Insurance
What are co-pays?
A co-pay, short for copayment, is a fixed amount a healthcare beneficiary pays for covered medical services. The remaining balance is covered by the patient's insurance company. Co-pays typically vary for different services within the same plans, particularly when they involve services that are considered essential or routine and others that are considered to be less routine or in the domain of a specialist. Co-pays for standard doctor visits are typically lower than those for specialists. Note that copays for emergency room visits tend to be the highest.
What is a deductible?
A deductible is a fixed amount a patient must pay each year before their health insurance benefits begin to cover the costs. After meeting a deductible, beneficiaries typically pay coinsurance—a certain percentage of costs—for any services that are covered by the plan. They continue to pay the coinsurance until they meet their out-of-pocket maximum for the year.
What is coinsurance?
After meeting a deductible, beneficiaries typically pay coinsurance—a certain percentage of costs—for any services that are covered by the plan. They continue to pay the coinsurance until they meet their out-of-pocket maximum for the year.
Do you accept my insurance?
We are contracted with most insurance carriers, PPO's, as well as Medicare. If you don't see your insurance carrier on our insurance and billing section, please give your health insurance plan provider a call to double check. The number can be found on your plan card. Service and benefit coverage vary based on geographic location or between an Urgent Care or Primary Care visit. While we do accept Medicare, at this time we do not accept Medi-Cal.
Do you accept HSA?
Yes, we accept HSAs. To check if we accept your insurance, please visit our website at carbonhealth.com/insurance-pricing.
Do you accept HMO?
Currently, we only accept a limited number of HMO plans at a few primary care and urgent care clinics. Please reach out to your specific clinic to verify if they take your HMO plan.
Additionally, we always recommend giving your health insurance plan provider a call to confirm your coverage and benefits. The number can be found on your insurance card.
Do you accept PPO?
While we're contracted with most PPOs, we always recommend contacting your health insurance plan provider to confirm your coverage and benefits. The number can be found on your insurance card. Out-of-network service and benefit coverage can vary based on geographic location, or between an urgent or primary care visit.
To check if we accept your insurance, please visit our website at carbonhealth.com/insurance-pricing.
Do you accept FSA?
Yes, we accept FSAs. To check if we accept your insurance, please visit our website at carbonhealth.com/insurance-pricing.
How much does COVID-19 testing, treatment, and vaccines cost?
The following information is for COVID-19 testing and treatment only and does not apply to other Carbon Health care visits.
COVID-19 Vaccinations
There is no cost to the patients for the COVID vaccines regardless of their insurance, ability to pay, or immigration status. Vaccines remain available for all patients.
COVID-19 Testing & Treatment
Uninsured Patients
Patients may apply for Medicaid benefits and seek care from participating providers. Carbon Health is only a Medicaid provider at limited locations.
Community Clinics may be available near you that are offering COVID related services with no out of pocket costs to the uninsured. Search HRSA’s “Find a Health Center”
Patients may apply for Carbon Health’s Financial Assistance Program based on Federal Poverty Guidelines, if you are unable to pay for COVID related services. An approved application and documentation is required for program approval. Patients can email carbonFAP@carbonhealth.com for more information.
Other testing options:
At home testing kits are also available through https://www.covidtests.gov/ (opens in a new tab)
Insurance Covered Patients
Testing for COVID-19 - Testing is still available at all Carbon Health locations. When the Public Health Emergency ends, insurance coverage may change and there may be an out of pocket responsibility due by the patient.
Treatment of COVID-19 - Majority of national payers are now requiring standard out of pocket costs to be paid by the patient for COVID-19 treatment. If you test positive for COVID-19, please confirm your out of pockets costs with your insurance company. You will be expected to pay for your out of pocket copays and coinsurances at the time of service.
COVID-19 travel testing or expedited testing
COVID-19 travel testing or expedited testing provided with a guaranteed turnaround time and requires the payment of a convenience fee. Because insurance plans are not required to cover the costs of COVID-19 tests associated with guaranteed turnaround times, Carbon Health asks patients to pay for these tests before the test is administered. See pricing for all travel testing options and find out where to book a test (here)[https://carbonhealth.com/covid-19-travel-clearance (opens in a new tab)].
How much will my co-pay be?
To get your specific copay cost amount for your visit, we'll need to see your insurance card and verify the insurance carrier. We recommend that you call the member's services number on the back of your insurance card and ask about coverage and co-payment fees for urgent care visits. Co-pays for an urgent care visit will typically be different than the co-pay amount for a primary care visit. If you don't have time to call your insurance, we can determine the co-pay amount if your plan and coverage is verified upon check-in to your visit, whether you are visiting Carbon Health for urgent care or primary care.
What does it mean if my insurance is not verified?
We have real-time insurance eligibility built into our app; however, there may be times when an insurance plan can't be verified due to the following: The Payer ID not being accurate, The insurance plan is from a third party, The insurance provider eligibility system is not responding.
How do I add my insurance if I'm on my family's plan?
If you are on your family's insurance plan as a dependent, after you scan the insurance card, select "Family Member" Instead of "This is me." If you are not given the option to select "Family Member" please contact your insurance and confirm that you are marked as a dependent on their plan. Keep in mind that certain information from the insurance card is auto-populated into your chart. If "This is me" is selected, or if you manually enter a family member's name instead of yours, your name will be incorrect in your chart. If this is the case please re-enter your insurance information.