Insurance Basics: Home
We often rely on our doctors to tell us what care we need. But to get the best care, you and your doctor should make decisions together. This process is called “shared decision making”.
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).
Thanks to a law passed in the spring of 2020, most Americans can be tested for COVID-19 for free. But that law didn’t make treatment for the virus free. Medical services for COVID-19 can be costly and sometimes run into tens of thousands of dollars. Whether or not you’ve been diagnosed with COVID-19, you can take steps now to understand your protections under the law and manage the costs of your treatment.
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.
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.
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.