In plain English
In a tiered network, providers are grouped into levels. Tier 2 names the second level. Members usually have higher cost-sharing for these providers than for Tier 1 providers.
In context
Here, "Tier 2" shows that the provider is in the network's second tier, which usually means higher member cost-sharing than Tier 1.
- Situation
- Checking provider networks, authorization, referrals, eligibility, and preapproval states
- What it communicates
- labels a provider's tier level in network filters or results.
Meaning limits
The term itself does not state the exact amount of member cost-sharing, and that amount can vary.
Examples
“Her surgeon was in Tier 2, so her plan charged more than it would have for a Tier 1 surgeon.”
“Before booking the appointment, he checked whether the clinic was Tier 2 under his insurance network.”