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Insurance FAQs

  1. Is my plan an HMO, PPO, POS, or Cobra Plan?

  2. Does my Primary Care Physician need to give me a referral for my surgery and follow-up care?

  3. Do I need to notify my insurance carrier before I am admitted to the hospital?

  4. Am I covered for both Ambulatory and Inpatient Surgery?

  5. Do I need a second opinion?

  6. What does "Out of Network" mean?

  7. What is my financial responsibility if I go "Out of Network"?

  8. Is the Hospital's fee included with the physician's?

  9. If I have an emergency can I go to any hospital?

Is my plan an HMO, PPO, POS, or Cobra Plan? 

All of the above are  types of insurance plans that may require you to get some kind of pre certification before you go into a hospital. It is important to know what your benefits are and whether or not your physician and this hospital participate in such plan. Call your plan and CHECK!

Does my Primary Care Physician need to give me a referral for my surgery and follow-up care?

If you are enrolled in an HMO or POS plan the answer is "Yes." You will need to obtain a referral for surgery and follow-up care for the hospital.

Do I need to notify my insurance carrier before I am admitted to the hospital?

Better safe than sorry. Many insurance plans require that you call them before you have services rendered.

Am I covered for both Ambulatory and Inpatient Surgery?

Many plans only cover a procedure if it is done in an Ambulatory setting. Check with your insurance carrier. You might require special approval for an Inpatient stay (to stay overnight or longer).

Do I need a second opinion?

Some procedures require a second opinion. Call and check with your plan.

What does "Out of Network" mean?

Out of Network means that the hospital or provider that you have chosen does not "participate" with your plan. Therefore, your insurance plan will only pay a percentage and you will responsible for the difference.

What is my financial responsibility if I go "Out of Network"?

The co-insurance and deductibles are outlined in your plan

Is the Hospital's fee included with the physician's?

No. These are two separate fees.

If I have an emergency can I go to any hospital?

Yes. You are entitled to have emergency care at any hospital. However, you will still be responsible for calling your insurance company and notifying them of your visit.

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Admitting DepartmentTel: (212) 979-4306

Address310 E. 14th Street
North Building, 1st Floor
New York, NY 10003

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