Out of network is a health insurance term that refers to health care providers not contracted with the insurer to provide health services at a negotiated rate. Therefore, a patient who sees an out-of-network provider can expected to pay much more than if they were to see an in-network provider. Some health plans do not reimburse the insured for these visits, while others may offer some coverage.
Health insurance companies make arrangements with a network of health care providers to receive a discounted rate for the promise of sending patients to the latter. For this reason, health plans cover much more of the costs of seeing an in-network provider as opposed to seeing an out-of-network provider. Nevertheless, at times, it may be necessary or advisable to see an out-of-network provider despite the higher cost.
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