Financial Assistance
It is important to identify and understand financial assistance that may be available in your area to help pay premiums, out-of-pocket expenses, or prescription costs. Most people with health insurance do not pay for most preventive care services; however, there are often costs for diagnostic care, hospital care, emergency care, and prescription drugs, including copays, coinsurance, and deductibles. Much of the cost sharing for routine care is generally manageable with most health insurance plans, but expenses can be significantly higher for emergency room visits, hospital stays, or major diagnostic services.
When cost sharing becomes due for more expensive care, such as major diagnostics or hospital services, be sure to review fair member pricing and explore financial assistance options before making payments. There are tools available to help estimate your costs in advance of services, and there are financial assistance programs that may help if you qualify. Below are updated ideas that may help you save money on premiums or out-of-pocket expenses:
- Check and apply for financial assistance before paying hospital bills, and before you make payment arrangements. If you are within 300% of the federal poverty level, hospitals may write-off your medical bills as charity care. If you are within 400% of the federal poverty level, then hospitals may help with some of your medical bills. Calculate your % of federal poverty level here
- See the Hospital specific applications below
- Understand how your benefit programs work and read your benefit summaries
- Use Preferred Providers whenever possible
- Use Preferred “National Providers” when out of your carriers immediate service area. Check for health plan national networks here
- Make sure all providers have your complete current insurance carrier information
- Check your bills carefully, and review all of your Explanation of Benefit reports
- Negotiate final bills directly with hospitals, providers and diagnostic providers whenever possible
- Check for eligibility for the Advanced Premium Tax Credit here
- Employers may be eligible for the Small Business Health Care Tax Credit. Check here
- Payment arrangements are usually available. Try all financial assistance options first. If you make payment arrangements, and then find out later that you may have qualified for relief, you may be asked to stay with your original payment arrangement.
- Understand the appeal process. If you find charges greater than what you see on www.healthcarebluebook.com, then you can inquire at the plan
- Keep your paperwork together and take notes. Write down the names of the people you talk with and their phone numbers.
- Do not delay responding to medical bills, because medical providers will send bills to collections. Additional relief may be available due to the virus.
- Make sure to get pre-determination for medical or dental treatments whenever possible
- Discuss scheduled surgeries or complex medical treatments with your insurance carrier prior to service
- Healthcare BlueBook. This site provides the approximate member cost for in-network services
- Health Savings Account Health Plans allow consumers to pay for qualified medical expenses tax-free. Read more here
- Contact us if you need assistance