Patient Estimates
Disclaimer
Please read the follow and click “Accept and continue” to proceed. By clicking “Accept and continue” you are acknowledging that you are accessing this information to determine your estimated out-of-pocket costs associated with your own healthcare services. The information provided on this website is intended to help you better understand potential out-of-pocket costs for healthcare services. The information is not a quote, nor is it a guarantee of payment or benefits for healthcare services. If you have insurance, your insurance policy (including deductibles, co-pay, co-insurance, out-of-pocket maximums, covered services and medical necessity) will further determine the amount owed. The estimate does not include any physician or professional service costs, including, but not limited to, office visits, surgeon, anesthesiologist, emergency room physician, radiologist, pathologist, consulting physicians, nurse practitioner, physician assistant, physical therapist, etc. or costs for prescription drugs administered through prescription drug benefit programs. Benefits and eligibility are subject to change at any time. This estimate may contain private information that is protected by law. If you are not the patient, patient representative or guarantor, sharing, copying or using this information in any way is against the law. For more information about how the information you’re sharing is collected, used and protected by Womans Hospital, please contact Womans Hospital. Note: Your estimate is not a guarantee of payment or insurance coverage. Please check with your insurance if you need help understanding your benefits for the services chosen. I HAVE READ THE DISCLAIMER AND UNDERSTAND THE INFORMATION ON THE FOLLOWING PAGES IS AN ESTIMATE ONLY. I UNDERSTAND THAT MY ACTUAL OUT-OF-POCKET COSTS MAY BE, AND LIKELY WILL BE, DIFFERENT THAN THE ESTIMATED AMOUNT SHOWN.