The main difference between in-network and out-of-network dental providers is that in-network providers are contracted with your insurance company and agree to discounted rates, while out-of-network providers are not contracted and can charge full price:
In-network
Providers are contracted with your insurance company and agree to discounted rates. You're usually responsible for paying a predetermined percentage of the bill, like 20%.
Out-of-network
Providers are not contracted with your insurance company and can charge full price. You may be responsible for paying a higher percentage of the bill, like 30% or more. You may also have to pay the difference if the doctor or facility charges more than your plan is willing to pay.
You can request a current list of network providers from your insurance company.
Some patients prefer out-of-network dentists because they can provide more personalized care and are free to provide the care they feel is best for patients. However, out-of-network providers are not subject to any fixed price, so fees may be higher. You will also usually have to pay at the time of service, so you will spend more out of pocket.
Questions?
Contact us at 434-384-7611.