One of the more infuriating experiences of private health plans, aside from potentially high premiums and out-of-pocket costs, is figuring out what doctors your insurer is going to cover. For some, going out of the provider network for care can cost hundreds or thousands more than getting care in the same network.But the question arises of how health plans structure these networks. How do they choose the providers in the network and the prices you pay those providers? Moreover, how does going out of network affect anyone to the extent that it's so expensive to get care out of your own health network?
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Why do insurers make you go in-network?
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One of the more infuriating experiences of private health plans, aside from potentially high premiums and out-of-pocket costs, is figuring out what doctors your insurer is going to cover. For some, going out of the provider network for care can cost hundreds or thousands more than getting care in the same network.But the question arises of how health plans structure these networks. How do they choose the providers in the network and the prices you pay those providers? Moreover, how does going out of network affect anyone to the extent that it's so expensive to get care out of your own health network?