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How Health Insurance Works

Health insurance is very important to protect your family in the event of an accident or unexpected illness.
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Health insurance is a way to reduce your health care expenses. Health insurers negotiate lower prices with health care providers and pass on the discounts to their members. They also pool money from their members and then help pay for health care expenses when members get sick.

Health insurance works when a large number of people become members of a group and agree to make monthly payments (premiums). The monthly payments allow members access to money that can be used to pay for health care.

Members can be part of an employer group or purchase insurance on an individual basis, directly from the insurer. If you have a job, your employer may pay part of your premium. Your part of the premium is usually deducted from each paycheck. If you are self-employed or have individual insurance, you pay the insurance company premiums directly.

Insurance companies offer different health plans. The benefits offered by each plan can vary. Sometimes you have to go to certain doctors or clinics. Sometimes you share the cost of medications with the insurer, sometimes the insurer covers the full expense. It is very important to know what services your plan covers and the amount the insurer will pay for services. You can access your benefits and learn more about your specific plan through MyChart.

Estimate Your Out-of-Pocket Costs

Determine costs you may incur prior to receiving health care services using the Determination of Benefits Form. To complete the form, you will have to ask your provider for medical coding information, including procedure codes, procedure modifiers and unit codes for the services.


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