Health Insurance Terms 101 A Brief Guide – Bright Healthcare

Medicaid reimburses for prescription medicines as well as hospitalization, doctor visits, and various other medical procedures.

One of the most vital healthcare insurance terms you need you need to understand is networks. A health insurance network comprised comprising doctors, hospitals and other healthcare providers who agree to provide care to customers who have a certain insurance plan. In general, you pay less when visiting a physician within the network than have if you visited an uninvolved doctor. You can make significant savings by checking with your insurance to confirm that you’re in the network of the particular provider you’d like to visit.


In the U.S the term “out-of-network” or OON refers to health providers who do not have a contract with a patient’s health insurance plan. It means the health insurance policy may not be able to cover some or all costs associated with care from this provider. Doctors, hospitals, as well as other health care providers are considered to be outside of network. Patients need to be aware of the risk of incurring higher expenses with an OON-based provider due to the fact that they are obliged to pay for the costs for services from their own pocket. It is essential to inquire with one’s health insurance plan in order to find out if OON coverage is offered and also to know the any associated fees.

OON providers could be needed under certain circumstances. In the case of a patient has an emergency medical situation and needs to be seen by a provider that isn’t covered by the health insurance coverage they have, they might be forced in choosing an out of network provider. Furthermore, patients could choose to see an OON provider to receive a specific treatment or procedure not included in their health insurance policy. If this happens, patients need to be ready to pay for the total cost from their own pocket. Talk to your health provider or insurance plan for OON coverage in case you have concerns.