What is the difference between “Network” versus “Non-Network” benefits?
“Network,” or contracted providers, have agreed to accept negotiated fee schedules. They are not allowed to charge you for covered services in amounts beyond your specified co-pay, deductible, and/or coinsurance amount. The combined amount paid by you and the plan must be accepted as payment in full. “Non-network,” or non-contracted providers, may charge considerably higher amounts. Therefore, if the billed amount exceeds the Allowable Charges fee schedule, your provider may bill you the difference. The balance-billed amounts are not covered by the plan, and therefore not applied to plan deductibles or out of pocket maximums. It is best to utilize Network providers whenever possible. If you should decide to obtain services from a non- network provider, it is recommended you discuss additional charges with your provider before services are rendered.
