Understanding the Difference between In-Network and Out of Network

Between deductibles, limits, maximums and co-insurance percentages, it can be pretty challenging to understand all the ins and outs of your health insurance policy. But in order to utilize the policy properly and make health care decisions that your policy affords you coverage for, you need to take the time to understand all of these terms. By far, one of the most confusing concepts is that of in-network and out-of-network providers, but it’s also one of the most important when it comes to choosing health care providers.

In-Network Providers
Your insurance company has worked with a group of medical treatment providers and facilities to deliver treatment to insurance policyholders at a pre-negotiated price. When you see one of these individuals or go to one of these centers, it is considered to be an in-network visit. This entitles you to in-network coverage which will have a lower co-insurance cost and lower overall service price than an out-of-network visit.

Out-of-Network Providers
In some insurance policies, you might have no coverage at all if you see an out-of-network provider unless it’s an emergency and there was no in-network option available. Some policies allow for a reduced co-insurance payment if you see an out-of-network provider.

Find out more about your Round Rock Health Insurance options from Evans, Ewan & Brady today!