I recently found out that my private insurance now considers nurse practitioners to be out-of-network. Regardless of geographical location, or which hospital/doctor's office they work in. So I can see my surgeon and only pay $30 out of pocket, or I can see her nurse in the same office and pay $500 out of pocket. Guess which one I'm going to choose?
Actually, their office writes that off when the insurance won't pay, which I'm sure just means they charge more for the surgeon's time and services to recoup their costs, since the nurse still needs to be paid. HOWEVER, it also means that I will not go to the Take Care Clinic inside Walgreens, or anything similar, because it's not staffed by actual doctors. Now that I know this, I will always choose to see an actual doctor, which I assume has higher rates.
Meanwhile, I keep hearing things on the radio about how everyone should consider seeing nurse practitioners instead of doctors, because there are more of them, and they charge less. Yeah, and if private insurance (which is already expensive) won't pay for me to see them, how am I going to afford that?
I was also denied having a PET scan when my doctor wanted to see if my cancer had spread to other parts of my body. I could have paid out-of-pocket, but the hospital wouldn't tell me exactly how much I'd be billed, and an online search said it could be anywhere from $3000-$10,000, which I can't afford. Instead, my doctor ordered a CT scan + a bone scan, which is a serviceable but less effective way to check. The insurance company was billed a few thousand dollars for that. So, from what I understand, the insurance company paid about the same for me to get the less effective test.