I just graduated, and I got a job at a private clinic. It is not affiliated with any medical system, but is partners with the pharmacy I used to work at. I just got all my benefits paperwork. I think this sounds kind of weird, but this is the first I've had insurance on my own, so I'm wondering if this is more common than I think. One of my letters says this:
"In an effort to maximize the benefits available and minimize out-of-pocket expenses, you are strongly encouraged NOT to use hospitals in the --- Health System for your healthcare needs... So, to help keep our health care costs down this year and in future years, --- Health Plan will assess a 5% fee on the net discounted price to all plan members who choose to utilize the --- Health system. Any fees paid by a plan member would not apply to the deductible and/or co-insurance limits."
Can they seriously do that? I could understand that if I worked for a hospital system, I should see physicians in that system, etc, and that out-of-network places are higher. But my company is not affiliated with any system at all, and this is an in-network health system according to the insurance.
Maybe I'm just peeved because my physician for 3 years is in this hospital system, so I either find a new doctor (even though mine is technically in network), or pay an extra 5% that doesn't actually go towards anything.
Featured Replies
Join the conversation
You can post now and register later.
If you have an account, sign in now to post with your account.
I just graduated, and I got a job at a private clinic. It is not affiliated with any medical system, but is partners with the pharmacy I used to work at. I just got all my benefits paperwork. I think this sounds kind of weird, but this is the first I've had insurance on my own, so I'm wondering if this is more common than I think. One of my letters says this:
"In an effort to maximize the benefits available and minimize out-of-pocket expenses, you are strongly encouraged NOT to use hospitals in the --- Health System for your healthcare needs... So, to help keep our health care costs down this year and in future years, --- Health Plan will assess a 5% fee on the net discounted price to all plan members who choose to utilize the --- Health system. Any fees paid by a plan member would not apply to the deductible and/or co-insurance limits."
Can they seriously do that? I could understand that if I worked for a hospital system, I should see physicians in that system, etc, and that out-of-network places are higher. But my company is not affiliated with any system at all, and this is an in-network health system according to the insurance.
Maybe I'm just peeved because my physician for 3 years is in this hospital system, so I either find a new doctor (even though mine is technically in network), or pay an extra 5% that doesn't actually go towards anything.