Insurance Basics: Surprise Billing

NY State of Health

NY State of Health is New York´s official online healthcare Marketplace. Individuals, families and small business owners in New York can use NY State of Health to compare health plans, and join the one that best meets their needs.

NY State of Health
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
Healthcare Services Not Covered by Health Insurance

You might think your health insurance plan will cover just about anything, from eyeglasses to private nursing. But you would probably be wrong. There are some healthcare services that most health plans don't cover. This guide will tell you about them.

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.

When Out-of-Network Care Can be Covered In Network

Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.

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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

Did You

Know

If you choose a high-deductible health plan (HDHP), you´ll pay less each month than you would in a traditional plan. But, you´ll also have to pay more up front before your plan starts paying for your care.

Did You

Know

Most plans have provider "networks", or a group of doctors, hospitals and other healthcare providers who agree to accept the amount your plan pays. If you see providers outside the network, you'll probably pay more.