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 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.
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.
Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.
If you have an ongoing illness or need a complicated procedure, it’s a good idea to get an FH Total Treatment Cost estimate.
This article will tell you what Medicaid is and how it works. It will also tell you whom and what Medicaid covers, including long-term care, and how to sign up for it. Finally, it will tell you about dual eligibility for adults 65 and older who qualify for both Medicare and Medicaid. This article doesn’t provide legal or financial advice. Consider speaking to a financial advisor or lawyer if you have questions about your specific situation.
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