What does “in-network” mean?
Healthcare providers (hospitals, sleep labs, doctors, HMEs, etc.) review insurance contracts to determine if they want to sign the payment agreement. Those providers signing the contract are referred to as “In Network Providers.” The healthcare providers have agreed with your insurance company in advance to what they will be paid for services. Your insurance carrier may require you to use an “In Network” healthcare provider. If you choose a healthcare provider that is “out of network,” then you may have additional out of pocket expenses to pay.
Your health care coverage is considered in network when you use a provider who participates in our network of more than 55,000 doctors and 100 hospitals. For HMO plans, it’s the Keystone Health Plan East network. For PPO plans, it’s the Personal Choice® network and you have the option to visit doctors out of network at a higher cost. To see if a provider or hospital is considered in-network, visit our provider directory.
