Insurance Basics: Home

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.

In-Network and Out-of-Network Care
Emergency Care and Urgent Care

Your plan´s rules and costs may differ for some types of care. Knowing these rules can help you control your costs and get the right care in the right setting.

Emergency Care and Urgent Care
Paying for Orthodontics (Braces)

Orthodontics is the field of dentistry that fixes misaligned teeth and jaws using braces and other corrective procedures. Many dental plans cover orthodontics, but the coverage often differs from other dental services.

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.

Insured and Self-Insured Plans

Employers offer health coverage to their workers in several ways. Some buy an “off the shelf” plan from a commercial insurance company.

Anesthesia Reimbursement

Anesthesia is used to block pain, relax you or control how awake you are. It is used during surgery or other complex procedures. You may need anesthesia even if you´re not in an operating room.

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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