Determining Out-of-Pocket Costs

At Saratoga Hospital, we are committed to providing you with the information you need to make the best possible decisions about your care. That includes information on the cost of certain services and what you might expect to pay in out-of-pocket expenses.

It's important to note that no two patients-and no two procedures-are exactly alike. For example, performing surgery on a young, healthy patient tends to be simpler and less expensive than performing a similar procedure on a patient with several chronic health conditions.

Healthcare Costs and Hospital Charges

Saratoga Hospital is committed to promoting greater transparency around healthcare costs, as well as a better understanding of hospital pricing, billing and insurance coverage, so that healthcare consumers like you, can make the best decision for you and your family. As part of our mission, we provide financial assistance to those in need and do our best to work with our community to be transparent by providing costs estimates and pricing information. Uninsured or under-insured patients should consult with our financial counselors to determine whether they qualify for discounts by calling 518-583-8343.

Q. Can I get an estimate in advance for the services I will receive at Saratoga Hospital?

A. Many insurance providers can offer individualized estimates of your out-of-pocket costs allowing for your specific health plan design. Saratoga Hospital financial counselors are also available to provide estimates based on planned services and your insurance plan information at 518-886-5075.

Q. How does Saratoga Hospital set prices?

A. Prices are based on many factors, including the cost for staff, equipment, facilities, medications, and other supplies; the amount of time involved; marketing competitiveness; reimbursement rates and information provided by the federal Centers for Medicare and Medicaid Services, which oversees Medicare and Medicaid. Various pricing methodologies are employed for our services based on the availability of cost information and the ability to measure resource consumption. Your bill reflects all of the services ordered by your physician and received during your hospital visit.

Charges fall into two categories:

  1. A basic daily rate, which includes your room, meals, nursing care, housekeeping, telephone, TV, etc.
  2. Charges for special services and supplies which include items your physician orders for you such as X-Rays, therapy, laboratory testing, medication and supplies.

For a complete list of Hospital Standard charges, please click here.

Q. Why am I being billed when I have insurance?

A.  Many insurance benefits have amounts which the patient must pay. These are called deductible, co-pay or co-insurance payments. If you have questions about why your insurance company did not pay part of a claim for your care, you should call your health insurance directly. 

Q. Does Saratoga Hospital accept my insurance?

A.  We accept most insurance and health plans, including Medicare and Medicaid. The best way to find out if your specific plan is included is to call your insurance provider.

 

Q.  Why did I receive several bills for services provided at Saratoga Hospital facilities?

A. It is also important for you to know that the physician services you receive in the hospital are not included in the hospital's charges. This practice results in separate bills for services, commonly referred to as surprise bills.  Physicians who provide services at the hospital may be independent physicians or they may be employed by Saratoga Hospital. Saratoga Hospital also contracts with a number of physician groups, such as anesthesiologists, radiologists and pathologists, to provide services at the hospital. These physician groups will also bill independently for the services they provide to you while you are while you are at the hospital.

We believe it's important for patients to have as much information as possible about our charges and our billing procedures.  Please review our list of physician practices that provide services at Saratoga Hospital. These include our employed physicians and other members of our medical staff.  Depending on the type of care you need, you/your insurance company could receive a bill from one or more of these practices.

Q. What if I can't afford my share of the cost?

A. We make financial aid available to all low-income, uninsured, or under-insured individuals who qualify for help with their Hospital bills. For more information on our financial assistance program, including an application, click here.

Q. What if I don't have insurance?

A. We have specially trained navigators who will help you compare and sign up for low-cost, quality health insurance plans through NY State of Health: The Official Health Plan Marketplace. Our navigators can also help you determine if you qualify for financial assistance to lower your costs even more.

Q. Where can I get more information?

A.  Click here for more information on understanding hospital prices. You may also contact us at 518-583-8343 and we'll be happy to answer your questions.