- 29,511
I just pop in every now and again to fact check. Here are snips from a TN policy so you can see the verb-age. They do pay actual charges, however, they do limit it to R&C based on the zip code the service is provided.
POLICY YEAR DEDUCTIBLE AND MAXIMUM BENEFIT
There is a Policy Year Deductible which is shown in the Policy Schedule. After the Policy Year Deductible has been
met, benefits are limited to the Policy Year Maximum Benefit shown in the Policy Schedule.
BENEFITS
After the Policy Year Deductible is satisfied, the policy pays the following percentages of Actual Charges for Covered
Expenses up to the Policy Year Maximum Benefit:
1. 60% - first Policy Year;
2. 70% - second Policy Year; and,
3. 80% - third Policy Year, and thereafter.
DEFINITIONS
Actual Charge(s): The actual amount charged or billed, not to exceed reasonable and customary charges, for covered
medical services by a Physician or supplier.
That sounds like double talk to me.