> I believe you can get out-of-state covered via out-of-network. But as mentioned, the out-of-pocket max on my plan is shockingly ~6x more for out-of-network than in-network. So you won't pay 90% of $200k, but it will still end up a very substantial amount. But maybe that could still be worth it to see an out-of-state specialist?
See, this would be the expected, plain reading of out-of-network vs. in-network deductibles and coverage.
But be very, very careful with out-of-network: the truth is that your insurance only covers whatever percentage they claim they cover of the "usual and customary" charges for out-of-network care, not the the actual charges you receive. Because out-of-network providers are by definition not contracted with the insurance carrier, they can (and do!) charge you whatever they want. And then your insurance only pays for 10% of that, because they then claim that the "usual and customary" charge for whatever care you received is only 10% of what your provider charged you. (And, of course, the out-of-pocket max for out-of-network care is only for "usual and customary", not any charges beyond that—so it offers basically no protection.)
...which leaves you with a bill for 90% of $200k that you're not particularly in a position to negotiate—neither with your insurance company, which has no incentive to cover it, nor with your care provider, which has already billed you and will happily send your bill to collections (most of the time, though not all the time) and take XX% of it rather than give you a 90% discount.
So: on the one hand, you have zero price transparency before you receive care; on the other hand, your insurance contract has terminology that implies one thing but hides the reality behind reasonable-sounding legalese. One would be hard-pressed to design a worse system.