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
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
Code Modifiers: How they Affect You

Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.

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.

Getting Care from a Medical Home

A medical home is a type of doctor´s practice that uses a team to focus on the “whole person”. It is sometimes called a patient-centered medical home (PCMH).

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