Understanding Insurance

Whether you're managing your own health coverage for the first time, new to the US healthcare system, or you've been managing your own insurance for years, we're here to help! Understanding your coverage is key to getting the most from your benefits.

If you have any questions or need clarification about your DSGHP coverage, the DSGHP staff is available by phone (603-646-9438), email (Dartmouth.Student.Health.Plan@Dartmouth.edu) or a prescheduled in-person appointment. Please call or email the DSGHP Office to speak with a representative or schedule an in-person appointment.

The following are a few common terms and concepts important to understanding your coverage in DSGHP and other US-based health insurance plans.

In-Network / Participating Providers

In-network refers to a health care provider that has a contract with your health plan to provide health care services to its plan members at a pre-negotiated rate. Because of this relationship, you pay a lower cost-sharing when you receive services from an in-network doctor.

Most claims will be submitted directly from the provider to the insurance. You will then receive a bill for your portion, and an Explanation of Benefits (EOB) will be available for your review in your Wellfleet Student Account. The EOB is not a bill.
If a claim is not submitted directly from the provider for any reason, and you are asked to pay at the time of service in full, you are responsible for submitting your claims for reimbursement. DSGHP will reimburse you for charges for covered services, minus any applicable deductible, co-payments, or co-insurance.

Out-of-Network & International Providers

Out-of-network refers to a health care provider who does not have a contract with your health insurance plan. If you use an out-of-network provider, health care services could cost more since the provider doesn't have a pre-negotiated rate with your health plan. Or, depending on your health plan, the health care services may not be covered at all.

If receiving services outside of the network or outside of the United States, you are responsible for submitting your claims for reimbursement. DSGHP will reimburse you for charges for covered services, minus any applicable deductible, co-payments, or co-insurance.

Deductible, Copay, and Coinsurance

Depending on the type of service you are receiving, you may be responsible for a deductible, copay, and/or coinsurance.

Deductible
- The amount you pay for covered health care services before your insurance plan starts to pay.
Copay
- A fixed amount paid by you for covered services.
Coinsurance
- A percentage of the total charge for covered health care paid by you.

Insurance ID Card

You should always carry your insurance ID card with you.

DSGHP ID cards are not automatically mailed to you. You must take action to get your ID card. Download and print your ID card, or request a copy by mail, from your Wellfleet Student Account.

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Understanding Insurance