One of the best ways to save on health care costs is to “stay in-network.” Here’s how it can save you money.
Access to great doctors for less cost
A network is a group of health care providers that can include doctors, specialists, dentists, hospitals and other facilities. These health care providers have a contract with us. As an Aetna member, you may receive services from these providers at a lower rate.
Member get lower rates
The contract rate for members is usually lower than what the doctor would charge for non-members. And the network doctor agrees to accept the lower rate as payment. You pay your coinsurance or copay, along with your deductible, and get the benefit of lower rates.
Savings can be significant
“In-network” means you have access to the care you need from skilled providers, but you may pay less than someone who has a different health plan. And the difference in cost can be huge—even for the same type of service or procedure.
Your health plan may pay less
Your health benefits and health plans may pay part of the doctor’s bill. Out-of-network providers have not agreed to pay Aetna contract rates, so their charges may be more. Some plans may not pay any benefits if you go out-of-network. Other plans cover out-of-network care only in an emergency. When choosing a plan, make sure your plan covers your needs.
Cost sharing increases
With many plans, your coinsurance may be higher for out-of-network care. Coinsurance is the portion of the covered service you pay after you reach your deductible.
Out-of-network rates are higher
We don’t know in advance what an out-of-network provider will charge. These charges are often greater than the amount that Aetna recognizes or allows.
Deductibles are higher and separate
Many plans have a separate out-of-network deductible that must be met before your plan pays any benefits. And this out-of-network deductible is higher than your in-network deductible. With in-network care, your deductible may be lower, or you may have no deductible.