Insurance Basics: Home

Explanation of Benefits (EOB)

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).

Explanation of Benefits (EOB)
How to Deal with COVID-19 Medical Costs

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.

How to Deal with COVID-19 Medical Costs
Code Modifiers: How they Affect You

Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.

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.

When Out-of-Network Care Can be Covered In Network

Receiving care from a provider in your health plan´s network usually costs you much less than going to an out-of-network provider.

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