Insurance Basics: Home

The Affordable Care Act

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.

The Affordable Care Act
Planning Your Costs Based on Where You Get Care

Your plan may have different rules and costs for different healthcare settings. In any setting, you may have to pay a copay, and in some cases, coinsurance. But, these may be waived for preventive services like flu shots and mammograms.

Planning Your Costs Based on Where You Get Care
Code Modifiers: How they Affect You

Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.

Anesthesia Reimbursement

Anesthesia is used to block pain, relax you or control how awake you are. It is used during surgery or other complex procedures. You may need anesthesia even if you´re not in an operating room.

Experimental Treatments and Clinical Trials

Most health plans don´t cover treatments they regard as “experimental”. Sometimes, they may deny a claim for such a treatment.

Looking Up Costs for Behavioral Health Services

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.