US Medical Term · insurance
Network Exception
Excepción de red
Also: Excepción de proveedor fuera de red (regional variant)
In 9 languages
| Language | Term |
|---|---|
| English | Network Exception |
| Spanish (Español) | Excepción de red |
| Chinese (中文) | 網絡例外 |
| Korean (한국어) | 네트워크 예외 |
| Vietnamese (Tiếng Việt) | Ngoại lệ mạng lưới |
| Filipino (Tagalog) | Eksepsyon sa network |
| Portuguese (Português) | Exceção de rede |
| Thai (ภาษาไทย) | ข้อยกเว้นเครือข่าย |
| Japanese (日本語) | ネットワーク例外 |
What it means
A network exception, sometimes called a network gap exception or out-of-network exception, is a formal approval from your insurance company allowing you to receive care from an out-of-network provider at in-network cost-sharing rates. You may qualify if no in-network provider in your area offers the specialty or service you need, or if your current treating physician is not in your plan's network and continuity of care requires you to remain with that provider. You must request a network exception in writing and typically need supporting documentation from your doctor. Approvals are not guaranteed and may be granted for a limited time period.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
I need to request a network exception because there is no in-network specialist near me.
Necesito solicitar una excepción de red porque no hay especialistas dentro de la red cerca de mí.
My doctor is out of network but I need continuity of care — can I get a network exception?
Mi médico está fuera de la red pero necesito continuidad de atención — ¿puedo obtener una excepción de red?
What documentation do I need to submit for a network exception request?
¿Qué documentación necesito presentar para una solicitud de excepción de red?
Where you'll see it
Related terms
Sources
Last reviewed: September 2026