Many plans sold on the health insurance marketplaces offer a tradeoff: lower premiums in exchange for limited choices of doctors and hospitals. But consumers who opt for these plans with the idea that they'll go out of network when necessary may be taking a big financial risk.
The health law generally limits how much consumers can be required to pay out of pocket for medical care (not including premiums). In 2014, the limit for an individual plan is $6,350 and for a family plan, $12,700.
But those limits apply only to care provided by doctors and hospitals in a plan's approved network. There may be a separate out-of-pocket maximum for services provided out of the network in marketplace plans, or no cap at all, says Margaret Nowak, research director at Breakaway Policy Strategies, a research and consulting firm.
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