Out-of-Network Providers

An out-of-network provider is a healthcare provider, such as a doctor, hospital, or clinic, that does not have a contract with a health insurance company; as such, they do not offer members of the health insurance company a discounted rate for their service.

These members will often need to pay more out-of-pocket costs, including higher co-pays, deductibles, and coinsurance.

This is in contrast to an In-Network Provider who will typically have lower co-pays and deductibles because they have a contract with the insurer.

Some health insurance plans may still provide coverage for out-of-network providers, but the coverage levels and out-of-pocket costs may be different from those for in-network providers.