OON
Medical abbreviation · Health Insurance
| Stands for | Out-of-network |
|---|---|
| Categories | Medical |
OON stands for Out-of-network, a health insurance abbreviation.
Describes providers or facilities without a contract with a patient's health plan, so the plan pays less or nothing for their services and the patient may face higher cost sharing and balance bills. HMOs and EPOs usually cover OON care only in emergencies.
Example: The anesthesiologist was OON, but the No Surprises Act limits what I owe.
Usage notes
In-network providers agree to accept the plan's negotiated rates, whereas OON providers may bill the difference between their charges and what the plan pays. The No Surprises Act, effective in 2022, protects patients from such balance bills for emergency care and certain non-emergency care at in-network facilities. Some plans say "non-participating" instead.
Related abbreviations
More health insurance abbreviations
- NCCI – National Correct Coding Initiative
- NCD – National coverage determination
- NCQA – National Committee for Quality Assurance
- NPI – National Provider Identifier
- NSA – No Surprises Act
- OEP – Open enrollment period
- OOP – Out-of-pocket
- OPPS – Outpatient Prospective Payment System
- PACE – Program of All-Inclusive Care for the Elderly
- Par – Participating (provider)
- PDP – Prescription drug plan (Medicare Part D)
- PHI – Protected health information
See all 107 health insurance abbreviations →
This entry is for general education and is not medical advice. Abbreviation use varies between institutions; always confirm in context.