Insurance Basics: Home
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
The Affordable Care Act (ACA) of 2010 makes it easier for many Americans to get health insurance. It also expands the services that health plans need to cover.
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.
Your plan´s rules and costs may differ for some types of care. Knowing these rules can help you control your costs and get the right care in the right setting.
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.
Since providers are able to decide how much to charge for out-of-network care, sometimes that charge might be higher than you expected.