In-network providers are healthcare professionals or facilities that have contracts with the Co-Op. They are our partners in providing care and will have negotiated terms for the cost of care for our members. In-network providers are more affordable for members, because the contract will set a cost of care for our members.

Out-of-network providers are healthcare professionals or facilities with whom the Co-op has not contracted. These providers will not have an agreed-upon cost of care for our members, and care will be more expensive. Out-of-network providers are not held to contracted rates. This means they balance bill.

Balance Billing occurs when a provider bills you for the difference between the provider’s charge and the allowed amount (which is set by your insurance company). For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. An in-network provider cannot balance bill you for covered services.