Insurance

Insurance plans vary by provider and individual policy. Before receiving care, contact your insurance company to confirm your coverage and understand any out-of-pocket costs you may be responsible for.

Questions to ask your insurance company may include:

• Is this service covered under my plan?
• Is my provider or facility in network?
• Have I met my deductible?
• Will I owe a copay or coinsurance?
• Is prior authorization required?

Having this information ahead of time can help you avoid unexpected costs and make informed decisions about your care.

If you have insurance, your insurance company can help you estimate what you may pay for a specific procedure or service. Because your insurer has access to your individual coverage, benefits, deductibles, and copays, they are often the best resource for estimating your out-of-pocket costs.

Many insurance companies offer online cost estimator tools or customer service representatives who can provide personalized estimates.

If you have an upcoming treatment at Kootenai Health, our financial clearance representatives can provide you with a price estimate. 

Your out-of-pocket costs for healthcare services are unique to you and can be affected by several factors, including:

• Your health insurance coverage and benefits
• Your specific health condition and care needs
• The provider or services involved in your care

Because these factors vary from person to person, it is often difficult to determine the exact cost of care in advance.

Deductible
The amount you are responsible for paying out of pocket before your insurance company begins paying for covered services. This amount is typically reset each year.

Copayment (Copay)
A fixed dollar amount you pay for covered healthcare services, such as an office visit.

Coinsurance
The percentage of covered healthcare costs you are responsible for paying after your deductible has been met.