Out-of-network Services

Definition

Health Economics

  • These are services by US health care providers that are not employed by or under contract with a managed health care plan. Some plans require care to be provided only by doctors approved by the plan and some allow a member to see physicians outside the plan subject to deductibles or coinsurance payments. Emergency medical care outside of the geographic area of a benefit plan is not considered out-of-network, but is usually specifically covered.
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