insurance

Network (Insurance)

A group of healthcare providers, repair shops, or service providers that have contracted with an insurance company to provide services at pre-negotiated rates. Using network providers typically results in lower out-of-pocket costs for policyholders.

Example

Maria saved $300 on her medical procedure by choosing a doctor within her health insurance network instead of going out-of-network.

Memory Tip

Think 'NET savings WORK together' - the network providers work with your insurer to net you savings through negotiated rates.

Why It Matters

Using network providers can dramatically reduce your medical bills, auto repairs, or other covered services because insurers negotiate lower rates with these providers. Going outside the network often means paying significantly more out of pocket.

Common Misconception

Many people believe that network providers offer lower quality services due to their discounted rates, but network providers are typically chosen based on quality standards and credentials. The lower costs come from volume discounts and negotiated rates, not reduced quality.

In Practice

John needs an MRI that costs $2,000 at the standard rate. His health plan has a $500 deductible and covers 80% after the deductible. If he uses an in-network provider who has negotiated the rate down to $1,200, John pays the $500 deductible plus 20% of the remaining $700 ($140), totaling $640. If he goes out-of-network, he might pay the $500 deductible plus 40% of the full $2,000 rate ($800), totaling $1,300. The network saves him $660.

Etymology

From the concept of interconnected systems, originally from Old English 'net' and 'work,' adapted in insurance to describe the web of contracted service providers working together with insurers.

Common Misspellings

netwroknetworknet worknework
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Related Terms

Out-of-Network

More in insurance

Other insurance terms you should know

Actual Cash ValueThe amount of money an insurance company will pay to replaceActuaryA trained professional who uses mathematics, statistics, andActuarial TableA statistical chart that shows the probability of certain evAdditional InsuredA person or entity that receives coverage under someone elseAdditional Living ExpensesInsurance coverage that pays for the extra costs of living aAdjusterAn insurance professional who investigates, evaluates, and s

See Also

preferred providerin-networkcopaymentdeductible
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