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).
Your plan may have different rules and costs for different healthcare settings. In any setting, you may have to pay a copay, and in some cases, coinsurance. But, these may be waived for preventive services like flu shots and mammograms.
An Accountable Care Organization (ACO) is a group of doctors or hospitals who have agreed to work together to coordinate and improve their patients´ care
NY State of Health is New York´s official online healthcare Marketplace. Individuals, families and small business owners in New York can use NY State of Health to compare health plans, and join the one that best meets their needs.
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.
Health insurance is important. It protects you against what can be the very high costs of healthcare. But, to get health insurance, you need to enroll, or sign up. And, in most cases, you can’t enroll in a health plan any time you want. You have to do it during certain times.