Out-Of-Network - Health Insurance Definition
An Out-Of-Network physician or
hospital is one that is not on the list of preferred
health care providers for your insurance company.
In most cases, using an out of network doctor,
hospital or clinic means that your claim will
be denied - that you’ll bear the entire
cost of those services without participation by
your insurance company. This policy is typically
part of a closed
access insurance program. But even if that’s
the case, there are exceptions and you should
be aware of them.
The most common exception is when you are traveling.
Whether you’re in another state on a business
trip or visiting friends in the next city, you
can never be certain you won’t need medical
treatment. Whether it’s an accident or a
sudden illness, you need to know what to do if
it happens. Talk to your broker.
If your insurance company has a network of approved
providers, get the full list so that you can find
an approved doctor or clinic when you’re
away from home. If your insurance doesn’t
recognize health care professionals or facilities
in other areas, find out what the policy is for
emergency care. Most policies include a clause
that provides for emergency health care even if
an out-of-network doctor or hospital provided
the care. |
