Insurance Basics: Home

The Affordable Care Act

The Affordable Care Act (ACA) of 2010 makes it easier for many Americans to get health insurance. It also expands the services that health plans need to cover.

The Affordable Care Act
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
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.

Dental Coverage for Retirees

Getting dental care is at least as important when you're older as when you're younger, and maybe more so. Past dental problems may require additional treatment over time, such as when a filling becomes broken or chipped.

Negotiating Your Costs

Since providers are able to decide how much to charge for out-of-network care, sometimes that charge might be higher than you expected.

Out-of-Network Docs at In-Network Facilities

Suppose you receive care in a hospital that is in your health plan´s provider network. You may still get a bill from providers who treated you at the hospital but are not part of your plan´s network.

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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