a supplier network is a network of doctors, hospitals and specialists who provide health care services to members of the insurance plans at a discounted price. This reduced price is negotiated by the insurance company and helps keep costs low for consumers.
Consumers who see the network of health care providers will pay less than if they see off-network providers. It is always important for a consumer to be network-aware that their health insurance plans cover before buying. People who have a doctor should check if their doctor will be considered in or out of network.
The amount of coverage of a health insurance plan will provide care outside the network depends on the type of policy. Preferred Provider Organizations (PPO) will pay for part of the cost for off-network visits, but will cover more for networked services.
Health Maintenance Organizations (HMO's) will not provide coverage for visits to the off-network doctor without references to a primary care physician. HMO plans will require consumers to choose a primary care physician (PCP). Once a consumer chooses a PCP, they will visit the PCP for all diseases or health care services. If a PCP believes that consumers should see a specialist, they will then see a specialist who is in the network. After a consumer is called an HMO policy will pay for some health care services.
When a consumer sees a doctor who is not in their network providers, they will usually pay a larger share at the time of services.
For more information on network providers and primary care physicians, visit our Quick Answers section health insurance.
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