Insurance Basics: Home
Many insurers offer different types of plans. The costs, coverage and rules differ for each
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.
Employers offer health coverage to their workers in several ways. Some buy an “off the shelf” plan from a commercial insurance company.
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."
Health insurance is important. It protects you against what can be the very high costs of healthcare. But, to get health insurance, you need to enroll, or sign up. And, in most cases, you can’t enroll in a health plan any time you want. You have to do it during certain times.