Insurance Basics: Home

Getting Covered

There are three main sources of health coverage. The first is your job. The second is a plan that you buy. The third is a government program for older, disabled or low-income

Getting Covered
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
Cost Sharing

Health insurance protects you from paying the full cost of your care. But, you will likely still have to pay some money out of your pocket. Almost all plans call for “cost sharing”. That means your insurer pays for part of your care, and you pay for part.

Dental Plans

Most medical plans do not include coverage for many dental services. Often, dental services are covered under a separate plan. Like medical plans, most dental plans have specific out-of-pocket costs, like coinsurance, copayments and deductibles.

Having More Than One Health Plan

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."

Managing Costs for Day Programs for the Elderly and Disabled Younger Adults

An adult day program is a type of long-term care program you go to during the day. Program costs vary, but most aren’t covered by health insurance.

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