Insurance Basics: Home
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.
Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.
Medical supplies and equipment, such as bandages and wheelchairs, and ambulance rides are often listed separately on bills and Explanation of Benefits (EOB) forms.
To look up the estimated costs for behavioral health services (including mental health and alcohol and/or drug services), go to our home page, fairhealthconsumer.org, and click on Medical and Hospital Costs.
New rules have expanded access to two types of limited health insurance plans. They are association health plans (AHPs) and short-term, limited duration (STLD) health plans. Because they don’t have to follow the Affordable Care Act, these plans can cost less than regular health plans. But, they have limitations you should know.
If you’re 65 or older, figuring out how Medicare works and when to sign up can be challenging. It can be hard to know what kind of coverage you’ll need. There are Part A, Part B, Part D, Medicare Advantage plans (Part C) and Medigap. There also are other complex terms to know. This article will cover the basics of what you need to know about Medicare.
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