Insurance Basics: Home
We often rely on our doctors to tell us what care we need. But to get the best care, you and your doctor should make decisions together. This process is called “shared decision making”.
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.
By law, consumers living in New York State have certain protections when shopping for and using their health insurance. Your insurer must provide up-to-date information about who is in your network.
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.
Being covered under two health plans doesn't mean the two plans will pay the same amount twice for the same doctor visit. Instead, the plans follow rules about which plan pays what, known as "coordination of benefits."
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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