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Saving on in-network vs. out-of-network providers

You can save money in two ways when you choose one of the more than 350,000 healthcare providers in our network.  First, in-network providers offer you discounted rates for their services. Second, we cover 80 percent of your costs for eligible expenses when you use a doctor in our network.

The chart below is an example of how one member, we'll call him Jason, saved $3,100 by choosing a doctor in our network.



Because the doctor is in the Humana network, he offered his services at a discounted rate of $3,000. Since Jason had met the medical deductible, we covered 80 percent of the discounted healthcare cost. This meant Jason paid $600.

If Jason had used a provider outside of the network, he could expect the doctor to charge $5,500 for the services provided. We would have covered 60 percent of the maximum allowable fee. Jason would be responsible for the other 40 percent, plus the $2,500 difference between the doctor's charge and the maximum allowable fee, meaning that Jason would pay $3,700.


 

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