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CHA helps man with disabilities get to dialysis treatment on time.

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The medical transportation service arranged by Rafael’s insurance was always late, causing him to miss three consecutive dialysis appointments. His CHA Advocate found a reliable in-network transportation service for his future appointments and made sure that the new transportation service started immediately and continued three days a week thereafter.

“Before Urban Health Plan, I had no one who could help me. Now I know I have somebody I can rely on. I was scared that I would miss my dialysis appointments because it is dangerous for me to go without transportation assistance. I am so grateful.” —Rafael Roa, Bronx, NY

How do I use my health insurance?

Health insurance gives you better access to medical services, can improve your health, and protects you from paying high out-of-pocket costs when you get sick. This section is meant to help you understand how to use your health plan by explaining your plan’s rules for accessing care and your rights and responsibilities as an enrollee.

Health Insurance Basics

The first thing you need to know are some key terms related to health insurance. Examples of key terms include: Explanation of Benefits (EOB); in-network provider; out-of-pocket cost; formulary, etc. These and other terms are defined to help you understand your health plan’s rules. For more information on key terms and their definitions, click here.

Secondly, it is important that you know what type of managed care plan you have because this will help you get access to the care you need. For example, it tells you if you can see doctors that are outside of your health plan’s network or if you need a referral to see a specialist. If you don’t know what type of managed care plan you have, look on your insurance card, contact your health plan, or contact your employer (if your plan is employer-based). For more information on the different types of managed care plans, click here.

You should also know that you have rights as an enrollee. If your plan refuses to cover a service, you have the right to appeal the service denial, but you have a limited amount of time to do so. For more information on how to fight an insurance denial, click here.

Finally, if you have already been through the appeals process and you need help with a medical bill, you have options for how to handle the bill. For more information on how to dispute a medical bill, click here.

If you need assistance understanding your health plan’s rules or accessing care, please contact CHA at 888-614-5400.

 

CHA can help answer your healthcare questions.

  • Call our helpline at (888) 614-5400 Monday to Friday, 9am to 4pm,
  • or email cha@cssny.org.

Healthcare Q&A

Read short articles that answer frequently asked questions about healthcare and insurance. Find out how CHA has helped others, and can help you. Choose a topic: