Insurance Basics: Home

Shared Decision Making

We often rely on our doctors to tell us what care we need. But to get the best care, you and your doctor should make decisions together. This process is called “shared decision making”.

Shared Decision Making
In-Network and Out-of-Network Care

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.

In-Network and Out-of-Network Care
Cost Sharing

Health insurance protects you from paying the full cost of your care. But, you will likely still have to pay some money out of your pocket. Almost all plans call for “cost sharing”. That means your insurer pays for part of your care, and you pay for part.

Provider Networks

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”.

Anesthesia Reimbursement

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.

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