Provider network

Provider networks are a group of healthcare providers that have contracts with an insurance provider and consequently, offer care at a discounted rate. 

Using services within your provider network usually means lower copayments and coinsurance costs, with a lower out-of-pocket maximum. 

Certain plans, for instance, some Health Maintenance Organizations (HMOs), will not pay for care received outside the provider network, so make sure you check which healthcare providers are included in your plan.

Related Terms: 

Coinsurance

Copayment / copays

Health Maintenance Organization (HMO)

In-network

Out-of-network

Out-of-pocket maximum

 

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