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• For health plans that utilize an HMO or PPO, a health care provider (such as a hospital or doctor) that is not contracted to be part of the HMO or PPO network. Depending on the health plan's rules, an individual may not be covered at all or may be required to pay a higher portion of the total costs when he/she seeks care from an out-of-network provider.

  Minnesota Department of Commerce, Insurance - Cite This Source - This Definition
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  Cite Definition for Out-of-network provider

  American Psychological Association (APA)

  Out-of-network provider. (n.d.). Glossary of Health Insurance Terms. Retrieved December 1, 2022, from website: http://www.expertglossary.com/definition/out-of-network-provider.

  Chicago Manual of Style (CMS)

  Out-of-network provider. mn.gov. Glossary of Health Insurance Terms. Minnesota Department of Commerce, Insurance. http://www.expertglossary.com/definition/out-of-network-provider (accessed: December 1, 2022).

  Modern Language Association (MLA)

  "Out-of-network provider." Glossary of Health Insurance Terms. Minnesota Department of Commerce, Insurance. 1 December. 2022 http://www.expertglossary.com/definition/out-of-network-provider.

• Browse Related Terms: Exclusive Provider Organization (EPO) Plan, Health Maintenance Organization, Health Maintenance Organization (HMO), In-Network provider, Managed Care, Medicare Advantage, Medicare Advantage (Medicare Part C), Medicare Cost Plans, Medicare Select Plans, Out-of-network provider, Point of Service (POS) Plans, Point-of-Service Plan (POS), Preferred Provider Organization (PPO), Primary Care Physician (PCP), Referral, Third-Party Payer