Managing your Cost / Don't Overpay!
An Explanation of Benefits (EOB) is a statement that your insurance company sends that summarizes the costs of the health care services you received. This is not a bill. An EOB shows how much your health care provider is charging your insurance company and how much you may be responsible for paying. Closely review your EOB to make sure that it includes only services that you received and that the amount you owe is consistent with your health insurance benefits.
If there are services on your…
Getting Health Insurance / Getting health insurance coverage
Health insurance plans are complicated; and, that can make it difficult to decide which one to choose. To really understand what you’re buying you need to step back and look at the whole plan as a package, adding up the pros and cons.
Look at the total cost
Looking only the monthly premium cost will not give you a good picture of what a health plan will cost you, unless you do not expect to use it. The premium is only part of what you will pay. Learn more.
How much the plan requires you to…
Getting Health Insurance / Your options and why you need coverage
As you are look at your insurance options, you may notice different types of health plans. What do all those initials mean?
Getting Health Insurance / Your options and why you need coverage
Health insurance will help you pay for health care, and protect you financially in the case of illness or injury.
Financial protection in case of medical emergencies
Medical emergencies, like serious injuries from a fall or a heart attack, can be very expensive. Fixing a broken limb, emergency surgeries, or spending a night in the hospital can cost thousands of dollars. These costs can lead to significant debt or even bankruptcy without health insurance.
Preventive care
With health…
Managing your Cost / Don't Overpay!
Most of the time, you will pay something when you receive medical care. When you and you insurance company each pay part of the cost, it is known as “Cost Sharing”. There are a number of different types of cost sharing, and sometimes you’ll pay more than one for a particular service:Deductible
The deductible is the amount you will pay each year (or policy period) for most health care services before your insurance company begins to share the costs.
For example, if your deductible is $500, you…
Navigating the System / Prescription drugs
How much you will pay depends on where you fill your prescription, what “tier” your plan puts that drug in, and how your plan works.
Which pharmacy you use makes a difference
Learn where you can fill your prescription and where you’ll get the best deal:
Most plans require you to use in-network pharmacies. Other plans allow you to use out-of-network pharmacies, but you’ll likely pay more.
Some plans require you to use mail-order for medications you take regularly. Others don’t require mail…
Navigating the System / Prescription drugs
Price
The main difference between generic drugs and their brand-name counterparts is that generic drugs are typically much less expensive.
Generic drugs are just as effective as brand-name drugs
According to the Food and Drug Administration (FDA), generic drugs work the same as brand-name drugs. Learn more.
A generic version of a brand-name drug will have:
The same active ingredient (the drug listed on the label)
The same strength
The same use indications
The same form (such as a…
Getting Health Insurance / Getting health insurance coverage
Medicare supplemental insurance
Insurance companies sell individual Medicare supplement insurance policies that help pay some of the costs that you would otherwise have to pay yourself under original Medicare, such as co-payments, co-insurance, and deductibles. This kind of policy is also known as a Medigap policy because it fills in the gaps in traditional Medicare coverage. You will want to check the supplement plan benefits to understand what is covered, as each plan can be different but…
Managing your Cost / Can't Afford Care
There are a number of organizations in New Hampshire that can help you get health care regardless of your ability to pay, or help you find a health plan that is affordable. Get started by visiting the links below:
Community health centers and low-cost care:
https://bistatepca.org/centers/
https://healthynh.org/initiatives/access-to-care/nh-health-access-network/
Help paying for prescriptions:
https://healthynh.org/initiatives/access-to-care/medication-bridge/
Children’s medical assistance…
Navigating the System / Getting care, what's covered
Hospitals in a network vary by carrier and by specific plan.
For the 2022 plan year, you can review the networks for individual health insurance products here:
Navigating the System / Prescription drugs
Check the formulary
The list of covered generic and brand name drugs (known as the formulary) is different from plan to plan.
Find out which “tier” your prescription is in. Something to watch for is which group or “tier” your medications belong to on that particular formulary. A lower tier means that you will pay less, and a higher tier you will pay more. The tier can make a big difference in how much you pay when you fill your prescription. Learn more about how prescription drug cost…
Managing your Cost / Don't Overpay!
Each insurance company negotiates discounted rates
Health insurance companies rarely pay the full charge for a service; instead, they negotiate the price they will pay for health care services ahead of time. Each insurance company negotiates with health care providers to establish the discounted prices that their members will pay to receive care and services.
So, when you’re choosing a plan you may want to use the Health Costs section of this site to do some comparisons of sample services to…