Health Insurance

Understand your plan, use preventive benefits, and navigate claims with confidence.

Health insurance guidance

Coverage Basics

Key terms to help you choose and use your plan.

Networks

HMO, PPO, and EPO differ in referrals, flexibility, and costs.

Out‑of‑Pocket

Understand deductibles, copays, coinsurance, and annual maximums.

Prior Auth

Know when approvals are required and how to avoid delays.

Maximize Benefits

Use covered services to protect health and reduce costs.

Preventive Care

Annual wellness visits, vaccines, and screenings are often fully covered.

  • Age‑appropriate screenings
  • Immunizations
  • Health counseling

Chronic Care

Disease management programs, remote monitoring, and telehealth support.

  • Care coordination
  • Medication management
  • Virtual follow‑ups

Claims & Appeals

Step‑by‑step guidance to resolve issues quickly.

1

Verify

Check EOBs and plan documents.

2

Call

Contact member services for clarification.

3

Appeal

Submit documentation and provider notes.

4

Follow Up

Track timelines and escalation paths.

Need Help With Your Plan?

We’ll review your benefits and map the best routes to care.

Plan Types

Know the trade‑offs to pick the right fit.

HMO

Lower cost, referrals required; care coordinated through a PCP.

PPO

More flexibility, higher costs; out‑of‑network options available.

EPO

No referrals, limited network; good balance for many.

Cost‑Saving Tips

Use benefits to reduce out‑of‑pocket spending.

In‑Network Care

Confirm provider network to avoid higher out‑of‑network bills.

Preventive Benefits

Vaccines and many screenings are fully covered—use them.

Frequently Asked Questions

Insurance basics in plain language.

What is an EOB?

A statement explaining what your plan paid and what you owe.

When is prior auth needed?

For certain tests, procedures, or meds—check your plan first.

How do I appeal?

Submit documentation and provider notes; track timelines.