What is the difference between in-network and out-of-network providers?

An in-network provider is one contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates.  An out-of-network provider is one not contracted with the insurance plan.  Typically, if you visit a physician or other provider within the network, the amount you will be responsible for paying will be less than if you go to an out-of-network provider.  Though there are some exceptions, in many cases, the insurance company will either pay less or not pay anything for services you receive from out-of-network providers.