Alyssa Lane
Mercy Health accepts a variety of health insurance types, including commercial, Medicare, and Medicaid, from many local and national health insurance carriers. Mercy Health West Hospital and Mercy Health — Springfield Regional Medical Center also accept a variety of health insurance types from many carriers. Children's Mercy Kansas City accepts insurance plans such as Well First by Medica (offered in St. Louis) and cost-sharing plans, where individuals are responsible for paying a certain amount each month.
| Characteristics | Values |
|---|---|
| Insurance types | Commercial, Medicare, and Medicaid |
| Insurance plans | Well First by Medica (offered in St. Louis) |
| Patient types | Self-pay, short-term medical plan, cost share or ministries sharing group coverage, limited benefits plan |
| Services | Office visit with a doctor or nurse practitioner |
| Billing | Outpatient hospital |
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What You'll Learn
Mercy Health accepts commercial insurance
Mercy Health accepts a variety of health insurance types, including commercial insurance, to ensure that the healthcare needs of the community are met. This means that patients with commercial insurance can access healthcare services at Mercy Health hospitals and Mercy Health Physicians.
Mercy Health hospitals, including Mercy Health West Hospital, Mercy Health Springfield Regional Medical Center, and Mercy Health St. Anne Hospital, accept a range of health insurance plans. While the specific plans accepted may vary by location, Mercy Health aims to accommodate a diverse range of insurance carriers. It is recommended that patients contact their insurance providers before their appointment to verify coverage and ensure that their specific insurance plan is accepted at the hospital they plan to visit.
Commercial insurance plans typically involve the policyholder paying a premium, which is a monthly amount for their coverage. Additionally, there may be a deductible, which is the amount the insured person pays for covered services before the insurance plan contributes. Other components of commercial insurance include co-insurance and co-pay. Co-insurance refers to the percentage of a medical charge that the insured person is responsible for paying, usually after meeting the deductible. On the other hand, co-pay is a set amount that the insured person pays at the time they receive a particular service or medication.
It is important to note that some health insurance plans are not contracted with Mercy Health and are considered out-of-network. In such cases, Mercy Health is unable to bill the insurance company on the patient's behalf, and the patient becomes responsible for the total billed charges. Therefore, patients are advised to confirm their coverage and understand the restrictions of their insurance plans before seeking treatment at Mercy Health facilities.
In addition to commercial insurance, Mercy Health also accepts Medicare and Medicaid. For Medicare Part B, payments may be made directly to the patient, who then submits payment to Mercy Health for any portions not covered by Medicare or other insurance. Medicaid, along with the Children's Health Insurance Program (CHIP), provides free or low-cost health coverage to various demographics, including low-income individuals, families, children, pregnant women, the elderly, and people with disabilities.
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Medicare Part B payments
Mercy Health accepts a variety of health insurance types, including commercial, Medicare, and Medicaid, from many local and national health insurance carriers.
Medicare Part B is medical insurance that covers outpatient services. Some Medicare Part B payments are made directly to the patient, who then submits payment to Mercy Health for any portions not covered by Medicare or other insurance.
The standard monthly premium for Medicare Part B enrollees was $164.90 in 2023 and will be $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $240 in 2024, an increase of $14 from the annual deductible of $226 in 2023. The increase in the 2024 Part B standard premium and deductible is mainly due to projected increases in healthcare spending.
There are several ways to pay Medicare Part B premiums. Most people get their Medicare Part B premium deducted automatically from their Social Security benefit payment or Railroad Retirement Board benefit payment. If you do not receive benefits from Social Security or the Railroad Retirement Board, you will receive a premium bill from Medicare. You can pay your premium using a check, money order, credit card, debit card, or Health Savings Account (HSA) card. You can also pay directly from your savings or checking account through your bank's online bill payment service.
The fastest way to pay your premium is online through your Medicare account or using Medicare Easy Pay. All Medicare bills are due on the 25th of the month, and your premium is usually due the same month that you get the bill.
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Medicaid and CHIP
Mercy Health accepts a variety of health insurance types, including commercial, Medicare, and Medicaid. Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans. This includes low-income people, families, children, pregnant women, the elderly, and people with disabilities.
Medicaid programs must follow federal guidelines, but coverage and costs may vary from state to state. Some programs pay for care directly, while others use private insurance companies to provide coverage. Even if someone does not qualify for Medicaid based on income, they should still apply. They may qualify for their state's program, especially if they have children, are pregnant, or have a disability.
When choosing a Medicaid plan, there are several factors that affect the overall price. These include the premium, deductible, co-insurance, and co-pay. The premium is the monthly amount paid for coverage, which does not include payment for any medical services. The deductible is the amount paid for covered services before the insurance plan pays a portion of the bills. Co-insurance is the percentage of a medical charge that someone is responsible for paying, usually after meeting the deductible. Finally, the co-pay is a set amount that someone must pay at the time they receive a certain service or medication.
It is recommended that individuals confirm coverage and restrictions with their insurance provider before seeking services at Mercy Health. Some health insurance plans do not use a contracted network of providers or are not contracted with Mercy Health, and are therefore considered out-of-network.
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Cost-share or health care share plans
Mercy Health accepts a variety of health insurance types (including commercial, Medicare, and Medicaid) from many local and national health insurance carriers. This includes Mercy Health hospitals and Mercy Health Physicians.
Mercy Health – St. Anne Hospital, Mercy Health – St. Charles Hospital, Mercy Health – St. Vincent Medical Center, and Mercy Health – St. Elizabeth Boardman Hospital are some examples of these. It is recommended that patients confirm coverage and restrictions with their insurance provider before seeking services. Some health insurance plans are out of network at Mercy Health, meaning that patients will be responsible for the total billed charges.
Children's Mercy Kansas City also accepts insurance plans and contracts with many insurance networks to provide healthcare services to their participants. These include Well First by Medica (offered in St. Louis). As a pediatric health system, Children's Mercy Kansas City does not contract or participate with any Medicare Advantage plans. If patients have Medicaid coverage and do not live in Kansas or Missouri, they must contact their State Medicaid Agency or Health Plan to verify that Children’s Mercy Kansas City is authorized to provide care.
A cost-share or health care share plan is provided by organizations whose members "share" medical costs. As part of a health care sharing plan, members are responsible for paying a certain monthly share amount, as well as an "annual unshared amount" for their own expenses (similar to a deductible) that their medical expenses must exceed before the plan shares expenses. Per the No Surprises Act, individuals with a cost-share or health care share plan are considered uninsured. Therefore, any patient enrolled in a sharing plan will be identified as self-pay or uninsured when seeking care at Children’s Mercy.
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Insurance plans accepted by Children's Mercy
Children's Mercy Kansas City contracts with many insurance plans and networks to provide healthcare services to their participants. It is important to note that participation with these plans does not guarantee payment or coverage.
Children's Mercy accepts the following insurance plans:
- Well First by Medica (offered in St. Louis)
- Medicaid (for residents of Kansas and Missouri)
Children's Mercy does not contract or participate with any Medicare Advantage plans. If you have Medicaid coverage but do not live in Kansas or Missouri, you must contact your State Medicaid Agency or Health Plan to verify that Children's Mercy is authorized to provide care.
If you have questions regarding your benefits and coverage, please contact your insurance plan directly.
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Frequently asked questions
Mercy Health accepts a variety of health insurance types (including commercial, Medicare and Medicaid) from many local and national health insurance carriers.
Children's Mercy Kansas City contracts with many insurance plans and networks, including Well First by Medica (offered in St. Louis).
If you are a self-pay patient, you will be responsible for the total billed charges.
