Insurance Basics: Your Costs

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.

Cost Sharing
Planning Your Costs Based on Where You Get Care

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.

Planning Your Costs Based on Where You Get Care
Flexible Spending Plans

Flexible spending plans let you set aside money from your paycheck. You can use it to pay for care before meeting your deductible, and for copays and coinsurance afterward.

Health Insurance ID Cards

Your health insurance ID card is your proof of insurance. You use it when you visit the doctor, hospital or other provider.

Provider Networks

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”.

Preventive Care and Wellness Services: Coverage and Costs

Preventive services, such as vaccines and screenings, can help you avoid certain diseases and catch others in their early stages, to limit the harm they can cause.

Negotiating Your Costs

Since providers are able to decide how much to charge for out-of-network care, sometimes that charge might be higher than you expected.

Managing Costs for Chronic Conditions

If you´ve been diagnosed with a chronic condition, this article will give you some guidelines to help manage your care and costs. In it you will learn how you can get help to:

Shared Decision-Making

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”.

Help for Caregivers

Are you caring long-term for a sick or disabled family member or friend? If so, you may sometimes feel alone and overwhelmed. Luckily, there are resources to help you.

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.

Types of Out-of-Network Reimbursement

Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.

Finding Treatment for Opioid Use Disorder

If you or someone close to you has opioid use disorder, also called opioid addiction, you aren’t alone. The United States is in the middle of an opioid crisis. Find out about how you can afford treatment—no matter what your income level is—and about resources for support.

Using Health Insurance While Traveling

If you’re planning a trip, the last thing you may want to think of is healthcare. But accidents and illnesses can happen on the road as well as at home. Here are the basics on using health insurance while traveling.

Getting Covered for Alternative Medicine

Acupuncture, chiropractic care and massage therapy have one thing in common: They may not be covered by insurance. That’s because they may be looked at as alternative treatments, not part of conventional medical care.

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