Ugh!

Looks even a little more official now. MJ heard from my insurance company this morning. They told him that they won't pay for the transplant because the Seattle Center is "Out of Network". Apparently seeking out the best is not an option. I went through all the benefit books this morning, and these are the only things I could find that looked relevant. Boring techno-jargon to follow...

"Excluded Medical Expenses
The Medical Expenses which are excluded from Covered Charges under this Plan are any charges: (...)
u. for the care, treatment, therapies, services, procedures, devices and supplies, which in the judgment of the Plan Administrator, are Experimental, Investigative or Unproven in nature."

"The University of Missouri offers employees and their eligible dependents the following medical coverage choices:
Choice – UM Choice Health Care Program (available to all employees)
The UM Choice Health Care Program provides two basic coverage levels:
Level A – Covers services provided by any network provider from a nationwide network of providers. The program allows direct access to all network physicians with no referral requirement.
Level B – Covers services provided by non-network providers."

"Non-network benefits
Non-network benefits are paid for care you receive from physicians, hospitals and other health care facilities that do not participate in the Coventry UM Choice Health Care network. Exceptions apply to life-threatening emergencies, as described under Network benefits.
The amount the plan pays for non-network care is shown in the Benefits Summary."

"Covered medical services
You can receive benefits only for charges incurred by a covered individual for the services and supplies listed as eligible expenses in the section called Eligible Expenses and Exclusions on page 30. These services and supplies must be prescribed or performed by a physician or other qualified medical provider for the medically necessary treatment of a non-occupational sickness or injury and provided based on generally accepted medical practice."

"Precertification penalty
If precertification is not received before a non-network hospital admission or surgery (inpatient or outpatient), you will pay an additional $500 of the covered charges. The penalty will not count toward your deductible, hospital copay or out-of-pocket limit."
We are currently in the pre-certification stage.

That's it. Level B (non-network)has a $500 deductible per person, out-of-pocket limit of $2,500, and Lifetime maximum of $2 million. All costs for care are listed at 20% after deductible. That is all it says.