Health insurance networks negotiate discounted rates with healthcare providers, allowing members to access care at a lower cost.

PPOs typically offer the broadest range of healthcare providers, allowing members to choose from a wide network of doctors and hospitals.

PPOs offer more flexibility in choosing healthcare providers, while HMOs typically require members to stay within a specific network of providers.

EPOs typically exclude out-of-network providers from their network, meaning members must use in-network providers to receive covered care.

POS plans offer more flexibility in choosing healthcare providers compared to HMOs, while still providing some coverage for out-of-network care.

HMOs typically require members to obtain a referral from their primary care physician before seeing a specialist.

A healthcare provider who has a contractual agreement with a health insurance network is referred to as a contracted provider.

The amount that a health insurance member pays for covered medical services before the insurance plan starts to cover the costs is called the deductible.

The percentage of the cost of a covered medical service that a health insurance member is responsible for paying is called coinsurance.

The fixed amount that a health insurance member pays for a covered medical service, regardless of the actual cost of the service, is called a copayment.

The maximum amount that a health insurance member is responsible for paying for covered medical services in a given year is called the out-of-pocket maximum.

The process of selecting a health insurance plan and enrolling in it is called health insurance shopping.

The period of time during which individuals can enroll in or change their health insurance plans is called the open enrollment period.

The period of time during which individuals can make changes to their health insurance plans, such as adding or dropping coverage for dependents, is called the special enrollment period.

The process of submitting a claim to a health insurance company for reimbursement of covered medical expenses is called a health insurance claim.