What could impact the accuracy of the price estimate UVA gives me?
These factors could impact your price estimate and/or increase the cost of your care:
- Provider or patient providing incorrect or incomplete information
- Your doctor ordering additional tests or procedures
- If the patient stays for observation after a procedure longer than what’s expected
- Cost and quantity of medications
- Changes in patient deductible or out-of-pocket maximums due to timing of insurance claims processing
- Co-payments and co-insurance
- Unforeseen complications
- Out-of-network status
What do these terms mean: Deductibles, copayments and coinsurance?
A deductible is the amount of money you have to pay for healthcare costs every year before your health insurance begins to cover your costs. Depending on your insurance plan, you can have either an individual or a family deductible.
Copayment or Copay
A copay is the specific, flat fee your health insurance requires you to pay for each designated health service.
Co-insurance means that you and the health insurance company each pay a percentage of your covered medical costs, after you have paid your deductible.
What is a maximum out-of-pocket?
This term refers to the most you have to pay for healthcare costs in a year. After you spend this amount on deductibles, copayments and coinsurance, your health insurance pays 100% of your medical costs.
The out-of-pocket limit doesn't include your monthly premiums. Only services covered by your health insurance count toward this limit.
If I have met my maximum out-of-pocket for the year, will I owe anything?
No, as long as your health insurance covers the healthcare services in question.
You'll want to understand:
- What healthcare services your insurance covers
- Which providers belong to your health insurance network and which don't (in-network and out-of-network)
- Whether you have individual and/or family out-of-pocket maximums
How can I compare my UVA estimate to that of other organizations?
UVA out-of-pocket estimated expenses include both the hospital and the provider charges. If you request information from another healthcare organization, request both of these components to get a more accurate estimate of your total expenses. This will allow you to make accurate comparisons. Remember, additional tests or procedures and/or complications may impact your estimate.
If I have a surgical procedure done, are all the costs included in the estimate you provide?
The estimate will include the charges of the hospital, the surgeon and, if applicable, anesthesia. We'll also include applicable pharmacy, implants and supply costs.
If you request information from another healthcare organization, be sure to request all of these components in order to make accurate comparisons. Extra tests or procedures and/or complications can impact the estimate.
Will my final bill match the price estimate I was provided?
Not likely. Your final bill can include charges not accounted for in the price estimate. While we have done our best to provide a good faith estimate, a number of variables can impact the result. You're responsible for paying the amount of your final bill, regardless of the amount of the estimate.