Demystifying Networks

You’ve probably heard that it’s better to go to an in-network doctor, but what exactly does that mean? How can you tell if your doctor is part of your insurance’s network? Here’s how to find the best deal for your health care.
In-Network: These providers are contracted with your insurance carrier, and have generally agreed to accept a negotiated discounted amount. You’ll end up paying less out-of-pocket for medical services or supplies with an in-network provider.
Out-of-Network: These providers are not under contract with your carrier. Out-of-network providers will accept your insurance, but the level of coverage is usually lower than in-network services. You may be billed a non-discounted amount for any amount your insurance plan does not cover.
Non-Participating: This refers to providers who have declined entering into a contract with your insurance carrier, usually because the fee offered by your carrier is less than they’re willing to accept. Because non-participating physicians don’t have an agreement with your insurance provider, they may no longer accept any insurance or even Medicare. You could pay all costs out of pocket.
Avoid asking providers if they accept your insurance. Instead, ask specifically if they are contracted as a participating provider with your carrier. The best way to check is to call the customer service phone number on the back of your insurance card to verify a provider’s network status.
Be sure to go to an in-network provider whenever possible to save money!