Insurance Basics: Surprise Billing
NY State of Health is New York´s official online healthcare Marketplace. Individuals, families and small business owners in New York can use NY State of Health to compare health plans, and join the one that best meets their needs.
By law, consumers living in New York State have certain protections when shopping for and using their health insurance. Your insurer must provide up-to-date information about who is in your network.
You might think your health insurance plan will cover just about anything, from eyeglasses to private nursing. But you would probably be wrong. There are some healthcare services that most health plans don't cover. This guide will tell you about them.
Suppose you receive care in a hospital that is in your health plan´s provider network. You may still get a bill from providers who treated you at the hospital but are not part of your plan´s network.
Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.
Even if your hospital takes your plan, the doctor who treats you there may not.
After you visit the doctor, your plan may send you an “Explanation of Benefits”, or EOB, explaining how much they paid and why. If you owe any money, you´ll get a bill directly from your provider.