Top 5 Benefits of Going In-Network

sneezing student160937546Your insurance plan contracts with a number of doctors, specialists, hospitals, labs, radiology facilities, and pharmacies. These providers make up your network, and can sometimes be known as your insurance provider network or PPO network. It is generally best to seek care within your network and there are several benefits of going in-network for health care.

The top 5 benefits of going in-network are:

You save money

Providers in your network have agreements with your insurance company that save you money. These providers agree to accept your plan’s contracted rate as payment in full for services. This contracted rate included both your insurer’s share of the cost and your share.

Services are provided at a lower rate

Your plan may require higher co-pays, deductibles, and co-insurance for out of network care. For example, if you usually have to pay 20% of the cost of the service in-network, you may have to pay 30% of the cost out of network. Often, you will have to pay that as well as any difference between your insurer’s allowed amount and what the provider charges.

Streamlined expenses

You will typically expect that the process when seeking medical care from a provider that is part of your network is the process is much smoother and streamlined, with less paperwork to complete and in some cases you may not have to make any payments upfront.

Quality Standards

Providers are held to certain quality standards for plan members, this means that you can be certain you are receiving the highest possible quality of care when you seek in-network treatment, allowing you a certain peace of mind.

No Coverage!

Your plan may not cover out of network care at all. If this is the case, you will have the pay the full cost of treatment yourself, and paying for health care without insurance can get very expensive very quickly.

If you seek health care from a provider outside of your network, you will certainly end up paying more for care, for a variety of reasons. If at all possible, try to make sure that any health care providers you use are within your insurance network. This will help keep your out-of-pocket expenses relatively low. For more information about insurance provider networks, please visit our insurance explained section to learn more.


Posted by Jennifer Frankel

Jennifer is the International Director at International Student Insurance. Jennifer is a graduate of the University of Florida where she holds a Masters in International Business and a Bachelors of Science in Business Administration. She has lived and worked abroad in Mexico, Chile, Costa Rica and England, and traveled extensively in South America, Europe and Asia.

One thought on “Top 5 Benefits of Going In-Network”

Vivian Black says:

I did not know that if you go out of your network for health care, then you may pay a higher co-pay and deductible. We just got married and we are trying to find the best plan for us through my husband’s work. It seems a bit complicated, but if we read all the information it begins to come together. We will call the medical insurance specialist tomorrow with all our questions. https://ellendanielsagency.com/medicare-health-plan


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