Are you someone who spends time finding the right healthcare providers who fit your individual or family needs? What can it mean when your healthcare provider tells you they are no longer in-network? Let us review what this change will mean to you and your pocketbook.
What does being in-network mean? When in-network providers contract with insurance companies, they agree to provide healthcare services at a set rate. This rate is normally lower than they would typically charge. These providers can also be referred to as preferred or participating providers.
Should I try to stay with in-network providers? Whenever possible, using in-network providers can cost you less out of pocket. These in-network providers have agreed to accept the insurance carrier’s reimbursement as payment in full, leaving you responsible for the smaller copay or coinsurance cost specific to your plan.
What happens when I use out-of-network providers? Some plans do not cover out-of-network providers or they pay a very small portion. If your plan does allow you to use out-of-network providers, expect your copays and coinsurance to be higher. Remember, when staying with in-network providers, they have agreed to accept a set contracted rate, which leaves you paying less out of pocket.
It is important to get the most out of your healthcare by using in-network providers whenever possible. If you would like help determining which providers are in-network with your health plan, we are just a phone call away.