network provider
A doctor, hospital, or healthcare facility that has contracted with an insurance plan to provide services at negotiated rates.
Example
“Going out of network instead of using a network provider cost her an extra $3,000 in uncovered charges.”
Memory Tip
IN-NETWORK — always check first. Out-of-network costs can be devastating.
Why It Matters
Understanding network providers helps you minimize healthcare costs because in-network providers charge negotiated rates that are typically much lower than out-of-network providers. Choosing network providers can save you hundreds or thousands of dollars per visit and helps you meet your insurance deductible faster.
Common Misconception
Many people assume that all doctors and hospitals in their area are part of their insurance network, but networks vary significantly between insurance plans. Just because a provider is in-network for one insurance company does not mean they are in-network for another plan, so you must verify before scheduling appointments.
In Practice
If you have a health insurance plan with a 20 percent coinsurance rate, visiting an in-network cardiologist charging a negotiated rate of 200 dollars means you pay 40 dollars. The same visit to an out-of-network cardiologist charging 500 dollars could cost you 100 dollars or more, plus the full amount may not count toward your deductible.
Etymology
Modern health insurance term — providers within the insurer's negotiated network.
Common Misspellings
Compare insurance quotes and save
Related Terms
More in insurance
Other insurance terms you should know
See Also
Need financial definitions?
Clear definitions for 2,500+ finance, insurance, and investing terms.