Health insurance companies contract with doctors, hospitals and labs to provide medical services to policyholders for a specified amount. Thees contracted providers make up the network for that insurance company's health plan.
When an insured person goes to these providers, they are protected by the contracted rate for covered services, which is lower than the provider would offer to others.
Often, the providers will allow the insured to receive the service for a specified co-payment amount.
When there is no copay, the insured would still benefit from a preferred coinsurance rate after the policy's deductible was satisfied.
In a Health Maintenance Organization (HMO), the insured must use only the network providers.
In a Preferred Provider Organization (PPO), the insured can receives services out of network, but the rates will not be as favorable.
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