X's company offers several very good insurance plans and we pay the higher price for the best of the lot, so I can in fact see any specialist who takes my insurance (which a great many of them do), no referral or anything needed, for a $35 fee. When I went to my shoulder specialist and mentioned I was having back issues, he recommended a spinal specialist and I simply called up and made an appointment.
Sometimes more paperwork is needed; for example, insurance generally won't cover physical therapy unless it's prescribed for a diagnosed condition, so every six months I have to get my doctor to put a new prescription on file with both the PT office and my insurance company. The spinal specialist wanted me to get an MRI, and insurance makes you get an X-ray first before they'll cover the MRI, just in case the X-ray provides sufficient information that the more expensive MRI isn't needed. But when you pay for these high-end plans, a lot of what you're paying for is not needing to jump through hoops, so mostly it just works.
If I want to see a doctor or get a test and my insurance won't cover it, I can pay out of pocket. That's what I do with my therapist; insurance payments for psychotherapy are so stingy that very few therapists take insurance at all. I submit receipts to my insurance company and get reimbursed the amount of that stingy payment.
I'm not seeing all the listed doctors there—that's a combined list for all four of us. But I am seeing nine or ten of them, so I'm glad I can do it without much hassle!
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Sometimes more paperwork is needed; for example, insurance generally won't cover physical therapy unless it's prescribed for a diagnosed condition, so every six months I have to get my doctor to put a new prescription on file with both the PT office and my insurance company. The spinal specialist wanted me to get an MRI, and insurance makes you get an X-ray first before they'll cover the MRI, just in case the X-ray provides sufficient information that the more expensive MRI isn't needed. But when you pay for these high-end plans, a lot of what you're paying for is not needing to jump through hoops, so mostly it just works.
If I want to see a doctor or get a test and my insurance won't cover it, I can pay out of pocket. That's what I do with my therapist; insurance payments for psychotherapy are so stingy that very few therapists take insurance at all. I submit receipts to my insurance company and get reimbursed the amount of that stingy payment.
I'm not seeing all the listed doctors there—that's a combined list for all four of us. But I am seeing nine or ten of them, so I'm glad I can do it without much hassle!