{"id":2483,"date":"2023-04-21T20:36:38","date_gmt":"2023-04-21T20:36:38","guid":{"rendered":"https:\/\/www.bluekc.com\/bluekcblog\/well-said\/for-members-only-april-2023\/"},"modified":"2023-05-12T13:59:35","modified_gmt":"2023-05-12T13:59:35","slug":"for-members-only-april-2023","status":"publish","type":"well_said","link":"https:\/\/www.bluekc.com\/blog\/well-said\/for-members-only-april-2023\/","title":{"rendered":"For Members Only – April 2023"},"content":{"rendered":"\n
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There\u2019s a lot to know as a consumer of health insurance. When you enroll in a health plan, it can feel like a strange vocabulary with words like deductible, out-of-pocket limit, coinsurance, and provider network.<\/p>\n\n\n\n

We\u2019re here to help you understand the terminology and use it to get the most out of your health plan. Today we\u2019ll unravel provider network<\/strong>, because once you know how to navigate it, you\u2019ll save money and gain peace of mind.<\/p>\n\n\n\n

The Basics<\/strong><\/h2>\n\n\n\n

What is a provider network?<\/strong> Your Blue KC network is the group of providers and facilities you have access to for your healthcare. It includes primary care physicians, specialty physicians, hospitals, urgent care clinics, labs, x-ray providers, pharmacies, same-day surgery centers, and other healthcare professionals.<\/p>\n\n\n\n

What is an in-network provider?<\/strong> When a doctor or other healthcare provider joins a Blue KC network, they\u2019re considered in network and have signed a contract to charge lower rates negotiated by Blue KC. Once you\u2019ve met your deductible<\/a>, each time you visit an in-network provider, you\u2019ll pay only a portion of those lower rates in the form of coinsurance <\/a>or copayment<\/a>. Blue KC will pay the rest.<\/p>\n\n\n\n

What is an out-of-network provider?<\/strong> A doctor who hasn\u2019t signed a contract agreeing to Blue KC\u2019s lower, negotiated rates is an out-of-network provider. Depending on the terms of your health plan, out-of-network doctors may only be partially covered by your plan, or not at all.<\/p>\n\n\n\n

Four Reasons to Stay In-Network<\/strong><\/h2>\n\n\n\n

Even though you may have access to out-of-network providers through your Blue KC plan, you benefit by choosing in-network providers. Here\u2019s why:<\/p>\n\n\n\n

1. Pay less for healthcare.<\/strong><\/p>\n\n\n\n

You\u2019ll pay less for healthcare in two ways when you use in-network providers:<\/p>\n\n\n\n