Watch this video to learn about the costs of care at MSK and what to know about your insurance.
This video will help you learn about the costs of care at Memorial Sloan Kettering Cancer Center, MSK, how your insurance can help you pay for them, and where to go at MSK for help.
MSK accepts many different types of insurance. Before you set up an appointment with an MSK doctor, review your health insurance coverage. Coverage for your hospital, doctor, and prescription drug expenses may be different.
If you have any questions about your insurance benefits, you can call your insurance company. It's most important to find out whether your plan considers MSK to be in network or out of network.
In network means that your insurance company has a relationship with MSK and they have agreed to pay for most of the costs of treatment and services at MSK.
Out of network means that your insurance company does not have a relationship with MSK. For you to have services at MSK, you will need their approval first.
Out of network insurance plans are all very different. Some plans may agree to pay for a large part of your treatment at MSK, while others may not.
A deductible is a set amount of money you must pay each year before your insurance plan will start to pay for your healthcare expenses, whether MSK is in your plan's network or not. Not every treatment you have counts toward your deductible.
Your deductible includes charges from all healthcare providers, so your insurance company is the best source to confirm the amount you have left to pay.
In addition to your deductible, your insurance company may require you to pay for a portion of the medical care that you receive during the year. The amount could be a percentage of the total costs or a set fee for a visit.
Co-insurance is the percentage of charges of a covered healthcare service that you pay after you've paid your deductible. For example, after meeting your deductible for the year, if you have a procedure that costs $1,000 and your co-insurance is 20%, your insurance will pay $800 and you will pay $200.
A co-pay is a predetermined fee that you need to pay to your doctor's office at the time of your visit. Most plans have a different co-pay for your regular doctor and specialists like the cancer doctors at MSK. Co-pays can range from $25 to a few hundred dollars depending on the doctor.
All these costs are referred to as out-of-pocket because you pay for them yourself. Some insurance plans have an out-of-pocket maximum. This means that after you have paid up to a certain amount for the year, your insurance will pay 100% of your medical bills for the plan year. You can ask your insurance company if your plan has this.
You should also find out whether you need a referral for services at MSK. This means you'd need to ask your primary care doctor, called your PCP, or the doctor who diagnosed you with cancer to refer you to MSK. Some insurance companies require a referral, but many don't.
Some insurance companies also ask for an authorization before a test or procedure. This means the insurance company agrees in advance to pay for your treatment. Certain services and treatments, like outpatient surgery, radiation therapy, chemotherapy, and radiology, are more likely to require an authorization. You may also need an authorization if you have to be admitted to the hospital for a surgery or a procedure.
MSK is responsible for getting this authorization before your appointment.
Even if you don't have insurance, MSK may be able to help you pay for your care. We offer financial assistance and can often help cover some of your costs depending on your ability to pay.
Trying to figure out how to pay for your care can feel overwhelming. Our patient financial services staff are here to help. We can help whether you're new to MSK or you're already part of our family. We want you to get the best care possible and to relieve your worries about paying for it.
You can call us or schedule in-person meetings to discuss your financial concerns. We are at 212-639-3810 from Monday through Friday between 8:30 a.m. and 5:30 p.m.
For more information, go to MSKCC.org and search for insurance and financial assistance.
