Definition
An insurance network structure where providers are grouped into tiers based on cost and quality metrics. Tier 1 providers have the lowest cost-sharing (preferred), while Tier 2 and 3 providers cost more out of pocket. This encourages patients to use cost-effective, high-quality providers.
Related Terms
- Deductible
The amount you must pay out of pocket for covered healthcare services before you...
- Copay
A fixed amount you pay for a covered healthcare service after you have met your ...
- Coinsurance
Your share of the costs of a covered healthcare service, calculated as a percent...
- Out-of-Pocket Maximum
The most you have to pay for covered services in a plan year. After you spend th...
- Premium
The amount you pay each month for your health insurance coverage, regardless of ...
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