In-network vs. out-of-network and how it impacts costs

By Regence
couple on laptop

What is a network?  A provider network includes the doctors, dentists, hospitals, pharmacies and other medical professionals that are part of your health plan. We negotiate rates with these providers so you get high-quality care at the lowest possible prices.

Choosing in-network care saves you money

Imagine you’re shopping for groceries. You have two stores to choose from: Store A gives you a special discount because you’re a member, and Store B doesn’t. Where would you shop? Most likely, Store A, right?

In-network providers

Think of an in-network provider as Store A. Because they’ve agreed to prices with your health plan, you pay less when you visit them. It’s like having a member discount card for your health care. We cover more of the costs for in-network providers.

Out-of-network providers

An out-of-network provider is like Store B. Sure, they might have what you need, but they don’t have the same member discount and you will pay more.

If you visit a provider outside your network, your health plan may not cover your care. You’ll be responsible for paying most, if not all, of the bill. The same is true for services your doctor recommends. For example, your doctor might refer you to a medical imaging facility that's not in your network, which could cost you more money.

Regence members can sign into your account to easily find providers who are in your network. Our Customer Service team can also help you understand the difference between in-network versus out-of-network benefits and more.