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Protections for New York Consumers: Understanding Your Out-of-Pocket Costs

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.

Protections for New York Consumers: Understanding Your Out-of-Pocket Costs
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.

Cost Sharing
How Medical Supplies and Ambulance Rides are Billed

Medical supplies and equipment, such as bandages and wheelchairs, and ambulance rides are often listed separately on bills and Explanation of Benefits (EOB) forms.

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.

Narrow Networks

Health plans negotiate the price of medical services with certain doctors, hospitals, labs and other providers.

Major Life Events and Planning for Health Insurance

Sometimes you know ahead of time that a major event will happen in your life. Examples might include getting married or divorced, changing jobs or having a baby. Other times, such as at a death, you may not have advance warning.

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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