Questions About Health Care Costs

Insurance plans vary for each patient. Most health care provider plans do cover a portion of your medical expenses. However, patients are often responsible for some of the costs related to their medical care. Most plans require a co-payment: a fixed dollar amount that your health care plan provider (insurance company) requires you to pay every time you visit an approved medical professional. If you have any questions about your insurance coverage, your health care plan provider will be able to help you and discuss the details of your plan.

University of Rochester and the UR Medicine Maternal-Fetal Care group works with most insurance plans in Western New York, and our team will bill insurance directly for services in our office.

Most of the UR Medicine care providers and hospitals accept most insurance plans (see the list of Accepted Insurance Carriers).

When your care provider sends you to the hospital or arranges a procedure or test, ask your care provider for the name of the providers who will perform the service and then ask your insurance company if you will need a referral. For some specialist visits (such as MFM consultation, MRI imaging, Genetic testing services) a prior authorization or referral may be needed.

Consultative care allows you to receive your ongoing prenatal care with your doctor/provider, and typically deliver with your provider at your preferred hospital. Our specialists will work with you and your provider to develop a plan for you and your growing family around a specialist concern that is outside of the typical services of routine prenatal care.

Please note that when you speak with a specialist in our practice about a specific concern during an ultrasound, or as a visit to review medical concerns or pregnancy complications, this type of consultative care is outside of the typically global billing for prenatal care, and you will receive separate charges for these visits.

Sometimes you'll receive multiple separate UR Medicine bills for some of the health care services you received. The logo at the top and description of the charges can help you identify the source of the charges.

• The UR Medicine Statement of Professional Services includes fees for the provider who was involved with your care or test/imaging. 
• The UR Medicine/Strong Memorial Hospital/Highland Hospital statement includes fees related to the facility (e.g., exam/surgery rooms, medicine given, ultrasound technical fees, etc.).

Some common examples of when patients might receive “two bills for one visit” include:

• For patients referred for breastfeeding medicine services, there may be separate charges at the same visit for the pregnant person and infant(s) depending on the issues, and would come separately under each name. Breastfeeding services may also include separate bills for the lactation consultant and the provider.
• For patients receiving ultrasound services, there will be hospital technical fees for the technician and the equipment for performing the ultrasounds, and a separate profession (physician) fee for interpreting the ultrasound. 
• If you have a consultation (face to face discussion) with the physician about findings on your ultrasound, this would also be a separate charge/bill from the ultrasound.
• If you have a visit with a physician or genetic counselor visit on the same day as your ultrasound visit about medical concerns or for testing or prenatal care, this would also create a separate visit and charge.
• If the nurse or physician gives medications or vaccinations during your visit this may also generate a separate charge—one for the medication (pharmacy or hospital bill) and one for the administration of the medicine.
• After admission to the hospital there will typically be a hospital bill related to facility fees (exam/surgery rooms, medicines given, operating room costs, imaging technical fees, etc.) and a statement of professional services for the care given by each of the different types of physicians during your visit (obstetricians, anesthesia, radiologists, emergency medicine, etc.). 

On our website, you can view a list of UR Medicine lab locations. For most laboratory testing ordered in our office the "lab slip" is sent electronically and you do not need a paper requisition.

For some genetic testing and screening there may be paper forms that were given to you by your genetic counselor. You can have these drawn at any UR Medicine Laboratory, but please bring these paper forms with you or the technician will NOT be able to appropriately draw your test. If you need additional copies, please call our office at (585) 487-3352.

Some testing requires an appointment or for you to fast. A three-hour glucose test is a good example of this. Please call the laboratory you wish to go to directly to schedule this.

Good information helps patients and families make smart decisions about their health care. In 2012, UR Medicine created the Health Care Cost Estimator service to help determine anticipated Costs at UR Medicine. Our billing experts work with patients and families to estimate how much they could pay for UR Medicine health care services. Please visit the UR Medicine health care estimation page for more information.

UR Medicine also offers a financial assistance program for individuals who cannot afford the health care they need. If you cannot afford to pay for part or all of your essential health care services, you may be eligible for financial assistance. For more information, please view our financial assistance information or call (585) 784-8889.

UR Medicine provides compassionate, medically necessary healthcare to anyone in need, regardless of insurance status or ability to pay.

If you do not have insurance coverage, there are programs available that may help you. New York State offers several options for both adults and children. Please contact our financial counselors. They are happy to help guide, coordinate, and provide outreach services for patients who require public health benefits. Some common programs include:

• Medicaid - A program for New Yorkers who cannot afford to pay for medical care
• Medicare - A medical care program for senior citizens and disabled persons
• Healthy NY - Health insurance plan for eligible small businesses, sole proprietors and individuals
• Child Health Plus - A New York State health insurance plan for kids
• Family Health Plus - Public health insurance for adults between the ages of 19 and 64 who do not have health insurance—either on their own or through their employers—but have incomes too high to qualify for Medicaid