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Health Plans 101

How Health Insurance Works

Health insurance is very important to protect your family in the event of an accident or unexpected illness.

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 your premium to the insurance company 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, and 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 Out-of-Pocket Costs

Determine costs you may incur prior to receiving health care services using the Determination of Benefits Form, which can be found on MyChart. 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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What Is a Claim?

A claim is a detailed invoice sent to Quartz seeking payment for covered health care services. This invoice shows exactly what services you received.

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Understanding Health Care Expenses

Here’s help to understand common health care coverage buzz words

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