In-network vs out-of-network

Learn about the different types of care to help you find the right providers at more affordable costs.

Networks can make a big difference in how much you spend on health care. That's because your in-network providers – which may include doctors, hospitals, labs, and pharmacies – contract with your health insurance company to bring you negotiated rates.

How in-network costs work

Let's say a provider's fee for service is $200, but the provider is in-network with your insurance plan and has a contracted rate of $120 for that same service. You would only be responsible for $120. That saves you $80.

How out-of-network costs work

An out-of-network provider's $200 fee for services may not be covered, meaning you'll be responsible to pay the entire amount.

Even with an insurance plan that covers some out-of-network costs, you may still have to pay more for covered services.

Finding in-network care

Find in-network providers, information about covered procedures, and details about cost savings by logging in to your Blue Connect℠ member portal.

You can also use our Find Care tool to search for providers and facilities even if you're not registered for Blue Connect.

Remember, doctors can change networks year to year, so it's best to also check in with your regular doctor during annual open enrollment period.

Find Care

Emergency room care

During an emergency, you don't need to worry about finding an in-network emergency room (ER). You can find more information about what's covered under emergency room care and how your insurance is applied in your Benefit Booklet.

Did you receive an ER bill that you don't understand? Learn more about surprise billing or balance billing.