What is the difference between in-network and out-of-network coverage?

In-network coverage refers to healthcare services sought from providers who have a contractual agreement with The Regence Group. These providers have agreed to a predetermined fee schedule, thus offering lower costs to insured individuals. Under in-network coverage, patients typically pay lower deductibles, copayments, and coinsurance. Out-of-network coverage, on the other hand, includes healthcare services sought from providers who do not have a contract with The Regence Group. These providers have not agreed to the fee schedule, resulting in higher costs for insured individuals. Out-of-network coverage typically involves higher deductibles, copayments, and coinsurance, and may also require individuals to pay for services upfront and seek reimbursement later. It is advisable to choose in-network providers to maximize coverage benefits and minimize out-of-pocket expenses.