A doctor, hospital, or other health care provider that has a contract with your insurance plan to provide services at negotiated, discounted rates. Visiting in-network providers almost always costs you less than going out of network.
Related Terms
HMO
A Health Maintenance Organization is a type of health plan that requires you to choose a primary care physician (PCP) and get referrals to see specialists. HMOs typically have lower premiums and out-of-pocket costs but limit coverage to in-network providers except in emergencies.
Out-of-Network Provider
A health care provider that does not have a contract with your insurance plan. Services from out-of-network providers typically cost significantly more, and some plans (like HMOs and EPOs) may not cover out-of-network care at all except in emergencies.
PPO
A Preferred Provider Organization is a health plan that gives you more flexibility to see any doctor or specialist without a referral. You pay less when using in-network providers, but you still have partial coverage for out-of-network care. PPOs typically have higher premiums than HMOs.