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).
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.
After you visit a provider, you may get a bill telling you how much you have to pay.
Your plan may contract with doctors, dentists and other healthcare practitioners; hospitals; labs; radiology facilities; pharmacies and other types of providers. These are the providers 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.
Visiting your doctor or other healthcare provider? Whether you’re seeing your provider online or in person, good communication between you and your provider is key to getting the most out of your visit.
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