Got it right here in front of me.
Wrong.
So now, you are saying you've read it ??
Must have missed.... this part.
-Bug-
Yes!!! Exactly that. Thank you for finding this piece of info. Unless we use US Imaging (which for some may be possible but not for all) the bills are paid at 80% of the ALLOWABLE (major medical) rate (not charge) and we would pay the remaining 20% of the ALLOWABLE rate PLUS (since this would be out of network) any remaining balance over and above the ALLOWABLE after Teamcare pays its portion and the 20% COINSURANCE from the patient. This would continue until we have satisfied the "EXPENSE LIMIT" which is $1,000 individual and $2,000 family annually. Keep in mind that only the 20% of the allowable (major medical) rate is applied towards the EXPENSE LIMIT and not the balance in excess of the allowable rate not the deductible (starts in 2018). Once that EXPENSE LIMIT has been satisfied after deductible (which begins in 2018) then Teamcare would begin to pay 100% of the ALLOWABLE (major medical) rate leaving a balance for which we would be responsible.
For example
MRI or any other radiological diagnostic done anywhere except by US Imaging:
Charge- $2,000
Major Medical (allowable) -$400
Teamcare pays 80% of major medical-$320
Member coisurance 20% of major medical -$80 ($80 applied to expense limit of $1,000 annually individual, $2,000 family annually)
Balance remaining after 80/20 -$1,600 which is patient responsibility since this is not a US Imaging provider.
Let's be honest. It can be done in network but with Teamcare there are far fewer providers and a much higher risk of being out of network.
God forbid any of us or our families become seriously ill, wouldn't you opt for a more expansive network with more options? I would.
BTW- same scenario for Lab work if not done by Quest and ONLY Quest. That's what Teamcare means when they say they've "partnered" with Quest and US Imaging. Teamcare is a cheaper healthcare option for UPS!!!!