PearsonVue Health Insurance Practice Exam

Question: 1 / 400

What affects a patient's costs when using an out-of-network provider?

Lower premiums due to reduced provider numbers

Higher out-of-pocket costs and uncovered charges

The selection of higher out-of-pocket costs and uncovered charges accurately reflects the financial implications for patients choosing to use out-of-network providers. Typically, health insurance plans have specific arrangements with in-network providers, which means costs for services provided by these providers are lower due to negotiated rates.

When a patient opts for an out-of-network provider, they often face higher co-pays, deductibles, and coinsurance. In many cases, insurers may not cover services at all when provided out of network, leading to patients being responsible for the entire cost of care that is not deemed necessary or not covered. This can significantly increase the overall expenses for the patient compared to staying within the network.

The other choices reflect misunderstandings about how insurance coverage generally works. For instance, lower premiums due to reduced provider numbers can lead to other financial implications, but they don't directly answer how costs are affected when using out-of-network providers. The same costs as in-network providers and guaranteed coverage for the entire service suggest that insurance treats out-of-network care the same as in-network care, which is generally not the case.

Get further explanation with Examzify DeepDiveBeta

Same costs as in-network providers

Guaranteed coverage for the entire service

Next Question

Report this question

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy