Common use of Out-of-Network Providers Clause in Contracts

Out-of-Network Providers. If you elect to receive Covered Services and supplies from an Out-of-Network Provider, you will be balanced billed for and will be responsible to pay all amounts charged by the Out-of-Network Provider that are above the Allowed Amount. This means you may pay higher Out-of-Pocket Expenses for Covered Services and supplies you receive from Out-of-Network Providers. In addition to balance billing, when you receive care from an Out-of-Network Provider, you will also be responsible for any applicable Copay, Deductible, Coinsurance, amounts in excess of stated benefit maximums, and charges for non-covered services and supplies. Amounts in excess of the Allowed Amount do not accrue toward your Calendar Year Deductible or Out-of-Pocket Maximum.