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What Young Adults Need to Know about Health Insurance

Skipping health insurance may seem like you’re saving money in the short run—especially if you’re young and healthy. But the cost of getting care without health insurance can be more than you expect. An unforeseen hospital stay, for example, can cost you tens of thousands of dollars.

What Young Adults Need to Know about Health Insurance
In-Network and Out-of-Network Care

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.

In-Network and Out-of-Network Care
Narrow Networks

Health plans negotiate the price of medical services with certain doctors, hospitals, labs and other providers.

If Your Plan Doesn't Pay (Appealing a Reimbursement Decision)

Suppose your insurer won´t pay for a healthcare service, or pays less than you had expected. You have the right to “appeal”, or ask for your case to be formally reconsidered.

Getting Care from a Medical Home

A medical home is a type of doctor´s practice that uses a team to focus on the “whole person”. It is sometimes called a patient-centered medical home (PCMH).

Out-of-Network Docs at In-Network Facilities

Suppose you receive care in a hospital that is in your health plan´s provider network. You may still get a bill from providers who treated you at the hospital but are not part of your plan´s network.