All of the above are types of insurance plans that may require you to get some kind of pre certification before you go into a hospital. It is important to know what your benefits are and whether or not your physician and this hospital participate in such plan. Call your plan and CHECK!
If you are enrolled in an HMO or POS plan the answer is "Yes." You will need to obtain a referral for surgery and follow-up care for the hospital.
Better safe than sorry. Many insurance plans require that you call them before you have services rendered.
Many plans only cover a procedure if it is done in an Ambulatory setting. Check with your insurance carrier. You might require special approval for an Inpatient stay (to stay overnight or longer).
Some procedures require a second opinion. Call and check with your plan.
Out of Network means that the hospital or provider that you have chosen does not "participate" with your plan. Therefore, your insurance plan will only pay a percentage and you will responsible for the difference.
The co-insurance and deductibles are outlined in your plan
No. These are two separate fees.
Yes. You are entitled to have emergency care at any hospital. However, you will still be responsible for calling your insurance company and notifying them of your visit.