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
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
How Medical Supplies and Ambulance Rides are Billed

Medical supplies and equipment, such as bandages and wheelchairs, and ambulance rides are often listed separately on bills and Explanation of Benefits (EOB) forms.

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.

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.

Help for Caregivers

Are you caring long-term for a sick or disabled family member or friend? If so, you may sometimes feel alone and overwhelmed. Luckily, there are resources to help you.

Menu