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.
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.
Medical supplies and equipment, such as bandages and wheelchairs, and ambulance rides are often listed separately on bills and Explanation of Benefits (EOB) forms.
High-deductible health plans (HDHPs) have lower premiums than traditional health coverage
For many health services, you have time to plan and shop around. If you’re getting the service in a hospital or health system, you may be able to check the price ahead of time at different facilities. You can also use the Shoppable Services tool on this website to learn the average price for the service in your area and surrounding areas.
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