Talk to Your Doctor
Because your choice of hospital can affect your wallet, you should be an active partner with your doctor in choosing where you get care.
You can choose to go to Higher Cost Share hospitals1, but you will pay more for certain categories of service. If you choose Lower Cost Share hospitals, freestanding labs, and imaging centers, you will pay the lowest cost for your care.
Before Your Next Doctor's Visit
- Check your doctor's hospital affiliation, so you know where he or she would usually send you for care.
| If your doctor is only affiliated with Lower Cost Share hospitals | If your doctor is affiliated with Higher Cost Share hospitals |
|---|---|
|
You can expect to pay the lower cost share. |
You should review your options with your doctor. |
If your doctor is only affiliated with Lower Cost Share hospitals
|
You can expect to pay the lower cost share. |
If your doctor is affiliated with Higher Cost Share hospitals
|
You should review your options with your doctor. |
- Take time to review our helpful fact sheet on talking to your doctor about your Hospital Choice Cost Sharing benefits, so you know where he or she would usually send you for care.
When You Visit Your Doctor
- Let your doctor know that you will pay more if you receive certain categories of service at Higher Cost Share hospitals. You can bring along our Talking to Your Doctor About Hospital Choice Cost Sharing fact sheet to make the conversation easier.
- Share the categories of service and freestanding labs, and imaging centers with your doctor so you can review your options for care together.
To Avoid a Referral to a Higher Cost Share Hospital
| If You Are Being Referred for | Ask to Be Referred to a |
|---|---|
| Diagnostic Lab tests, MRI, or X-rays | |
| Outpatient day surgery or an Inpatient Admission |
Freestanding facility on an outpatient basis (your doctor will advise you if this is an appropriate option for your condition) |
If You Are Being Referred for
| Diagnostic Lab tests, MRI, or X-rays |
Ask to Be Referred to a
| Outpatient day surgery or an Inpatient Admission |
Freestanding facility on an outpatient basis (your doctor will advise you if this is an appropriate option for your condition) |
1. About Higher Cost Share hospitals: Some Higher Cost hospitals contract with Lower Cost Share providers, such as Quest Diagnostics or Shields MRI, to provide services within the hospital. You can call the Higher Cost Share hospital to find out if certain services (e.g., labs, MRIs) are billed by a Lower Cost Share provider. If they do, you'll be able to get care for the lower cost.