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Medical Decisions

Understanding Your Health Insurance: Coverage, Costs, and Claims

Health insurance can be confusing. Here's what you need to understand.

January 9, 2026
1 min read
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Understanding your health insurance helps you make better healthcare decisions.

Types of Plans

HMO, PPO, EPO, and HDHP plans have different coverage and costs.

Deductibles and Copays

Your deductible is what you pay before insurance. Copays are fixed amounts per visit.

Out-of-Pocket Maximum

Your maximum out-of-pocket cost is the most you'll pay in a year.

In-Network vs. Out-of-Network

Using in-network providers costs less than out-of-network.

Prior Authorization

Some treatments require approval from your insurance company before you receive them.

Filing Claims

Keep records of medical visits and bills. File claims promptly.

Appealing Denials

If your insurance denies coverage, you can appeal the decision.

Understanding Your Explanation of Benefits

Your EOB shows what your insurance paid and what you owe.

Use the End of Life Playbook to understand your healthcare options.

Ready to Start Your Playbook?

Turn these insights into action with our step-by-step playbook builder.