In-network: A hospital, pharmacy, physician or other medical service provider that has a contract to participate in one or more plans with Blue KC. A provider who is considered in-network for one plan may be considered out-of-network for another plan.
Out-of-network: A hospital, pharmacy, physician or other medical service provider that does not have a network contract with Blue KC to provide healthcare services to members. Both non-participating providers and non-preferred providers are also referred to as out-of-network providers. PPO members who visit an out-of-network provider will receive limited benefits. EPO and HMO members will not receive any benefits except in the case of an emergency.