Paying for Your Care

The Centers for Medicare & Medicaid Services’ Hospital Price Transparency Rule requires all hospitals to post a list of standard rates that represent the pricing information for all medical items and services that Montefiore provides, as well as negotiated rates with insurance companies. It is important to note that the list of pricing information required by this rule does not necessarily reflect your out-of-pocket financial responsibility for your hospital visit. Why? The most common reasons are:

• We are required to list the price paid by your insurer—but this does not necessarily reflect your out-of-pocket cost.
• The medical services provided may vary from what was originally planned based on necessary circumstances at the time of your care.
• You may also receive services from physicians or practitioners who are not employed by this hospital; their fees are not reflected in this listing.

It is also important for you to know that this price listing does not guarantee coverage, benefits, or payments. Since your financial liability may vary based on the particular terms of your insurance policy and the status of your health insurance benefits (i.e., deductibles, out-of-pocket maximum, co-insurance, and copays) at the time you receive care, your eligibility and the amount of your coverage will ultimately be determined by your health insurance provider. It is for this reason; Montefiore utilizes a price estimator tool that provides consumers with out-of-pocket cost estimates based on their personalized health plan benefits. We encourage you to utilize our consumer-friendly tool and/or take advantage of speaking with one of our managers at 914-378-6445.

We are committed to being transparent and compliant with the Centers for Medicare & Medicaid Services rules and are providing the following link to our machine-readable file. As stated earlier, the price information contained in this file is NOT an estimate of your out-of-pocket costs nor an accurate representation of charges since each episode of care is unique and charges are based on the actual services received. Additionally, while the file is posted based on the Centers for Medicare and Medicaid Services reporting requirements, it may be too large for consumers to open without special software. We again encourage you to utilize our consumer-friendly tool and/or take advantage of speaking with one of our managers at 914-378-6445.

You may view or download the standards rates file (file last updated 7/01/24).

For healthcare services provided at Montefiore you may receive bills reflecting both professional charges from providers, such as anesthesiologists, pathologists, oncologists or other specialists who have contributed to your care, as well as hospital charges, which include the cost of providing all other aspects of your care. Hospital charges, such as hospital stay, support staff, supplies, and medications, are billed separately from professional services. In addition, if your care was provided by a doctor affiliated with Montefiore, but who also has a private practice, you may receive separate bills from this doctor as is typical billing practice.

What are hospital and professional charges and how do they impact you?

The term “charges” refers to the dollar amount a provider sets for services provided before negotiating any discounts. The charge is different from the amount paid. Patients covered by Medicare, Medicaid, commercial insurance plans, as well as uninsured patients who qualify for financial assistance never pay full charges. We also offer steeply discounted rates to uninsured patients who do not qualify for financial assistance.

At Montefiore Einstein, we are committed to helping people understand the best options available to pay for their medical care. Our staff can help you understand what is covered by your specific health insurance benefits policy, expenses such as deductibles, co-insurance, co-payment and out-of-pocket expense limits. In addition, if you do not have insurance we can help you determine your eligibility for free or low-cost insurance, as well as governmental assistance. Our financial services counselors can also help assess if you qualify for financial assistance. Learn more about our financial services.

There are many health insurance plans that participate with Montefiore Einstein. Please note that some providers involved in your care may not participate in the same insurance plans covering care at Montefiore. Therefore, we recommend you check with the physician arranging for hospital services to determine if the physician participates in a plan that covers your care. A list of physicians who provide services at Montefiore Einstein facilities is available for you to review.