Insurance Basics: Home

Insured and Self-Insured Plans

Employers offer health coverage to their workers in several ways. Some buy an “off the shelf” plan from a commercial insurance company.

Insured and Self-Insured Plans
Provider Networks

Your plan may contract with doctors, dentists and other healthcare practitioners; hospitals; labs; radiology facilities; pharmacies and other types of providers. These are the providers in your “network”.

Provider Networks
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.

Types of Out-of-Network Reimbursement

Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.

Healthcare Services Not Covered by Health Insurance

You might think your health insurance plan will cover just about anything, from eyeglasses to private nursing. But you would probably be wrong. There are some healthcare services that most health plans don't cover. This guide will tell you about them.

Managing Costs for Day Programs for the Elderly and Disabled Younger Adults

An adult day program is a type of long-term care program you go to during the day. Program costs vary, but most aren’t covered by health insurance.

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