What Does Out Of Network Mean?

When you get medical care, it may be out of network. This is a definition that was made up by your insurance provider. Some medical institutions have contracts and agreements about service rates, so they are considered to be “in network.” Other institutions have no agreements with the insurance provider, so they are “out of network.”

This difference can become very important when considering medical debt. If you have a good insurance policy, you may not have to pay as much for in-network services. You may just have to meet your deductible, for instance, and then the insurance company will cover the other costs.

But if you get out-of-network services, then your insurance company may refuse to pay. Even though you do have an insurance policy, and you have been making monthly payments, your costs are not going to be covered.

Do you always know?

The problem this creates with debt is that a patient doesn’t always know what services are in-network and which are out-of-network. Insurance companies advise them to research their medical options first and ensure that they meet with the correct care providers.

But this is not always realistically possible. Say that your child suffers a serious injury at home. You rush them to the nearest hospital, where they go in for surgery. Are you really going to stop and consider whether the hospital – or even the surgeon themselves – is in your network? Of course not. You’re just going to get the medical care that your child needs.

If it was an out-of-network service, though, you could find yourself facing extensive medical debt. At this time, be sure you know what legal options you have.