Insurance Basics: Home
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.
After you visit a provider, you may get a bill telling you how much you have to pay.
Your plan may contract with doctors, dentists and other healthcare practitioners; hospitals; labs; radiology facilities; pharmacies and other types of providers. These are the providers in your “network”.
Most health plans don´t cover treatments they regard as “experimental”. Sometimes, they may deny a claim for such a treatment.
Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.
Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.