In health insurance, what is a 'network'?

In health insurance, a network refers to a group of healthcare providers who have agreed to offer their services at negotiated rates. This arrangement typically allows insurance companies to control costs and provide policyholders access to a range of doctors, hospitals, and specialists who are part of that network. By utilizing in-network providers, policyholders often pay lower out-of-pocket costs when seeking medical care compared to going out of network, where costs usually increase significantly.

This concept is foundational in many health insurance plans, including Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), as it helps both the insurance provider and the insured manage expenses while ensuring that patients have access to quality care. The partnerships formed between the insurance companies and the providers within the network facilitate this cooperative cost management.

The other options presented do not fully represent the definition of a network within health insurance. A list of healthcare services covered by a policy relates more to the scope of benefits rather than the relationship between providers and insurers. A database for tracking patient claims and payments refers to administrative functions rather than the clinical relationships involved in healthcare delivery. The concept of a team of specialists assigned to high-risk patients pertains to case management in healthcare, which is a different operational function.