Insurance Accepted by Gaylord Specialty Healthcare
Health insurance benefits are verified prior to initial service. Gaylord Specialty Healthcare participates with most insurance networks. Please bring your insurance card with you to insure information is accurate. Copays will be requested prior to services rendered.
Accepted managed care plans including but not limited to:
- Blue Cross
- Harvard Pilgrim
- United Healthcare
- Yale Health Plan
- State of Connecticut Medicaid
- VA Community Care Network(managed by Optum)
- Aetna Medicare Advantage
- Blue Cross Medicare Advantage
- Carepartners of CT
- Connecticare Medicare Advantage
- Wellcare Medicare
Pricing for Services
Gaylord Hospital wants to help patients make informed health care decisions. Because that includes having an understanding of your out-of-pocket costs for our services, we make available our chargemaster.
What is a chargemaster?
A chargemaster is a comprehensive list of charges for each service or item provided by a hospital. This includes each test, exam, procedure or any other service. Given the many services provided by hospitals, a chargemaster contains thousands of services and related charges.
Chargemaster amounts are almost never billed to a patient or received as payment by a hospital. The chargemaster amounts are billed to an insurance company and those insurers then apply its contracted rates to the services that are billed. In situations where a patient does not have insurance, our hospital has a financial assistance policy that applies discounts to the amounts charged.
Health insurance companies contract with hospitals to care for their customers. Hospitals are paid the insurance company’s contract rate, which generally is significantly less than the amount listed on the chargemaster. The insurance company’s contract rate, not the chargemaster, is the basis for determining the patient’s actual out of pocket costs. As an example, a hospital may charge $1,000 for a particular service, while the insurer’s contract rate may be $500. If the patient’s insurance plan indicates the patient is responsible for 20 percent of the contract rate, the patient would owe $100 ($500 x 20 percent).
Are the charges the same for every patient?
The list of charges is the same for all patients. However, the total charges for an individual patient often vary from one patient to anther for a number of reasons, including:
- How long it takes to perform the service
-The services requested in the plan of care determined by your provider
- Whether the service you receive is more or less difficult than expected
-Whether you experience complications and need additional treatment
-Other health conditions you may have that may affect your care
Is the charge the same as what a patient pays?
Chargemaster information is not particularly helpful for patients to estimate what health care services are going to cost them out of their own pocket. The charge listed in the chargemaster is generally not the amount a patient will pay. If you have health insurance, the amount you will be billed and expected to pay for your series depends on your specific health insurance coverage and your insurance company’s contract with the hospital. If you do not have health insurance you may be eligible for reduced costs under the hospital’s financial assistance policy, or you may be eligible for Medicaid coverage.
What is not included in the chargemaster list?
The hospital’s chargemaster does not include charges for services provided by all doctors who treat you while you are at the hospital. You may receive separate bills from the hospital and the doctors involved in your care. Here is a partial list of health care providers who may bill you separately:
- The hospitalist who sees you in the hospital
- The radiologist who reads your x-rays or other imaging
- Other doctors who may be consulted by your doctor during your time in the hospital
Patients covered by private health insurance are encouraged to contact their insurance carrier to understand their financial responsibilities. Contact information for your insurance carrier can be found on the back of your health insurance card or by visiting the carriers website. You can also call the Gaylord Hospital Patient Financial Services department at (203) 284-2827 or email [email protected]
View Gaylord Hospital Standard Charges