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THINGS TO KNOW (when looking at healthcare charges)
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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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