The federal health law does set a limit on the annual out-of-pocket charges for covered care. This year, that limit is 6,600 dollars for an individual. But Betsy Imholtz of Consumers Union says the group gets scores of calls from people who have out-of-network bills or can't figure out which providers are covered by their insurance.
"If you pay out of network, it's generally the case that that's not going to count towards your out-of-pocket maximum or your deductible. So it's conceivable that someone could go over the out of pocket max. "
Consumers Union supports a bill that would prevent patients from being billed for out-of-network costs for care they received at a medical facility covered in their health plan. Charles Bacchi of the California Association of Health Plans says insurers support that concept.
"We think that providers should contract with health plans and that we should have a better coordination at health care facilities to make sure that providers who have contracts with plans are providing care."
Health advocates have also proposed a measure to require more accurate provider directories. And they want price caps on prescriptions. The health plans don't support that. They say when patients pay for care at the time of service, monthly premiums are more affordable.