Insurance Basics: Home
Regular dental care is important for all people, but especially for children. The Affordable Care Act (ACA) requires federal and state-run health insurance exchanges to offer children´s dental coverage.
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.
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.
Most health plans don´t cover treatments they regard as “experimental”. Sometimes, they may deny a claim for such a treatment.
A medical home is a type of doctor´s practice that uses a team to focus on the “whole person”. It is sometimes called a patient-centered medical home (PCMH).
Most health plans have a “network”, a group of doctors, hospitals and other healthcare providers who agree to take your insurer´s rate.