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Health Insurance

Health Insurance can be confusing. Let’s take it one step at a time and get started with the basics to help you make informed decisions.
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Medical Bills

It can be challenging to understand and manage medical bills. Let’s walk through medical bills and the steps you can take to reduce costs before and after receiving care.
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Employment & Disability

If you are diagnosed with a medical condition that does not allow you to work in the same way as before, there are steps you can take. Let’s explore patient and caregiver protections, options when losing employment, and disability insurance.
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Did you know?
26% of Americans have
avoided care or treatment because
they were unsure of what their
insurance covers.
 
Click to learn how insurance works, how to pick a plan that works for you,
and how to use your insurance. 
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 Americans who appeal a denial of
 coverage from their insurance company, win the
appeal and get coverage for the care
prescribed by their health care team up to
60% of the time.
 
Click to learn tips on using your insurance and how to appeal denials of coverage.
 Learn MoreLoading
Only 40% of Americans say they're
"very confident" with choosing
the right health insurance
plan for them.
 
Click to learn tips on picking a plan that works for you.
 Learn MoreLoading
About half of the people in the U.S.
receive health insurance through
an employer.
 
Click to learn about employer and individual insurance.
 Learn MoreLoading
Receiving medical care and prescription
drugs from in-network health care
providers may save you money.
 
Click to learn about finding in-network health care providers and pharmacies.
 Learn MoreLoading
Some health insurance companies may require
you to get their approval before you
get certain medical care or prescription drugs,
which is often called a
Prior Authorization.
 
Click to learn tips for getting prior authorizations.
 Learn MoreLoading
You can file an exception request
with your health insurance company to
cover a drug that is medically
necessary for you and is not on the list
of drugs covered by your plan.
 
Click to learn about exception requests for prescription drugs and when they might be helful. 
 Learn MoreLoading
Get Answers Have you ever thought...

I have insurance, but I want to understand how to use it better to lower my out-of-pocket costs.

Lowering your out-of-pocket costs starts with knowing how to use your insurance. There are steps that may lower your out-of-pocket costs.  
Click on a topic to learn more: 

How do I pick a Health Insurance plan that works best for me? 

There are 3 questions to ask when picking a health insurance plan: 
  • What will the plan actually cost me? 
  • Are my doctors and other health care providers included in the plan’s network? 
  • Does the plan cover my prescription drugs? 
To learn more about picking a plan that works for you, visit the “Decide Which Plan Works for You” section within " Health Insurance "

My insurance company has denied coverage for my care, and I don’t know what to do. 

  • At some point, your health insurance company may refuse to pay for your medical care or prescription drugs, which is called a denial of coverage. If you disagree with your insurance company’s decision, you can appeal it, and those who do may win their appeal up to 60% of the time and get coverage for their care. 
  • To learn more, review “Appealing Denials of Coverage.”

Are there ways to lower my costs before I get care? 

Yes, there may be ways to lower your costs before you get care, including: 
  • Review your health insurance at least each year to make sure you have coverage that is best for you; and ensure your health care providers have your up-to-date contact and insurance information.  
  • Discuss costs with your health care team before receiving care. 
  • Go to in-network providers when possible 
  • Think of your health care like other goods and services you buy. You can shop around, compare, and even negotiate prices with health care providers.  
  • Keep track of and use your out-of-pocket maximums to your advantage. 
To learn more, review “Ways to Avoid Higher Medical Bills Before Care.” 

I've received a medical bill and can’t afford to pay it. 

If you get a medical bill that you are unable to pay, consider contacting your health care provider to talk about your options. You can often negotiate: 
  • More time to pay the bill
  • A payment plan
  • A lower lump-sum payment 
You may also qualify for financial assistance programs at your health care facility.  
To learn more, review “Negotiating and Paying Medical Bills.”  
Example
On MyHealthcareFinances, you can View, Print, and Share…
  • Interactive Content
  • Launch an interactive learning experience with voice-over and interactivity for you to learn at your own pace.
  • Be Informed Guide
  • Keep important information related to healthcare finances right at your fingertips.
  • Steps to Take Guide
  • Walk through steps to keep in mind for healthcare finance processes to be ready to take action that’s right for you.
  • Conversation Guide
  • Get questions to ask your healthcare providers, pharmacists, and family to spark conversation.
About Us

Our Goal

We believe access to healthcare improves lives. We understand paying for healthcare can be complicated and feel confusing and stressful for anyone.
MyHealthcareFinances is a tool to help you better understand finances related to healthcare and steps you may take to lower your costs. Our goal is to provide an overview of key topics that may be helpful to you and point you in the right direction on where to find more information.  
We hope that you will use what you learn here to work with your health care team, your family, and others who play a role in your healthcare finances. By using this tool, you are taking an important step to empower your path forward.  
We hope that you will use what you learn here to work with your health care team, your family, and others who play a role in your healthcare finances. By using this tool, you are taking an important step to empower your path forward.  

Our Team

MyHealthcareFinances is a collaboration between Pfizer and Triage Health, joining people with a shared passion for improving healthcare-related financial literacy. The development team has decades of experience helping people understand and navigate healthcare and healthcare finance questions. Content shared in this tool was adapted, with permission, from copyrighted content of Triage Health.
We’re in relentless pursuit of breakthroughs that change patients’ lives. We innovate every day to make the world a healthier place. It was Charles Pfizer’s vision at the beginning, and it holds true today.
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Triage Health provides free education on the legal and practical issues related to navigating a chronic or serious medical condition through events, materials, and resources. For more information about Triage Health and the topics discussed in this tool, visit TriageHealth.org. Triage Health is a program of Triage Cancer®.
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EQUITAS Life Sciences was founded on the values of kindness, empowerment, and fearlessness, with the mission of positively impacting global healthcare to improve patient outcomes by engaging with a diversity of people across the world with curiosity, empathy, and genuineness.
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Disclaimer: MyHealthcareFinances is intended to provide general information on the topics presented. It is provided with the understanding that neither Pfizer, nor Triage Cancer, is engaged in rendering any legal, medical, or professional services by its publication or distribution. Although this content was reviewed by a professional, it should not be used as a substitute for professional services. © Triage Cancer & Pfizer Inc. 2026  

Copyright © 2026 Pfizer Inc.
All rights reserved.
PP-UNP-USA-9105

Copyright © 2026 Pfizer Inc. All rights reserved. PP-UNP-USA-9105
remove.svgremove.svg-mobileChanges to Medicare in 2025 will cap your out-of-pocket (OOP) costs for covered Part D Drugs:
  • $2,000 is the total maximum OOP cost you will pay for all your covered Part D drugs in 2025. This includes your yearly deductible.
  • You also have the option to spread your OOP costs out over the course of the year by opting-into the Medicare Prescription Payment Plan.
Medicare Prescription Payment Plan
  • You can opt-in to the Medicare Prescription Payment Plan if you have Part D coverage or a Medicare Advantage Plan with prescription drug coverage.
  • Participation is voluntary and you must opt-into the program in order to participate.

Example

Opt-in during open enrollment or anytime during the plan year

Example

No payment required at pharmacy

Example

Receive monthly bills from your Part D plan
How to Opt-in
  • You can opt-in by contacting your plan directly, either by phone, paper request, or online.
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