Out-of-Network Services

Out-of-Area is defined as the area outside the counties or ZIP codes in which an HMO provides regular and preventive coverage.

Out-of-Area Services Example

Health care services from providers not in an HMO´s or a PPO´s network. Except in certain situations, HMOs will only pay for care received from within its network. If you´re in a PPO plan, you will have to pay more to receive services outside the PPO´s network.