What are my benefits when I receive care from non-network providers?
When you receive care from non-network providers, you will usually pay more for your care. Copays usually do not apply for non-network providers. Your plan will pay covered charges at the non-network benefit percentage, as stated in your certificate. Your certificate may also show that a higher deductible and out-of-pocket limit may apply for non-network charges. In addition, you will be responsible for all charges made by non-network providers in excess of the usual, customary and reasonable rates for the service. Your payment of these excess charges do not apply toward meeting your deductible or out-of-pocket limit.
