Health Insurance

10 Keep track of your bills. • Keeping track of your bills helps you protect yourself from fraud. • You may get something in the mail that says, “This is not a bill.” It may be called an Explanation of Benefits (EOB). You should not pay it. • If you do not understand a bill, call the people who sent it to you. You have a right to get an explanation. • If you think the bill is wrong, call your health insurance company. You can file a complaint or appeal if you disagree with the bill. See pages 28–29. • If you have two insurance policies, usually one policy pays first. Talk to your insurance companies to make sure you understand what to do with your bills. How much will I have to pay? It can be hard to know how much you may owe. Call your insurance company and ask for an estimate before you get a costly service. Ask if you can compare the costs of different providers online. Sometimes we have to make health care decisions without the best cost and quality information. Now you can use our California Healthcare Compare website, www. cahealthcarecompare.org to compare cost and quality for common services like knee replacements, diabetes treatment, and childbirth. In addition to asking your insurer, this tool can help you compare providers. The Allowed Amount Some policies have a limit on what they will pay for a service. This is called the “allowed amount” or “negotiated rate.” If your provider charges more, you may get a bill for the extra amount. This is called balance billing. A provider that is not in your PPO network may bill you for charges over the allowed amount. Learn about PPOs on page 18. However, a provider in your PPO’s network can only bill you for your deductible, co-pay and/or co-insurance.