Glossary Term


Out-of-network is a phrase used to describe a medical service obtained from a health care provider who does not belong to the network of the patient’s insurance plan. In-network health care providers have negotiated rates with the insurance plan for covered services. Out-of-network health care providers, in contrast, have no agreement with the patient’s insurance plan. If a health plan has a maximum out-of-pocket (MOOP) limit, expenses paid to out-of-network health care providers may not be applied to this threshold.

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