Insurance Basics: Home

Code Modifiers: How they Affect You

Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.

Code Modifiers: How they Affect You
Managing Costs of Chronic Conditions

If you´ve been diagnosed with a chronic condition, this article will give you some guidelines to help manage your care and costs. In it you will learn how you can get help to:

Managing Costs of Chronic Conditions
Looking Up Costs for Behavioral Health Services

To look up the estimated costs for behavioral health services (including mental health and alcohol and/or drug services), go to our home page, fairhealthconsumer.org, and click on Medical and Hospital Costs.

When Out-of-Network Care Can be Covered In 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.

Types of Out-of-Network Reimbursement

Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.

Limited Health Plans: AHPs and STLD Plans

New rules have expanded access to two types of limited health insurance plans. They are association health plans (AHPs) and short-term, limited duration (STLD) health plans. Because they don’t have to follow the Affordable Care Act, these plans can cost less than regular health plans. But, they have limitations you should know.

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IN AND OUT OF NETWORK

When Out-of-Network Care Can Be Covered in Network
PLAN COSTS

Flexible Spending Plans
YOUR RIGHTS

Appealing a Reimbursement Decision
KNOW BEFORE YOU GO

Choosing Your Healthcare Provider In-Network and Out-of-Network Care