When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional charges or pay the entire bill if you see a provider or visit a healthcare facility that is not in your health plan’s network.
“Out-of-network” means providers and facilities without a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the total amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
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