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BECOMING AN INFORMED HEALTH CARE CONSUMER
Take responsibility
– No one knows more about you than you do! Adopt healthy behaviors and
visit your doctor regularly. Follow your doctor's instructions about
life style issues such as diet and exercise. Take an active part in
health care for you and your family.
Know your insurance plan
– Learn about your health insurance plan or medical benefits before you
need to use them. Each insurance plan differs in what it covers, its
limits of coverage, and the rules that apply to the plan.
Know your hospital
– Many factors come into play when you are trying to select a hospital.
You may want a hospital close to home, one recommended by a family
member, or one that you have been to before. Or your insurance plan may
only cover care at certain hospitals. Whether you are choosing from
among many hospitals or only a couple, this website can give you
information about the median
charge (half the patients were charged more than the median charge, and
half the patients were charged less than the median charge) at South Dakota's hospitals. Keep in
mind that many factors affect a hospital's charges and utilization
rates. Such factors include the availability of physicians and staff
and the level of care or specialization of services offered.
Understanding charges
– Keep in mind that the "charges" shown on this website are different
from "cost," "reimbursement," "price," or "payment." Many factors will
affect your costs for a hospital stay including whether you have
insurance, the type of insurance, and the billing procedures at a given
hospital. The amount collected by a hospital is almost always less than
the charges billed. Three common examples are:
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Government programs such as
Medicare and Medicaid pay hospitals much less than billed charges.
These payments are determined by the government agencies and
hospitals have no ability to negotiate reimbursement rates.
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Commercial insurers or other
purchasers of health care services usually negotiate discounts with
hospitals on behalf of the patients they represent.
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Many hospitals typically have
policies that allow low-income persons to receive reduced-charge,
free, or charity care.
Remember, if you have
questions about specific health care needs and what the charges might be
for services,
ask your hospital |