Information about Charges
We know that paying for healthcare is a big concern for many and we are committed to providing you with as much information as possible so you can make informed decisions about your care, knowing in advance, what to expect in terms of cost.
Your out-of-pocket costs may depend on several factors including:
- the services or procedures you receive,
- your insurance provider,
- your specific health benefits policy including expenses such as your deductible, co-insurance, co-payment and the limit of out-of-pocket expense requirements,
- your eligibility for financial assistance.
Our staff can assist you with determining your out-of-pocket expenses using price estimation tools available via MyChart or via phone at 914-709-3069. For more detailed information regarding charges or your estimated out-of-pocket expense for any procedure, we recommend that you contact one of our staff members who can assist you further by providing a comprehensive estimate based on your insurance and benefits information and/or your personal financial situation.
Hospital and Professional Charges
For services provided at Montefiore, you will receive separate bills for professional charges from providers such as anesthesiologists, pathologists, oncologists or other specialists who have contributed to your care. You will also receive a separate bill for hospital charges. These charges include the cost of providing all other aspects of your care which are billed separately from professional services such as hospital stay, support staff, supplies, and medications. In addition, if your care was provided by a doctor who is affiliated with Montefiore, but also has a private practice, you may also receive separate bills from this doctor as is typical billing practice.
What are these standard charges and how do they impact you?
Charges are the dollar amount a provider sets for services provided before negotiating any discounts. The charge is different from the amount paid. Patients covered by Medicare, Medicaid, Commercial insurance plans, and uninsured patients who qualify for financial assistance never pay full charges. For patients who do not qualify for financial assistance, but are uninsured, we also offer steeply discounted prices.
We want to let you know that a new rule requires hospitals to maintain and make available a list of their standard charges for items and services provided. These standard charges do not reflect or represent how much you will have to pay, nor do they reflect the actual payment a hospital will receive for those items and services. You may obtain this list of charges here.
Hospitals are also required to post average charges for inpatient admissions grouped by the federal diagnosis related groups (DRGs). You can access this list here.
At Montefiore we are committed to helping people understand the best options available to pay for their medical care. Our staff can help you understand what is covered by your specific health insurance benefits policy, expenses such as deductibles, so-insurance, co-payment and out-of-pocket expense limits. In addition, if you do not have insurance, we can assist you with determining your eligibility for free or low-cost insurance, as well as governmental assistance. Our financial services counselors can also help assess if you may qualify for financial assistance. You can learn more here.
Participating Insurance Plans
A list of insurance plans participating with Montefiore is provided for you here. Please note that some providers who may be involved in your care may not participate in the same insurance plans covering care at Montefiore. Therefore, we recommend you check with the physician arranging for hospital services to determine if the physician participates in a plan that covers your care. A list of physicians who provide services at Montefiore facilities is available for you here.