A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
Speak with a licensed insurance agent 866-553-3223
Speak with a licensed insurance agent 866-553-3223
A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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provider

Infographic regarding health insurance providers

What is a provider?

Provider is a term used to refer to a medical professional or medical facility. It encompasses a wide range of professionals, including doctors, nurse practitioners, physical therapists, pharmacists, etc. as well as a wide range of facilities such as hospitals, clinics, pharmacies, surgery centers, etc.1

Most health insurance plans contract with a network of providers. Plan enrollees pay lower out-of-pocket costs if they use those in-network providers, and some health plans will only cover care that's received from an in-network provider.

Note that a health plan pays providers, but the health plan is not a provider itself.

 

Footnotes

  1. "Health Care Provider Definition and Cross-Reference Table" The Office of the National Coordinator for Health Information Technology. Accessed Oct. 9, 2024 

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