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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
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.

Cost Sharing
Health Insurance ID Cards

Your health insurance ID card is your proof of insurance. You use it when you visit the doctor, hospital or other provider.

How to Review Your Medical Bill

After you visit a provider, you may get a bill telling you how much you have to pay.

Provider Networks

Your plan may contract with doctors, dentists and other healthcare practitioners; hospitals; labs; radiology facilities; pharmacies and other types of providers. These are the providers in your “network”.

Receiving Care from an Accountable Care Organization

An Accountable Care Organization (ACO) is a group of doctors or hospitals who have agreed to work together to coordinate and improve their patients´ care

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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