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).
Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.
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.
Most medical plans do not include coverage for many dental services. Often, dental services are covered under a separate plan. Like medical plans, most dental plans have specific out-of-pocket costs, like coinsurance, copayments and deductibles.
High-deductible health plans (HDHPs) have lower premiums than traditional health coverage
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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