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Thank you everyone for responding to my questions.
The thing that scares me about PPOs is that I use to get the "Explanation of Benefits" forms. They would say the bill was $20k (for example), but that the negotiated rate was $9k. So, the HMO insurance would just pay the $9k and everything would be settled.
If I do a PPO, and go *outside* my medical group, than it is my understanding that the insurance will pay x% of $9k. But the doctor would still be expecting the $20k. So, I'd be on the hook for the remainder.
If this is true, why would I want to do a PPO, since the costs practically force you to stay within your medical group? Maybe other insurances have better plans than this? Or am I missing something?
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55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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