Insurance Basics: Home
After you get care, your provider sends a bill, or “claim,” to your insurance company. Your insurance company handles the claim and sends you an Explanation of Benefits (EOB).
Your plan may have different rules and costs for different healthcare settings. In any setting, you may have to pay a copay, and in some cases, coinsurance. But, these may be waived for preventive services like flu shots and mammograms.
Your health insurance ID card is your proof of insurance. You use it when you visit the doctor, hospital or other provider.
After you visit a provider, you may get a bill telling you how much you have to pay.
Most health plans cover medically necessary visits to an eye doctor. Sometimes they cover routine eye exams too, but to get complete vision coverage you may have to go to other sources. This article will tell you about those sources.
Most health plans don´t cover treatments they regard as “experimental”. Sometimes, they may deny a claim for such a treatment.