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
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
Dental Coverage for Children

Regular dental care is important for all people, but especially for children. The Affordable Care Act (ACA) requires federal and state-run health insurance exchanges to offer children´s dental coverage.

Explanation of Benefits (EOB)

After you get care, your provider sends a bill, or “claim,” to your insurance company. Your insurance company handles the claim and sends you an Explanation of Benefits (EOB).

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.

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.

Menu
Most Popular
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