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Things to Know (when
Looking at Health Care Charges)
If You Have Commercial
Insurance:
-
Commercial insurers
negotiate discounts with hospitals on behalf of the patients
they represent. The discounts vary among insurers.
-
Numerous factors, such
as type of plan, co-pay, co-insurance, deductible,
out-of-pocket maximums and other limitations will also
affect your financial responsibility to a hospital.
-
Begin by contacting
your insurance company to understand all of the factors
affecting your financial responsibility.
If You Have Medicare:
-
Medicare has a set fee
schedule that represents a discount from hospital billed
charges.
-
Medicare will pay for
many of your health care expenses but not all of them.
-
Special rules apply if
you have employer group health insurance coverage through
your own job or a spouse's job.
-
If you have a
supplemental insurance policy, it may cover some costs
Medicare does not cover.
If You Have Medicaid:
-
Medicaid pays hospitals
in accordance with a set fee schedule that represents a
discount from hospital billed charges.
-
Generally, Medicaid
recipients are not responsible for any portion of the bill.
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