Health insurance networks affect how much you pay for care. Learning how in-network and out-of-network coverage works can help you save money.
Whether you’re signing up for a health plan, searching for a doctor or prescription, or just checking to see if you owe anything, the terms “in-network” and “out-of-network” are bound to pop up.
Networks can make a big difference in how much you spend on health care. When a provider, which includes doctors, hospitals, labs, and pharmacies, is considered in-network, they have a contract with your health insurance company to give you negotiated lower rates.
Knowing your insurance plan's network is important because most of the time, there’s a difference in your costs between in-network and out-of-network. Over time, these costs can add up.
Let's say a doctor's fee for service is $200, but the doctor is in-network with your insurance plan and has a contracted rate of $120 for that same service.
You would only be responsible for $120. That saves you $80.
If you choose a doctor who is out-of-network and not a partner with your insurance plan, you'll be responsible for paying the entire amount of the doctor's bill.
Even with an insurance plan that covers some out-of-network costs, you may still have to pay more for covered services.
During an emergency, you should go to the nearest emergency room.
If you get emergency services from an out-of-network provider or facility, the most you can be billed is your plan’s in-network cost-sharing amount, such as copays and coinsurance. You can find what's covered under emergency room care in your benefit booklet.
When thinking about the difference in costs between in-network and out-of-network care, it's important to know about surprise billing.
This is when certain provider groups practicing at in-network hospitals stay out-of-network. This tends to happen when doctors know patients have no choice but to see them for care. For example, an anesthesiologist during surgery.
Just because you are at an in-network hospital, that doesn’t mean the doctor seeing you will be in-network. To avoid surprise billing, check with the doctor and hospital about who will be giving you care and if they are in-network.
A directory of in-network doctors can typically be found on your insurance company's website.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members can also use our Find Care search for in-network doctors and facilities.
Remember, doctors can change networks year to year, so it's best to also check in with your regular doctor during the annual Open Enrollment Period.
Get reliable answers to your insurance questions, such as how to get prior authorization and submitting a claim.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
Information in other languages: Español 中文 Tiếng Việt 한국어 Français العَرَبِيَّة Hmoob ру́сский Tagalog ગુજરાતી ភាសាខ្មែរ Deutsch हिन्दी ລາວ 日本語
Technical Information Privacy Policy Terms of Use Fraud & Abuse Linked Apps
© 2026 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.