DEFINITIONThe doctors, nurses, and other healthcare providers your health insurer has contracted with to provide health care services at a lower price for you. A doctor, physician's assistant, or nurse practitioner that has not contracted with your insurance or coverage plan is called an "out of network provider," and often costs more for you to see them.
EXAMPLEKristen needs to be seen by a dermatologist. She can call her health insurance to get a list of dermatologists that have a contract with her health insurance. If Kristen decides to see a dermatologist who is not on the list provided by the health insurance, she might end up paying more for the service because the insurance company will probably not pay for her to see a doctor who is not on the list.