In-Network
Healthcare providers who have contracted with a health insurer to accept negotiated rates.
What is In-Network?
An in-network provider is a doctor, hospital, specialist, or other healthcare facility that has a contractual agreement with a health insurance plan to provide services at pre-negotiated rates. When a patient uses an in-network provider, the insurer pays according to the negotiated rate (the allowed amount) and the patient's cost-sharing obligations — deductible, coinsurance, and copay — are applied to that lower rate. In-network care is almost always significantly less expensive for the patient than out-of-network care, and in HMO plans, out-of-network care is typically not covered except in emergencies. Insurers maintain directories of in-network providers, which patients should verify before scheduling care, as network participation can change. The breadth of a plan's network is a key factor when comparing health plans.
Example
A patient visits an in-network primary care physician for an annual physical. Because the physician is in-network, the allowed amount is $180 and the insurer applies it toward the deductible or pays per the copay schedule. The same visit with an out-of-network physician might cost the patient the full billed rate of $350 or more, with no negotiated discount.
Source: HealthCare.gov — In-Network