If you have OON benefits, you have the choice to seek the best medical care. You can go ahead and see the specialist with the most expertise to treat your diagnosis. That doctor will bill your insurance company, and you will pay some out-of-pocket expense as determined by your insurance policy.
You may not think much, if at all, about the out-of-network (OON) benefit on your health insurance policy until life delivers a dose of bad news.
Consider this scenario: you have a diagnosis that requires the attention of a specialist. Your doctor or family friend highly recommends this specialist – the best in the medical profession, the one they would see if they received the same diagnosis.
After checking with your insurance company, you discover the highly-recommended specialist is not in your network.
Well, if you have OON benefits, no worries, you have the choice to seek the best medical care. You can go ahead and see that specialist with the most expertise to treat your diagnosis. That doctor will bill your insurance company, and you will pay some out-of-pocket expense as determined in your insurance policy.
But what if you don’t have OON benefits? That means you won’t be able to be treated by that recommended specialist. Instead, your insurance company will hand you a book of in-network doctors, and you will find yourself flipping through the book in search of a different specialist that may not even treat your condition.
In this scenario, as in many others, the in-network doctor may also be far away from home and only have appointments several weeks or months from when you call.
We know that’s no way to find a doctor, especially at such a stressful moment in your life.
That’s why doctors and patients have joined together to call attention to this latest effort by New Jersey to reduce your benefits and restrict your medical care.