In the U.S., health insurers tend to have networks of healthcare providers with whom they have special contracts. Insurers agree to encourage subscribers to see certain providers in return for a discount. The negotiated rates between insurers and healthcare providers are significantly lower than the list price that providers bill to uninsured patients.
If a patient visits a doctor or hospital that her health plan has made a deal with, she is visiting a provider who is "in-network." If a patient visits a provider who is not recognized by her health plan, she is "out-of-network." In most all cases, visiting an in-network provider will be easier and cheaper than visiting one who is out of the network. Today, one of the biggest differences between HMOS and PPOs lies in how much patients are deterred from visiting out-of-network providers.
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For example, Pam and Gloria experience a biking accident. Pam and Gloria both purchased a major medical plan with a high deductible of $2,000; however, Gloria wanted to mitigate the high deductible and coinsurance expenses, just in case. So, she decided to buy a supplemental health insurance plan...
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