Define "out-of-network" benefits in health insurance.

Out-of-network benefits refer to coverage for healthcare services provided by healthcare providers who do not participate in a health insurance company’s network. These benefits are characterized by a higher cost to the insured compared to those services rendered by in-network providers. When an insured person uses an out-of-network provider, they might incur higher copayments, deductibles, or coinsurance, which results in greater overall expenses.

Health insurance plans typically negotiate lower rates with in-network providers, which allows them to keep costs down for plan members. When services are obtained outside this network, the costs are not discounted, making out-of-network care more expensive for the insured. This understanding of out-of-network benefits is crucial for insured individuals as they navigate their healthcare options and make informed choices about their providers based on potential costs associated with their plan.