Ask your insurance agent if you have to pay the full cost of non-emergent out-of-network medical care up front at the time of service.
It’s an increasingly common method that insurers are using to try to same themselves money and push the costs onto you.
Don’t ever sign up for a plan that does this.
The insurer may tell you that they will bill the government for you and pay you back anything that they might get as the result of that billing.
That’s not a good deal for you, even if they try to get you to enroll with extra benefits.