In-network Versus Out-of-network

Depending upon the type of insurance you have, where you go for health care can matter. For this reason it is important to find out whether the doctor you want to visit or the hospital you want to use for care is in or out of network.


Health insurers negotiate fees and sign agreements with health care providers and facilities that are then considered in network for members. Generally speaking, members pay less at these in-network facilities in the form of lower copayments and deductibles.


If providers do not have an agreement with an insurer, then they are considered out of network. Members who wish to visit an out-of-network provider or facility do not have the advantage of a negotiated lower rate. Because of this, services may be more expensive and may not be covered through the health plan.