How to find out your costs for health care
Before you receive care, use these steps to find out how much it might cost.
Ask your doctor for:
The name and CPT code for the surgery, procedure, or prescription drugs you need.
The names of doctors, hospitals, or other providers that will be sending you a bill after you get health care. Ask if any of the hospitals have facility fees.
Call your insurance plan:
Tell them the name and CPT code of the care you need. Have your insurance card in front of you when you call — it shows the plan’s phone number and information you may need, such as your Member ID.
Then ask:
Does my plan cover the treatment I need?
Are the hospital and doctors who will be treating me part of my plan’s network?
Does my plan cover the facility fee? If so, how much of the fee is covered?
Do I need to be pre-approved by the insurance company before getting this treatment?
How much of my deductible have I met? How much of my deductible is left before I meet it?
What will be the copay or coinsurance for the treatment I need?
What is a CPT code?
CPT stands for Current Procedural Terminology codes. Every medical treatment or service has its own CPT code. All medical providers and health insurance companies use these assigned CPT codes for reporting and billing the treatments that you get.
Special tips
To find what a treatment or service costs without insurance, you can review the hospital standard charges on the hospital website. These charges do not take into account in-network cost discounts from your insurance plan or the part of the bill your insurance plan will pay. But the website can help you think about how much care might cost in general.
Some insurance plans have an online cost estimator tool. Using this tool or calling your insurance plan will help you find out treatment costs and may tell you if a different provider offers the treatment at a lower price.