Insurance Basics: Home

In-Network and Out-of-Network Care

Your plan contracts with a wide range of doctors and other practitioners, as well as hospitals, labs, radiology facilities, pharmacies and other providers. These are the providers in your “network”. Each of these providers has agreed to take your plan´s contracted rate as payment in full for services.

In-Network and Out-of-Network Care
Narrow Networks

Health plans negotiate the price of medical services with certain doctors, hospitals, labs and other providers.

Narrow Networks
Insured and Self-Insured Plans

Employers offer health coverage to their workers in several ways. Some buy an “off the shelf” plan from a commercial insurance company.

Vision Coverage for Children and Adults

Most health plans cover medically necessary visits to an eye doctor. Sometimes they cover routine eye exams too, but to get complete vision coverage you may have to go to other sources. This article will tell you about those sources.

Women's Healthcare Coverage

If you´re a woman, you have different healthcare needs than men. Women may need access to birth control, or prenatal and maternity care.

Shopping for Shoppable Services

For many health services, you have time to plan and shop around. If you’re getting the service in a hospital or health system, you may be able to check the price ahead of time at different facilities. You can also use the Shoppable Services tool on this website to learn the average price for the service in your area and surrounding areas.

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IN AND OUT OF NETWORK

When Out-of-Network Care Can Be Covered in Network
PLAN COSTS

Flexible Spending Plans
YOUR RIGHTS

Appealing a Reimbursement Decision
KNOW BEFORE YOU GO

Choosing Your Healthcare Provider In-Network and Out-of-Network Care