Johns Hopkins Medicine participates in a wide range of insurance plans. Each hospital and member organization has its own accepted insurances. In some community hospitals and clinics, you may receive care from outside private practice providers who may not participate with your insurance plan. Before scheduling an appointment or seeking treatment, please contact your insurance plan to understand the benefits and your share of costs.
All patient cost shares and charges for non-covered benefits are due at the time of service. Please note that your insurance company may not pay for all of your services. For example, you may be required to pay out-of-pocket expenses (such as deductibles, copayments and coinsurance) or you may be required to seek services (such as lab and radiology services) at specific locations/providers.
Please be advised that Johns Hopkins Medicine hospitals and most Johns Hopkins University physicians participate with Medicare, but we are not contracted with most Medicare Advantage Plans. If your Johns Hopkins Medicine hospital doesn’t participate with a Medicare Advantage Plan, you can use out-of-network benefits if your plan has them.
How to Prepare For Your Visit or Admission
Talk to your physician
Before your admission or appointment, remember to discuss the estimated length of stay and anticipated tests and services with your physician. It’s good to be aware of all the details so that you can check with your insurance provider to understand what will be and what might not be covered.
To ease a hospital admission, we will begin the paperwork as soon as your doctor informs us of the admission date. A preadmission coordinator will call you at home to verify basic information such as the name of your employer, your home address and the type of insurance you carry.
Please note that your health insurance plan may require you to obtain a referral from your primary care provider before being seen by our specialists. Your physician will send a referral electronically, or you will be given a copy to take during your visit at Johns Hopkins. Our patient access staff will work with your physician’s office to obtain authorization from your insurance carrier when necessary.
Talk to your insurer
Many insurance carriers have coverage limits on room charges and certain services. If you aren’t sure what is covered, please contact your insurance provider to understand your benefits and costs before scheduling an appointment or seeking treatment.
Some plans may limit the geographic area in which you can receive care, even for routine services. Your plan may refer to this as a “limited network.” Johns Hopkins may not be part of your plan’s limited network.
Don’t forget important documents
To ensure proper billing and prompt payment, please be sure to provide complete information about all of your insurance plans, including Medicare and Medicaid. If applicable, the hospital will bill both your primary and secondary carriers.
If you do not know which plan is primary, a financial counselor will be happy to assist you — please call 855-662-3017. If not all insurance information is received at the time of service, the bill will be the responsibility of the patient/guarantor.
After each visit, the Johns Hopkins Medicine facility/member organization will file health insurance claims directly with your primary payer and, if appropriate, your secondary insurance payer. By signing the Agreement for Care Form, you agree that your Johns Hopkins Medicine health care provider can be paid directly by your insurance.
If you are not able to pay your bill in full, you may qualify for a payment plan and/or financial assistance.
Commercial Insurance, Medicare and MedicaidAll deductibles, copayments, charges for non-covered benefits, and other member cost shares are due at the time of service.
Automobile InsuranceThe hospital will bill auto insurance carriers if you authorize that benefits be paid directly to the hospital. Should this authorization be withheld, the bill will be the responsibility of the patient/guarantor.
Self Pay (No Insurance)The hospital requires payment in full and in advance of nonemergency admissions and outpatient services unless you have made other arrangements through the hospital’s financial counseling office. For more information, please contact billing and insurance customer service at 855-662-3017.