Hey there, I use an out-of-network provider who charges a rate of $120/session.

One year ago, my health insurance provider covered 70% of the full amount once I met my deductible, so my rate per session was $36.

At the beginning of this year, the allowed amount went down to $98, so 70% of the $98 was covered, and I had to pay the remaining 30% plus the difference ($120-$98). The rate per session works out to be about $50.

Now, out of the blue, the allowed amount dropped to $75 (nearly half of what it was one year prior), so only 70% of the $75 is covered, and I have to pay the remaining 30% plus the difference ($120-$75). The rate per session works out to be about $70.

This means the cost per session has nearly doubled within the year… Is this a mistake? I’m shocked to see the allowed amount change so erratically without any notice, and I want to be able to plan for this expense. Is there a minimum that the allowed amount can be? I don’t understand how this cost can change so dramatically for the exact same service in the exact same location just within the span of one year.

submitted by /u/Ok-Waltz8358

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Hey there, I use an out-of-network provider who charges a rate of $120/session. One year ago, my health insurance provider covered 70% of the full amount once I met my deductible, so my rate per session was $36. At the beginning of this year, the allowed amount went down to $98, so 70% of the $98 was covered, and I had to pay the remaining 30% plus the difference ($120-$98). The rate per session works out to be about $50. Now, out of the blue, the allowed amount dropped to $75 (nearly half of what it was one year prior), so only 70% of the $75 is covered, and I have to pay the remaining 30% plus the difference ($120-$75). The rate per session works out to be about $70. This means the cost per session has nearly doubled within the year… Is this a mistake? I’m shocked to see the allowed amount change so erratically without any notice, and I want to be able to plan for this expense. Is there a minimum that the allowed amount can be? I don’t understand how this cost can change so dramatically for the exact same service in the exact same location just within the span of one year.

submitted by /u/Ok-Waltz8358 [link] [comments]Read Morer/HealthInsurance