Understanding Your Financial Responsibility at JMC

What are “Covered Services”?

Medically necessary services your health plan will pay for.

 

What is a copayment?

A fixed dollar amount you must pay for a covered service, at the time you obtain services. Your health plan determines whether a service is covered and how much your co-pay is. The amount of your co-pay may vary by the type of service.

 

What is a deductible?

A fixed dollar amount determined by your health plan. You are required to pay this amount before your health plan pays for certain covered services. Preventive services and screenings may be paid for by your health plan before your deductible is met.

 

What is coinsurance?

Coinsurance is your share of the allowed amount that your health plan will pay for a covered service. Your coinsurance may vary by type of service and location of service. Coinsurance amounts may be higher if you select a provider that is not contracted with your health plan, sometimes referred to as an, “out-of-network” or “non-participating” provider.

 

Will you confirm my health plan benefits prior to my appointment at the hospital?

We will contact your health plan for information for all of your scheduled services. We will attempt to notify you by phone of the information provided by your health plan prior to services being rendered so that you can make an informed decision. Even though your health plan provides us information about your benefits, they do not guarantee payment. Your health plan will make a decision about payment when they receive the claim.

 

How can I find out how much my procedure will cost me?

Heath Insurance companies negotiate payment rates with health care providers, such as hospitals and doctors. While your policy determines how much of your health care costs you will be responsible for, the contract between the provider and the health insurance company determines how much your health plan will pay the provider. 

 

Our Insurance Verification Team will contact your health plan for information about your co-pay, deductible and co-insurance amounts before your scheduled visit. They will give you an estimated amount of your cost prior to your scheduled appointment. JMC cannot guarantee payment by your health plan. We always recommend that you contact your health plan directly to get specific information about your cost.

 

What if I don’t have insurance? 

We offer an array of financial assistance programs that our customer service associates can review with you. Please call 561-263-4440 for more information.

 

Can I choose not to use my insurance and pay for services directly?

Yes. You have the right to instruct JMC not to file a claim with your health plan. However, if you choose not to use your health plan benefits to pay for medical services, we cannot file a claim on your behalf. You will be asked to sign a document which confirms this request and your agreement to be personally responsible for paying for the services you receive. Since JMC will not file a claim with your health plan, the payments you make for these services will not be applied to your deductible, or out-of-pocket limit at any time. If you choose not to use your health plan benefits, you must pay for services in full prior to receiving services. If you have any questions, please call our Customer Service Representative at 561-263-4440.

 

Do you offer payment plans?

Yes. Our Access One Med Card Program provides a variety of affordable payment plan options. Please contact our Customer Service Department at 561-263-4440 for more information on this program and other options that might be available to assist you with paying for your health care services.