Insurance Basics: Home
The Affordable Care Act (ACA) of 2010 makes it easier for many Americans to get health insurance. It also expands the services that health plans need to cover.
Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.
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”.
Since providers are able to decide how much to charge for out-of-network care, sometimes that charge might be higher than you expected.
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."
You might think your health insurance plan will cover just about anything, from eyeglasses to private nursing. But you would probably be wrong. There are some healthcare services that most health plans don't cover. This guide will tell you about them.