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Shared Decision Making and Preference-Sensitive Conditions

To get the best care, it helps if you and your doctor make decisions together. The process is called "shared decision making." This article suggests ways to talk to your doctor about three common health problems where there may be no clear, "right" option. They are uterine fibroids, type 2 diabetes and low-risk prostate cancer. These are examples of preference-sensitive conditions.

Shared Decision Making and Preference-Sensitive Conditions
In-Network and Out-of-Network Care

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.

In-Network and Out-of-Network Care
Coverage for Cancer Care

A cancer diagnosis can change your life. While cancer care will differ by individual circumstances and the type of cancer, identifying ways to cover the costs associated with cancer can help you plan. This guide will help you to understand your options to pay for cancer care. It will explain the costs of cancer care, describe commercial and government coverage, and give you some tips on other ways to plan for the costs of your cancer care.

If Your Plan Doesn't Pay (Appealing a Reimbursement Decision)

Suppose your insurer won´t pay for a healthcare service, or pays less than you had expected. You have the right to “appeal”, or ask for your case to be formally reconsidered.

Out-of-Network Docs at In-Network Facilities

Suppose you receive care in a hospital that is in your health plan´s provider network. You may still get a bill from providers who treated you at the hospital but are not part of your plan´s network.

Mental and Emotional Health

Our mental and emotional health is a vital part of our well-being. If we don´t get the help we need, mental and emotional health problems can hurt our relationships with our family and friends, our jobs and even our communities.

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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