Insurance Basics: Home

Preventive Care and Wellness Services: Coverage and Costs

Preventive services, such as vaccines and screenings, can help you avoid certain diseases and catch others in their early stages, to limit the harm they can cause.

Preventive Care and Wellness Services: Coverage and Costs
Shared Decision Making and Preference-Sensitive Conditions

To get the best care, it helps if you and your doctor make decisions together. The process is called "shared decision making." This article suggests ways to talk to your doctor about three common health problems where there may be no clear, "right" option. They are uterine fibroids, type 2 diabetes and low-risk prostate cancer. These are examples of preference-sensitive conditions.

Shared Decision Making and Preference-Sensitive Conditions
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.

Dental Plans

Most medical plans do not include coverage for many dental services. Often, dental services are covered under a separate plan. Like medical plans, most dental plans have specific out-of-pocket costs, like coinsurance, copayments and deductibles.

Health Insurance ID Cards

Your health insurance ID card is your proof of insurance. You use it when you visit the doctor, hospital or other provider.

If Your Plan Doesn't Pay (Appealing a Reimbursement Decision)

Suppose your insurer won´t pay for a healthcare service, or pays less than you had expected. You have the right to “appeal”, or ask for your case to be formally reconsidered.