Why does my insurance company not pay the full cost?
Your insurance plan may have a deductible, coinsurance, or a flat copayment amount which you are required to pay. These amounts are also known as Patient Responsibility.
Deductible: A predetermined amount of money for covered services which the patient is responsible for before your health plan begins paying.
Coinsurance: A percentage of costs for covered services that is the liability of the patient.
Copayment: A set dollar amount you pay for every covered service health visit.
What is my Patient Responsibility?
For specific information on your Patient Responsibility, please refer to the explanation of benefits provided by your insurance carrier. Contact your insurance carrier to make sure you understand your benefits and your plan’s requirements.
Do I have to pre-pay my out-of-pocket expenses to attend my scheduled appointment?
No. Pre-service payments are optional for Hospital copayments, coinsurance amounts and deductibles for covered services. This is a new process to increase payment options for our patients. We’re providing the opportunity to pay now because many patients like taking care of their balances up front.
What happens if I do not pay my copayment/deductible before my scheduled appointment?
Once your insurance company has processed the bill for your visit, you will receive an explanation of benefits in the mail detailing any out-of-pocket costs you are responsible for paying the Hospital.
How can I pay my Hospital bill?
We have multiple options available for you to pay your Hospital bill:
- If you would like to pay the patient responsibility before checking in, please refer to our new Pre-Service Payment Hotline.
- Pay in-person at check-in, when you arrive for your procedure.
- If you choose not to pay in advance or in-person, you will receive a notice in the mail from the Hospital within 30-60 days after your visit, prompting you to pay via the post-service payment portal or by mail via check/credit card information using the address provided in the notice.
Can the Hospital waive my copayment/deductible?
Out-of-pocket payment amounts are part of your insurance coverage contract. We are obligated by the insurance company to collect these payments and are not authorized to waive these fees. If you have any questions regarding your copayment/deductible, you may contact your insurance company directly or refer to the explanation of benefits that your insurance carrier should provide.
If I do not have insurance or my procedure is not covered by my insurance, do I have to pre-pay my out-of-pocket expenses to attend my appointment?
Yes, if you do not have insurance or your procedure is not covered by your insurance carrier, you are responsible to pay prior to service. If you are uninsured and would like more information about the Hospital Charity Care program, please see the next FAQ.
Charity Care Program
NewYork-Presbyterian Hospital is proud of its not-for-profit mission to provide caring, high-quality healthcare that meets the needs and expectations of the communities we serve. We have developed a Charity Care program designed to assist patients who believe they face financial hardship and are unable to pay all or a portion of their medical expenses. For eligibility and more information about the Charity Care program, please contact a financial counselor at 866-252-0101 or visit the charity care page.