You don't share the cost with your employer. Some plans work with certain health care providers and facilities to provide care at lower costs. The providers are part of the plan's network. This is called managed care. There are many kinds of managed care plans:. Indemnity fee-for-service plans are not the same as managed care plans. The choice of doctors or hospitals you can use is not restricted.
Your provider is paid a fee each time you get care covered by the plan. When you choose a health insurance plan, carefully read the plan's rules and policies. Find out the cost of the plan the premium. What medical services are covered? How do the payments work? And how much choice will you have when you choose providers and hospitals? Ask for a summary of the plan's benefits. Read the plan's brochure closely before you sign up. Ask questions about parts you don't understand.
It may be helpful to know these terms:. It's a good idea to talk to your doctor's office. They can tell you which health plans are accepted and how the payments work. It's also a good idea to talk to your health insurance company before you have a planned surgery or procedure so you can be sure it's covered under your plan. In an emergency, get the care you need right away. It's a good idea to contact your doctor's office to find out which health plans are accepted and how the payments work. Find out how your insurance covers medicine costs.
In general, you'll pay less for generic medicines than for brand-name medicines. Some insurance companies require prior authorization from your doctor before they'll help you pay for a medicine. For instance, this may be the case if you'd prefer to take a brand-name medicine over a generic one in the same class of drugs. With some plans, you may have to pay more for medicines that aren't on the plan's list of preferred medicines formulary. Some insurers cover medicines that are bought only at certain pharmacies.
A formulary may put drugs into three groups, or "tiers," based on how much your health plan will pay and how much you will have to pay. If you have a choice between plans, check what your co-pay for prescription drugs will be, the maximum amount the plan will pay in a year, and other details. You can learn about the Affordable Care Act and how to get health insurance at www. This may help you choose which plan is best for you.
Find out more at www. When you are choosing a health insurance plan, think about questions you want to ask. For example:. After you get a health insurance plan, keep your insurance card with you. Save your insurance company's phone number in your phone's memory so that you have it available. Many plans require you to contact your insurance company before having an elective procedure, such as a surgery or certain medical tests, or for a hospital stay.
If you have a medical emergency, get help for the problem first. After the emergency is taken care of, contact your insurance company as soon as you can. It provides a health insurance marketplace that allows people to compare health plans, look for a plan that fits their needs, and find out if they may qualify for lower costs. It also sets guidelines for insurance companies, including rules about cost increases, coverage for preexisting conditions, and requirements for certain kinds of coverage, such as preventive care.
The ACA works in partnership with individual states. Parts of it may vary from state to state. Be sure to find out the options for health coverage in your state. You can learn more about the Affordable Care Act at www. Federally funded health centers provide medical and dental care for people who don't have health insurance. Health centers may offer services such as checkups, pregnancy care, immunizations for children, and other medical treatment.
The amount you pay for care depends on your income. Many states offer programs that help people get health insurance. Medicaid provides health coverage for certain families or individuals who are eligible.
The Children's Health Insurance Program CHIP provides low-cost insurance for children whose families don't qualify for Medicaid coverage but cannot afford private insurance. There are also ways to get help with medicine costs. Find out whether the drug company that makes your medicine has a patient-assistance program.
Some companies offer free or discounted drugs for people who cannot afford them. Find more resources and information for the uninsured at:. Author: Healthwise Staff. In person. More simple ways to get care in the moment. E-visit Fill out a short questionnaire about your symptoms online and get personalized self-care advice from a Kaiser Permanente health care professional.
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Read articles. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Find out if you're eligible. If certain requirements are met, you may qualify for Medicaid. You may be eligible for our special Medicare plans designed just for federal employees — current or retired.
Learn more about Medicare for federal employees. Our Kaiser Permanente health plans provide quality care from a connected team that includes your doctor, specialists, and pharmacists, working together for you. All of our available doctors welcome our Medicare health plan members — and you can change to another available Kaiser Permanente doctor at any time, for any reason. Language assistance Nondiscrimination notice.
Choose from options to meet your budget, lifestyle, and health needs. Get access to our wide network of doctors, hospitals, pharmacies, and labs. And manage your health online with tools that help you get and stay healthy. Explore federal employee plans. Our employee plans offer affordable, quality care with access to our wide network of doctors, hospitals, pharmacies, and labs. You can learn more about the types of plans we offer , or get complete information about plan options from your company's benefits administrator.
In the meantime, find out what makes Kaiser Permanente a great choice and see what it's like to be a member. We are unable to switch you to this area of care. Which plan is for me?
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