Out of Network Health Insurance?

Question by kelh0003: Out of Network Health Insurance?
I’m trying to understand what exactly out of network coverage is? I’m trying to help my boyfriend get health insurance and he travels a lot. Right now he is working in Florida (where his permanent address is) and this summer he will most likely be in Virginia for a month or two and possibly California later and he has a manual labor type of job so his risk of injury is greater. So would it be better to get a type of insurance where the out of network coverage is covered more? I just don’t quite understand it.

Best answer:

Answer by Stuart
You need to understand two terms: the first is ‘provider’. A provider is the insurance company – think Blue Cross, Cigna, State Farm, etc. The second term is ‘network’. A network is a company that has an agreement with doctors, hospitals, nursing homes, etc – the agreement says that they will only be paid a certain amount for a certain procedure.

So, if a provider like Blue Cross is your insurance company, and your family doctor is in their network, you can get the best deal on medical care at your doctor because Blue Cross will charge you less if you go to him. Other doctors in their network would let you get a similar deal.

If you go to a different doctor who is not in their network, there is not deal for set prices, so you might have to pay a lot more for your co-pay.

When you get insurance, the provider wil give you a list of the doctors in their network, and you can see which make the best money deal for your bf if they are near where he will be working.

– Stuart

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