Frequently
Asked Questions About Insurance Coverage
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Is
my plan an HMO, PPO, POS, or Cobra Plan?
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Does
my Primary Care Physician need to give me a referral for my surgery and
follow-up care?
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Do
I need to notify my insurance carrier before I am admitted to the
hospital?
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Am
I covered for both Ambulatory and Inpatient Surgery?
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Do
I need a second opinion?
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What
does "Out of Network" mean?
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What
is my financial responsibility if I go "Out of Network"?
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Is
the Hospital's fee included with the physician's?
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If
I have an emergency can I go to any hospital?
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Contact
the Admitting Department
Is
my plan an HMO, PPO, POS, or Cobra Plan?
All of the above are types of
insurance plans that 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!
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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.
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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.
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Am
I covered for both Ambulatory and Inpatient Surgery?
Yes, BUT 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).
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Do
I need a second opinion?
Some procedures require a second
opinion. Call and check with your plan.
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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.
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What
is my financial responsibility if I go "Out of Network"?
The co-insurance and deductibles are
outlined in your plan
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Is
the Hospital's fee included with the physician's?
No. These are two separate fees.
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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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Contact
the Admitting Department
If
you have any questions regarding your insurance coverage, please contact:
Admitting Department
(212) 979-4306
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