Insurance Basics: Home

Protections for New York Consumers: Understanding Your Out-of-Pocket Costs

By law, consumers living in New York State have certain protections when shopping for and using their health insurance. Your insurer must provide up-to-date information about who is in your network.

Protections for New York Consumers: Understanding Your Out-of-Pocket 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
How Medical Supplies and Ambulance Rides are Billed

Medical supplies and equipment, such as bandages and wheelchairs, and ambulance rides are often listed separately on bills and Explanation of Benefits (EOB) forms.

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.

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 of Long-Term Care

Long-term care is medical and nonmedical care that you receive for an extended period of time, at home, in your community or in a residential facility. This article will tell you how to manage the costs of long-term care. This article does not provide medical, financial or legal advice.

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IN AND OUT OF NETWORK

When Out-of-Network Care Can Be Covered in Network
PLAN COSTS

Flexible Spending Plans
YOUR RIGHTS

Appealing a Reimbursement Decision
KNOW BEFORE YOU GO

Choosing Your Healthcare Provider In-Network and Out-of-Network Care