Some plans in the exchange do not cover out of network providers and some do but at 65% after your deductible is paid, which in that case it would be less expensive to pay cash. Then it all depends on the plan you pick whether or not your doctor will now except that plan even in the out-of-network category. My advice before picking a plan if you want to keep your doctors is to check which ones they will be accepting after Jan. 1, 2014. I've learned not to trust much of the information provided on hospital websites and private practice websites because the information posted may not reflect what will change after the first of the year. Call.. first before you sign up if that is a concern for you.

Also, if you travel out of state or internationally and decide to go through the exchange policies for coverage be careful to read the fine print regarding coverage for that as many do not cover any physicians across state lines or internationally.

I don't mind paying out-of-network as long as the fee is the same or less than what I would pay if paying cash. When I did the calculations based on what the standard bill is for insurance at 65% + deductible it was $73.00 more expensive to use out-of-network insurance billing. I save money there and then I will also save money when I file my taxes so actually it is an incredible difference to do it this way for me.