Topic:

How Health Plans Work

There are many moving parts to a health plan. Here you can learn the basics⁠—from enrollment periods and explanations of benefits, to plan costs and prior authorization.

Featured Articles

A doctor consults with a parent and baby

How Health Insurance Works

Health insurance is a legal agreement between you and a health insurance company. That agreement includes...

a child receives a dental exam

How Dental Insurance Works

Dental insurance provides benefits that can help protect you from the high cost of dental care. Find out how they work and what they cover...

A pharmacist consults with a patient

What is Prior Authorization?

Learn more about prior authorization, the process to get pre-approval, and the impact of the No Surprises Act...

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How Does Health Insurance Work?

Health insurance is a legal agreement between you and a health insurance company. That agreement includes...

Family Health Insurance Deductibles

We’ll help you understand how deductibles work in family health insurance plans.

Copays, Deductibles, and Coinsurance

Copays, deductibles, and coinsurance let you know when and how much you may need to pay for your health care...

What is Inpatient vs. Outpatient Care?

The terms “inpatient” and “outpatient” have very different meanings. Knowing the difference between inpatient vs. outpatient care can help you manage your health care.

What is an Out-of-Pocket Maximum?

An out-of-pocket maximum is a cap, or limit, on the amount of money you have to pay for covered health care services in a plan year...

What is a Health Insurance Premium?

A health insurance premium is a monthly fee you pay each month for having health insurance coverage.

What is a Pre-Existing Condition?

A medical illness or injury that you have before you start a new health care plan may be considered a “pre-existing condition.” Conditions like...

Do You Need Health Insurance?

Having health insurance can help you manage your health care needs, as well as costs. There are health plans for...

What is an Explanation of Benefits (EOB)?

Knowing how to read an EOB can help you understand your health insurance plan and medical costs.

What is Prior Authorization?

Learn more about prior authorization, the process to get pre-approval, and the impact of the No Surprises Act.

In-Network vs. Out-of-Network Providers

You can avoid unexpected medical bills by knowing how your plan works. Certain choices you make can affect what you'll pay...

Generic vs. Brand Name Drugs

When it comes to generic vs. brand name drugs, the main difference is...

Health Care Reform Facts: Purchasing Your Own Coverage

Health care is a hot topic. Changing health care to make it better, more affordable, and within reach of more people is even...

Health Insurance Open Enrollment and Special Enrollment

There are certain times during the year when you can buy a health plan directly through Cigna Healthcare or on the Health Insurance Marketplace. These periods of time...

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Videos

VIDEO

What’s Coinsurance and How Does It Work?

Watch this short video to learn how coinsurance, copays, and deductibles work in an individual health care plan. (Length: 00:01:46)

VIDEO

Your Individual Deductible

This short video explains how an individual health insurance plan works and what it may cover. (Length: 00:01:44)

This information is for educational purposes only. It is not medical advice. Always consult your doctor for appropriate examinations, treatment, testing, and care recommendations.