Understanding Your Health Insurance

Health Insurance FAQ

What does "in-network" mean?

Your insurance company partners with a number of healthcare providers. This group of providers is known as your insurance company’s network. When you select one of these providers, you are choosing someone who is in-network.

How does it benefit me to choose in-network providers?

When a care provider, such as Benefis, is in-network, it means the provider works with the insurance company to negotiate mutually-acceptable rates of pay for medical services. When you receive care from a provider who is in-network with your insurance company, your insurance company typically charges you a lower fee, meaning you essentially receive a discount to get care at in-network facilities.

What does “out-of-network” mean?

Only some healthcare providers have negotiated rates and are in-network with your insurance company. When you go to a provider who is out-of-network, your out-of-pocket cost is higher.

Who is responsible for determining how much I pay out-of-pocket?

The actual amount you pay out-of-pocket depends on your insurance company and policy – it is not determined by your healthcare provider. Some insurance policies require you to pay a larger percentage of the total bill if you go out of-network, but others may not cover out-ofnetwork care at all. That can leave you, the patient, with the responsibility of paying a large medical bill yourself.

How can I keep my medical expenses down?

Consider whether a provider is considered in-network or out-of-network by your insurance company. Read your health insurance policy to see whether out-of-network care is covered at all. If it is, take note of what your financial responsibility would be compared to in-network care. You can also call your insurance company using the number on your insurance card to verify that you correctly understand your policy.

Learn more about Benefis Health System's commitment to improving healthcare affordability for our patients.

Current In-Network Insurance Plans

The following insurance plans are currently in-network at Benefis Health System: