Participants in a preferred provider organization network can use medical providers outside of the network, but the benefits aren't nearly as good, according to Consumer Reports. In particular, the covered person pays a higher portion of service charges when using out-of-network care.
The same expectation of a higher payment holds true when using an out-of-network hospital or medical facility, reports Medicare.gov. It is also possible that the insured person must pay the provider directly and file a reimbursement claim afterward with the insurance company, according to About Health. Annual deductibles and coinsurance payments are also common with out-of-network provider care.