Insurance Basics: Home

Preventive Care and Wellness Services: Coverage and Costs

Preventive services, such as vaccines and screenings, can help you avoid certain diseases and catch others in their early stages, to limit the harm they can cause.

Preventive Care and Wellness Services: Coverage and Costs
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.

Help with Insurance Issues

Being covered under two health plans doesn't mean the two plans will pay the same amount twice for the same doctor visit. Instead, the plans follow rules about which plan pays what, known as "coordination of benefits."

Getting Covered for Alternative Medicine

Acupuncture, chiropractic care and massage therapy have one thing in common: They may not be covered by insurance. That’s because they may be looked at as alternative treatments, not part of conventional medical care.