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.
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.
Whatever age you are when you retire, you have health insurance options.
Since providers are able to decide how much to charge for out-of-network care, sometimes that charge might be higher than you expected.
Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.