Insurance and payment questions worth asking early

We do not verify benefits, submit claims, obtain authorizations, or guarantee that any service will be covered. Confirm everything directly with your plan and the program.

Ask your insurance plan

• Is this specific program and this specific level of care in network?
• Is prior authorization required, and who submits it?
• What is my deductible, coinsurance, copay, and out-of-pocket maximum this year?
• How many days or sessions are authorized at a time, and how are extensions reviewed?
• What happens if I need a different level of care than the one authorized?
• Is there an out-of-network benefit, and what would I owe?
• Can I get the answer in writing, with a reference number for the call?

Ask the treatment program

• Are you in network with my exact plan, not just my insurance company?
• What will you bill me for, and when?
• Do you offer a sliding scale, financial assistance, or a payment plan?
• Do you accept Medicaid or Medicare, and are there enrollment requirements?
• What happens financially if my insurer denies continued stay?

If you are uninsured or underinsured

New York offers Medicaid and other public coverage options, and many certified programs accept public insurance or use sliding-scale fees. New York State's certified program directory and the public support lines below can help identify programs that serve people regardless of ability to pay. Enrollment assistance is available through New York State of Health and hospital financial counseling offices.

Watch for red flags

• Anyone who guarantees coverage, admission, or a specific outcome
• Pressure to travel far from home before local options have been reviewed
• Requests for your insurance member ID over a web form or unsolicited call
• Refusal to put costs in writing before you commit