Insurance Basics: Home
Your plan´s rules and costs may differ for some types of care. Knowing these rules can help you control your costs and get the right care in the right setting.
Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.
Health insurance protects you from paying the full cost of your care. But, you will likely still have to pay some money out of your pocket. Almost all plans call for “cost sharing”. That means your insurer pays for part of your care, and you pay for part.
Health plans negotiate the price of medical services with certain doctors, hospitals, labs and other providers.
Since providers are able to decide how much to charge for out-of-network care, sometimes that charge might be higher than you expected.
Most health plans don´t cover treatments they regard as “experimental”. Sometimes, they may deny a claim for such a treatment.