Ways to Save on Healthcare Costs

How to Save on Healthcare Costs

This is the first in a series of articles designed to help members of health plans administered by us save on healthcare costs. Continue reading to learn how to keep hard-earned dollars where they belong -- in your wallet.

In-Network vs. Out-of-Network

This article applies to major medical plans that offer a PPO network.

Are you among the millions of Americans covered by a health benefit plan with a PPO? Do you make the most of your benefits by selecting in-network vs. out-of-network doctors and hospitals? Did you know that you can save by going in network and still choose from a wide range of healthcare providers?

A PPO plan is the most common type of plan, according to the 2023 Employer Health Benefits Survey from the Kasier Family Foundation.

What does in network mean?

People who have a PPO plan gain access to a wide range of healthcare providers, such as primary care doctors, specialists, hospitals and other facilities, as well as labs and behavioral health providers, that provide services typically costing less than those provided by out-of-network providers.

In-network costs are generally lower than out-of-network costs because:

• You do not get a network discount if you go to an out-of-network provider.
• Your cost share is higher when you go out of network. Your plan has a separate out-of-network deductible and coinsurance, which do not apply to your in-network deductible and in-network coinsurance maximum.
• You are not subject to balance billing when you go in-network. Out-of-network providers may charge more than what your plan will allow for a particular service and bill you for the remainder, a practice known as balance billing.

To help you avoid balance bills, make sure your providers are in network vs. out of network before you make an appointment.

 

To learn more, read Go In-Network for Big Savings.