are contracted with the insurance company.
Does that make sense to anyone? I think I would be more concerned about my baby's life than checking coverage. I've already ensured that I went to a covered hospital what more can I possibly do during an emergency?