Cost of Care

Health insurance will pay for many of your health services, but not all of them.

• Begin by contacting your insurance company to understand your insurance policy’s deductible, co-payment, coinsurance, and maximum out-of-pocket levels.
• To avoid out-of-network penalties, check to see if you are required to use hospitals that are in your insurance company’s network.
• In addition, ask if you need to obtain pre-certification or referral approvals prior to your hospital service. This will help you avoid your policy’s penalties and additional amounts owed when the required approval is not obtained.
• Some insurance companies negotiate discounts with hospitals on behalf of the patients they insure. The discounts will vary among insurance companies, and are not reflected in the charge list.

Medicare will pay for many of your health services, but not all of them. Medicare does not pay hospitals based on charges, but instead pays according to pre-established rates depending on the services you receive. Your Medicare deductibles and coinsurance are also pre-established based on the services you receive.

• If you have a Medicare supplemental insurance policy, it may pay all or a portion of your Medicare deductibles and coinsurance.
• Special rules apply if you or your spouse has health insurance coverage through your employer.
• Special rules also apply if you have coverage through a Medicare Managed Care plan. Contact your Medicare Managed Care plan to understand your deductible, co-payment, coinsurance, and maximum out-of-pocket levels. To avoid out-of-network penalties, check to see if you are required to use hospitals that are in the Medicare Managed Care plan’s network.
• You can contact Medicare at www.medicare.gov.

Medicaid will pay for many of your health services, but not all of them. Medicaid does not pay hospitals based on charges, but instead pays according to pre-established rates depending on the services you receive.

• A few services have minimal pre-established co-pays that are your responsibility to pay. Co-pays will not apply if you are in a Medicaid Managed Care Plan.

If you have a financial need, a variety of financial assistance options are available that may help pay all or a portion of your hospital charges. In some cases, you will be asked to provide income and other asset information to determine whether or not you qualify for full or partial financial assistance.

• To obtain more information, please call Customer Service at (785) 354-6130. If you are located outside of the Topeka area, call (866) 327-3475.