A lot of people are confused about the concept of providers in the network when Medicare Advantage Plans use it. First of all, providers are doctors. They can be family doctors, specialists, or physicians in the hospital. Medicare Advantage Plan usually contracts with a set of doctors, these are the doctors are in the network that members of the Medicare Advantage Plans are allowed to see. So what is the difference when Medicare Advantage Plan say designated network provider vs network provider?
Both are in network providers, not out of network providers. Out of network providers usually require patient to pay most of the out pocket.
In terms designated, it could be either a provider assigned to you if you have HMO plan and this is a primary care physician. or it could mean it is a preferred provider in the network. Health plan internally measures the quality of the provider (by medical expense, by quality scores), the more favorable one usually is the preferred status. If the provider fee schedule is lower, they can also be placed in the preferred status.