Insurance, In-Network, Out of Network, Medicare

There is alot of confusion regarding insurance coverage, In-Network benefits, Out Of Network benefits and what you, the patient, are required to pay for treatment.

The chart below lists the major differences between In-Network and Out of Network benefits.

 In- Network    (I-N)

 Out of Network   (O.O.N)





 OON usually higher

 Co-pay ( pt pays)

Depends on Policy


  Co-pay out of network

 Percentage pay (pt pays)



 Less than Co-pay/visit

 # Visits limit/yr



 Insurance payout limit



 Choice of Doctor

Only within network plan


Your choice of Doctor

In summary:

  • Each category of benefits typically has a deductible.  This is the amount you must first pay before the insurance company will even consider contributing to the cost of your care
  • Co-pay(s) are associated with In Network benefits.  The amount of co-pay ranges from $15-75 per office visit.
  • Percentage pay is generally limited to Out of Network benefits.  The insurance will pay a percentage of your visit.  The most common seen in this office are 50/50, 60/40 and 70/30.  The patient is responsible for the smaller percentage.   This can be more cost effective than In Network co-pay, especially if the co-pay is close to the cost of the office visit.
  • Limitations of visits and insurance contribution is seen with both In and Out of Network benefits.
  • Dr. Kanzic accepts all plans and is an OUT of NETWORK provider.
  • Dr. Kanzic accepts assignment on MEDICARE.

Please feel free to contact the office at 713-683-6800 to discuss your insurance benefits  - ask for Jessica.  We hope to hear from you soon !


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Review By Our Satisfied Patient

  • "My back first went out when I was 21 years old. I came to see Dr. Kanzic when I was 44 due to a reinjury. I could NOT stand upright without pain. I could not sit or drive without pain. . Also, I could not pick up my child or anything more than 10 pounds without PAIN.."
    SP - Houston, TX