Differences in Price

The price of healthcare services often differs depending on whether the patient has insurance coverage or is eligible for financial assistance.

For an insured patient, the price for healthcare services is the rate negotiated for services between the payer (aka, health insurance company) and the provider, including any copayments, coinsurance, or deductible due from the insured patient.

For an uninsured patient, price is first determined by eligibility for financial assistance. If the patient qualifies for financial assistance, the price is reduced according to the terms of the provider’s financial assistance policy, provided that the patient works with the provider to supply the documentation necessary to establish financial need.

If an uninsured patient has the financial means to pay for the services rendered, the price could be as much as the provider’s full charge for the services, although the patient and the provider may negotiate a discount from the charge.