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Health Care Reform:

Health Insurance & Affordable Care Act

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Out-of-Network, also called out-of-plan or non-preferred provider

Many types of health plans have a list of doctors, hospitals, and other providers called the plan’s network. Providers in the network have agreed to accept a certain rate for people with that plan. Your pay less when you use one of the providers on this list.

If you see a doctor or use a hospital that is not on the plan’s list, you are going out-of-network. You usually have to pay more for out-of-network care. Some plans won’t cover any amount of out-of-network care.

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