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The Hospital Takes Insurance – Does the Doctor?

hospital Medical debt from hospital bills can send families spiraling into bankruptcy. If you have health insurance coverage, you might think that you will be able to afford going to a hospital for the health care you need. The hospital might take your insurance, but that doesn’t mean individual doctors within the hospital are also going to accept that form of payment.

Not all trips to the hospital are going to be things that you can plan. Accidents can happen that lead to emergency visits. In those situations, people end up hoping that they were taken to a hospital that will accept their health insurance, or that is in the network for their plan.

Sometimes, a person will be able to schedule an elective procedure. Women who are pregnant have a “ballpark” idea of when they can expect to be in a hospital in order to give birth. In these cases, a person has time to investigate whether or not the hospital will take their health insurance.

One might think that if you find a hospital that will accept the type of health insurance you have, and that also is within the network that your health insurance company wants you to stay inside of, that you will have nothing to worry about. Everything should be covered by your health insurance, right? Unfortunately, that isn’t always going to be true.

Individual doctors who are working in the hospital at the time you check in could be from other hospitals, or could essentially be “independent” from the hospital itself. While there is a small chance that these doctors will just so happen to be willing to accept your health insurance, the likelihood is that they won’t. You may not discover it until after you receive a hospital bill that is much higher than you had been lead to expect it would be.

This type of situation tends to happen with doctors who provide anesthesia, radiology, pathology, or emergency room services. These doctors are not obligated to wait for the insurance companies that the hospital is working with in order for them to receive their payment. This means that the doctors could have selected to opt-out of insurance, in order to get themselves a higher, speedier, payment for their services.

Before you schedule a procedure, surgery, or childbirth in a hospital, you should ask a lot of questions. Find out which doctors will be treating you, and if they will accept the same health insurance as the hospital will.

If not, ask for a specific amount of what that will cost you. Don’t be afraid to ask if the hospital can lower that cost for you, (because some of them will do that if you ask). If the hospital won’t give you a discount, see if you can work out a payment plan with the hospital that will be something your family can afford to pay. Asking questions, and negotiating with the hospital, can potentially keep you from receiving an unexpectedly high medical bill after you return home from your hospital visit.

Image by José Goulão on Flickr

This entry was posted in Health by Jen Thorpe. Bookmark the permalink.

About Jen Thorpe

I have a B.S. in Education and am a former teacher and day care worker. I started working as a freelance writer in 2010 and have written for many topics here at Families.com.