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What is a Network?

A network refers to the group of physicians, urgent care facilities, and hospitals that will accept your medical insurance policy coverage. Medicare supplemental insurance policies are generally accepted at any medical provider location where traditional Medicare coverage and medical policy riders are also accepted. A health care provider's network is generally quite large to ensure a broad range of acceptable physicians for their policyholders. This is done to provide policyholder's with a choice and preference of physician to handle their every medical need.

Medicare supplemental insurance policies, like many health care providers, do have certain medical practices in their network. Therefore, it is important to thoroughly read through any medical paperwork received to know which physicians are within your health care provider's network. If it is not mentioned in any paperwork, it is strongly suggested that you contact your health insurance provider, or search online, for a comprehensive list of medical practitioners who will accept your medical insurance. If you currently have a medical physician and wonder if that physician falls within your health insurance's network, contact your physician to inquire. In the instance that your physician is not a member of your health insurance's network, it may be of interest to you to determine if the out of pocket expenses are manageable.

Using Out of Network Providers

You may wonder what might happen if you choose to visit a medical doctor that is out of your health insurance's network of providers. In that instance, there may be some additional paperwork necessary to be completed. Some doctors may deny you as a new patient if they are not accepted by your health insurance provider's network. If that occurs, that is generally because the doctor does not want any individual to have to incur out of pocket expenses for medical attention. However, most medical practitioners and hospitals will not deny medical attention in the instance of an emergency.

Should you choose to go to an out of network provider, do not be surprised if you are held accountable for all expenses incurred. This includes your deductible, co-pay, lab costs, or any other expense incurred from your visit to the doctor. You should always check with your plan provider if you are interested in using an out of network provider, or if you are hesitant to use an out of network medical provider.

Benefits of In Network Providers

Health insurance companies provide a network for their policyholders for many reasons. Having a network of physicians helps when attempting to find a new physician for the first time, whether that is a primary care physician, an eye doctor, or even a dentist. The network provides a list of physicians that will accept your insurance and who are known and trusted by your medical insurance company. Often times medical practitioners who are in your medical insurance's network will generally accept new patients and treat those new patients on the same day, should openings be available.

The biggest benefit of using in a medical insurance network physicians is the fact that they do accept your medical insurance. This means that you will generally only be responsible for your co-pay and any applicable deductible based on your policy coverage. You pay premiums for a reason, and now those premiums are working to cover the vast majority of your medical expenses from medical treatment sought by you. Most medical insurance companies will provide annual, or bi-annual, medical reports that outline your usage. This will include the medical providers used, the treatment sought, the amount of deductible you have paid, and the amount of expenses your insurance company has provided for you.


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