Out-of-Network
Updated October 20261 minute read
Out-of-network means a healthcare provider has no contract with your insurance plan. You pay the provider directly at their own price, and if your plan includes out-of-network benefits, you can submit a claim yourself for partial reimbursement.
"Out-of-network" describes the relationship between a provider and an insurance plan — not the provider's quality or legitimacy. Many physical therapists choose to work out-of-network so they can treat one patient at a time instead of the volume insurance contracts require.
For you it means: no gatekeeping, a price you know upfront, and — if your plan has out-of-network benefits — the option to get partially reimbursed by submitting a superbill. Reimbursement percentages apply to your plan's allowed amount after the out-of-network deductible.
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This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.