If you have received medical care outside of University Health Services, it is likely that you will receive a bill for charges that were not covered by your medical insurance. Most health insurance policies include an annual deductible, which is the amount the person covered must pay before insurance coverage “kicks in.” The amount of your deductible will depend upon your specific policy. Most insurance also involves coinsurance, which is the percentage of costs the subscriber (the patient) has agreed to pay. For example, if your health insurance pays 80% of eligible expenses, you may be required to pay the remaining 20% of eligible expenses as your coinsurance. Coinsurance is usually billed after a service is received. A copayment is similar to coinsurance and the terms are sometimes used interchangeably. Copayments refer to the $5 to $30 you may pay at the time of the visit when receiving outpatient services. See this glossary of common insurance terms and their definitions to help you understand your bills. Learn more about: Understanding your medical bill Paying your medical bill Financial support resources on campus Understanding Your Medical Bill Ordinarily, you are expected to pay a medical bill only after the provider has submitted claims to your insurance company and insurance company has made payment. The provider then bills you for costs remaining after the insurance payment. You may receive from your insurance company something called an explanation of benefits (often referred to as an “EOB”) after receiving services but before receiving a bill. No action is required of you when you receive an EOB; it is an indication that your insurance company is processing a claim. If you are confused about your bill or are unsure whether insurance claims have been processed and paid to the medical provider, call both the medical provider and your insurance company to learn more about your bill. The number for your health insurance company can be found on the back of your insurance card. The provider’s bill should include a billing number, which you can reference during your call. You may receive more than one bill after receiving care at the hospital. This is because certain providers (e.g., specialists) who see patients at the hospital bill for their services separately from the hospital or emergency room. If you were transported to the hospital by ambulance, you may receive a bill for this service as well. Insurance companies and providers may refer to bills from physicians as professional fees, and to charges for the hospital, surgicenter or other facility as facility fees. Paying Your Medical Bill If after clarifying your medical bills you are concerned about your ability to pay the bill, there are steps you can take: Call the medical provider’s billing office to ask whether they are willing to reduce the charges on your bill or to set up a payment plan. Medical bills can often be negotiated with the provider when the patient has difficulty paying. If you believe that your health insurance has not paid for a covered expense, you should discuss this with a representative at your insurance company. You can request that a claim be reconsidered; you can also appeal your insurance company’s decision not to pay a claim. If you have worked with your medical provider(s) and your insurance company to reduce the amount you owe or to set up a payment plan, and if you find you are still unable to pay your bill, you may want to consider financial support resources at the University. Financial Support Resources The University has a number of funds to assist in paying your bills. Review each of the following to find one that fits your situation, as application requirements vary. Emergency Funding: multiple funds exist to support undergraduate students and graduate students experiencing financial hardship The Financial Aid Office (for undergraduate students): Although most financial aid awards do not change during the year, your aid may be adjusted if there are changes in your family’s financial situation or your student budget. The most common reason for revisions due to family changes are financial problems such as loss of a job/income or emergency expenses. For further information, contact the Financial Aid Office ([email protected]). Medical Expense Assistance Program: Special funds exist to assist enrolled graduate students with unreimbursed medical expenses that create a financial hardship for them. Medical expense assistance takes the form of a grant to reimburse expenses not covered by insurance; therefore, you must first submit insurance forms and determine your out-of-pocket expenses before you can apply for reimbursement through these funds. To request funding, visit the Graduate School’s website. Short-Term Contingency Loan Program (for graduate students): Short-term contingency loans are designed to help graduate students in coping with unexpected financial emergencies. For more information about the loans, visit the Graduate School’s website. The University Health Services Special Needs Fund and Mental Health Loan: Read more about these funds on our cost and billing page.
