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Sunday
Oct042009

The true cost of going outside your GA health insurer's 'network'

If you are employed in Georgia, you will likely be covered by your employer’s health insurance. Health insurance companies negotiate with groups of doctors for certain rates. These “in-network” doctors should be able to provide you with health care in GA with limited or no out of pocket expenses. You can of course choose to use a doctor in Georgia who is not “in-network” but you may (read will be) out of pocket as a result.

A journalist with the Atlanta, GA Journal Constitution relocated, and needed to find a pediatrician for her infant daughter:

I sought recommendations from several acquaintances, and the same name came up repeatedly. (I’ll just call her Dr. Amy.) I called Dr. Amy’s office and was given an immediate appointment. But I was also told she is “out-of-network” for the company’ health insurer. I called the insurance company and they explained I would pay several hundred dollars a year extra for the privilege of taking my baby girl to Dr. Amy. Cynthia Tucker

Unfortunately, the "in-network" doctor in Georgia could not provide an appointment for several weeks. So what do you do? Do you pay the additional money to get the health coverage you want and need or do you use the group health insurance provided by your employer?