Cost for Care
Holyoke Medical Center provides quality care to all patients regardless of their ability to pay. Each patient is unique in their need for healthcare services and in their insurance coverage (such as copayments, deductibles, coverage limitations, etc.). This makes it difficult to provide specific cost information in every situation. If you would like to estimate the cost of a service based on your specific insurance coverage, including copays/deductible/co-insurance (as applicable to your benefits), HMC has installed CarePricer, a tool that can help you estimate your portion of the cost for the care you will receive:
Patients are always encouraged to contact their insurer to request an estimate of out-of-pocket costs based upon their specific health insurance plan.
If you have questions about the cost of your healthcare needs, we encourage you to please call the Holyoke Medical Center Patient Financial Obligation Inquiry Line at 413.534.2871.
The maximum amount a provider bills for a specific healthcare service before the application of any discounts, negotiations, or other forms of charges reduction or adjustment regardless of payer .
Is a comprehensive list of all billable services and items provided by a hospital. It captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges. A chargemaster can contain thousands of services and related charges.
The amount of covered benefits that the patient is responsible for paying after reaching his or her deductible amount. For example, if your co-insurance is 20 percent of medical costs, and your bill totals $100, you pay $20 and the insurance company is responsible for $80.
The fixed amount of out-of-pocket costs you pay for a particular healthcare service. One example is a visit to your primary care doctor. If your co-pay is $20, that means you pay $20 per visit regardless of the reason for seeing your doctor, and your insurance company pays the rest.
The amount you owe for healthcare services before your health insurance plan begins to pay. For example, if your deductible is $100, your health insurance won’t pay anything until you’ve met your $100 deductible for healthcare services. Your deductible may not apply to all services, for example, some plans offer yearly diagnostic or preventive mammograms or physical exams without a deductible or copay or coinsurance.
Diagnostic Related Group (DRG)
DRGs are payment categories that are used to assign inpatient services for the purpose of reimbursing hospitals. DRGs are a fixed payment for services rendered and take into account the procedure(s), diagnoses and health status of the patient.
Holyoke Medical Center offers payer specific payment rates on hospital and physician services in order to comply with federal regulations regarding price transparency. These files are updated once a year and as a result they will not contain any mid-year rate adjustments, if any. These price transparency files are not intended to be an estimate of what a patient could be expected to pay to receive a service at HMC.