What is the difference between an out-of-network provider and an in-network provider?
Your insurance company negotiates contracts with hospitals and physicians to provide services to their clients at reduced prices. If a hospital or a physician chooses to contract with the insurance company, they are considered an in-network provider and your insurance company has negotiated a discount with the hospital or physician. An out-of-network provider is defined as a hospital or physician who has chosen not to offer a discount to the insurance company. If you choose to use an out-of-network provider, generally the out-of-pocket cost to the individual is higher than from using an in-network provider because the insurance company will not receive a discount from the hospital or the physician and the individual may be financially responsible for the difference.
