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COST-CONTROL PLAN FOR HEALTH CARE COULD COST YOU
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Quote:WASHINGTON (AP) — You just might want to pay attention to the latest health insurance jargon.

It could mean thousands of dollars out of your pocket.

The Obama administration has given the go-ahead for a new cost-control strategy called "reference pricing."

It lets insurers and employers put a dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements.

Some experts worry that patients could be surprised with big medical bills they must pay themselves, undercutting financial protections in the new health care law.

That would happen if patients picked a more expensive hospital — even if it's part of the insurer's network.

The administration's decision affects most job-based plans as well as the new insurance exchanges.

The new strategy works like this:

Your health insurance plan slaps a dollar limit on what it will pay for certain procedures, for example, hospital charges associated with knee and hip replacement operations.

That's called the reference price.

Say the limit is $30,000.

The plan offers you a choice of hospitals within its provider network.

If you pick one that charges $40,000, you would owe $10,000 to the hospital plus your regular cost-sharing for the $30,000 that your plan covers.

The extra $10,000 is treated like an out-of-network expense, and it doesn't count toward your plan's annual limit on out-of-pocket costs.

"The problem ... from the patient's perspective is that at the end of the day, that is who gets left holding the bag,"

http://bigstory.ap.org/article/cost-cont...d-cost-you

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It's the "BILL OF RIGHTS" not the bill of "needs"
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