Insurance Basics: Home
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).
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.
If you´ve been diagnosed with a chronic condition, this article will give you some guidelines to help manage your care and costs. In it you will learn how you can get help to:
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.
Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.