Ways to Help Predict Healthcare Costs

If you have insurance, there are many factors that can affect what you pay. While you can’t always control where you receive care, here are a few questions to consider asking before scheduling an appointment:

• Is the provider in-network or out-of-network? In-network providers are usually less expensive.
• Are the services covered by my plan? Routine check-ups are often covered, while other services may not be.
• How much is my deductible?
• Have I already met/paid my deductible for the year?
• Is there a co-pay for this type of appointment?
• Will I need to pay co-insurance?
• Have I reached my out-of-pocket maximum for the year?

Patient families may request an estimate of what they will have to pay before their appointment. When booking your appointment, ask your provider what the expected cost is with your insurance plan.

You may also want to call your insurance company and ask the following questions:

• Is the provider I’m going to see in-network?
• Are the services I need covered by my plan?
• Is a referral or prior authorization required before I visit?
• Will I need to pay a deductible, co-pay or co-insurance?

Need help understanding all the different words and phrases health insurance companies use? Check out our glossary of commonly used health insurance terms.

At Children’s, we offer payment options and services for paying your child’s hospital bill, as well as financial aid and insurance assistance. Visit choa.org/billing for more information.