Insurance Basics: Choosing Your Healthcare Provider
Your plan contracts with a wide range of doctors and other practitioners, as well as hospitals, labs, radiology facilities, pharmacies and other providers. These are the providers in your “network”. Each of these providers has agreed to take your plan´s contracted rate as payment in full for services.
Your plan´s rules and costs may differ for some types of care. Knowing these rules can help you control your costs and get the right care in the right setting.
Your plan may contract with doctors, dentists and other healthcare practitioners; hospitals; labs; radiology facilities; pharmacies and other types of providers. These are the providers in your “network”.
Health plans negotiate the price of medical services with certain doctors, hospitals, labs and other providers.
Anesthesia is used to block pain, relax you or control how awake you are. It is used during surgery or other complex procedures. You may need anesthesia even if you´re not in an operating room.
An Accountable Care Organization (ACO) is a group of doctors or hospitals who have agreed to work together to coordinate and improve their patients´ care
A medical home is a type of doctor´s practice that uses a team to focus on the “whole person”. It is sometimes called a patient-centered medical home (PCMH).
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.
Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.
Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.
Visiting your doctor or other healthcare provider? Whether you’re seeing your provider online or in person, good communication between you and your provider is key to getting the most out of your visit.
Our mental and emotional health is a vital part of our well-being. If we don´t get the help we need, mental and emotional health problems can hurt our relationships with our family and friends, our jobs and even our communities.
Are you caring long-term for a sick or disabled family member or friend? If so, you may sometimes feel alone and overwhelmed. Luckily, there are resources to help you.
Most plans have provider "networks", or a group of doctors, hospitals and other healthcare providers who agree to accept the amount your plan pays. If you see providers outside the network, you'll probably pay more.
Even if your hospital takes your plan, the doctor who treats you there may not.