Understand how much you will be expected to pay before receiving hospital care

If you have health insurance:

Contact your insurer.

• Explain what is to be done, when it will be done, and by whom (hospital/physician).
• Confirm that the procedure and the provider will be covered.
• Ask if there are any limitations to the coverage.
• Ask what the expected out-of-pocket costs will be.
• Ask if the out-of-pocket costs would be less if a different hospital/physician was involved.

The AZ Hospital Choice Web site provides information on billed charges for all types of inpatient care and selected outpatient services. However, lower hospital charges may not necessarily mean that you will pay less out of your pocket. That is why it is important for you to contact your insurer.

Many commercial insurance companies or employer self-funded plans require enrollees to seek care exclusively from a specific group of hospitals and physicians under contract with the insurer or employer in order for the service to be covered. The group of hospitals and physicians is often called a “network.”

Other insurers and employers will cover the services of hospitals/physicians that are not in the network, but require the patient to pay a higher percentage of the cost if they use the services of non-network providers.

If you are required to use the services of physicians who are in your insurer’s network to receive the highest level of coverage, ask your insurer to provide the names of the anesthesiologists, pathologists and radiologists in the network who provide services at the hospital. These are types of physicians who may provide services related to your inpatient stay or other hospital service, but it’s possible you may never interact personally with them. As with surgeons, they are often not employees of the hospital and therefore their services will probably be billed separately. If they are not part of the insurer’s network, you may be responsible for a larger portion of their fee or the entire fee.

If you do not have health insurance:

Contact the hospital and ask about its payment policies. Hospitals have charity care policies that offer partial or total fee reductions, or payment plans, to patients who have a financial need. However, hospitals expect that patients will cooperate in the eligibility determination process.