Insurance Basics: Home
Your employer may offer more than one health plan, or you may be shopping for your own individual plan.
After you get care, your provider sends a bill, or “claim,” to your insurance company. Your insurance company handles the claim and sends you an Explanation of Benefits (EOB).
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.
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.
Getting dental care is at least as important when you're older as when you're younger, and maybe more so. Past dental problems may require additional treatment over time, such as when a filling becomes broken or chipped.
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.