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).
Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.
Employers offer health coverage to their workers in several ways. Some buy an “off the shelf” plan from a commercial insurance company.
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”.
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.
Sometimes you know ahead of time that a major event will happen in your life. Examples might include getting married or divorced, changing jobs or having a baby. Other times, such as at a death, you may not have advance warning.