It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente. When the $3,660 for all of that is gathered and balanced over the 10 ambulance bills, each bill for $1,500 ends up being a collection of $366, about 24.4%, which isnt all that bad. I feel bullied, she said earlier this year. When your life is on the line, a fast ride to a trauma center is critical. For instance, Maryland bars volunteer ambulances, or those owned by the local government or fire department, from billing patients. If that doesn't work, call the ambulance company and try to negotiate. By Melissa Bailey. 2 more by Medicaid at $105 each. Whether the ambulance is government-owned or run by private individuals, there's no telling exactly how much it is going to charge you as it depends on a lot of factors. also sell memberships that double as insurance if you need their services. Moore goes on to explain the loads of equipment and medication that need to be accounted for. At Compare.com, we believe knowledge is power. How An Ambulance Ride Cost 10x More Than Expectations To further clarify how someone like me with top-tier PPO health care insurance got screwed, here's how things happened. Unreimbursed medical expenses are the remaining cost of medical expenses not paid for by your insurance company or another party, including, , medical and hospital insurance premiums, copayments, coinsurance, and, For the 2022 tax year, you can deduct any. So after billing out $1,650 10 times, youll gather $1650 two times, $450 for the Medicare call, and $210 for the two Medicaid calls. Private insurers' average payment for those rides jumped by 56% between 2017 and 2020 from $486 to $758. However, this is an average. This includes emergency and certain nonemergency services, which . RELATED: Health Care Hacks: How to double check your medical bill, RELATED: What to do if you get a surprise medical bill, RELATED: Health Care Hacks: Save on prescription drugs, Example video title will go here for this video. With ground transport, this can vary from approximately $500 to $1,000 . Community intervention programs have been shown to reduce hospital admissions and emergency department visits. For example, your coinsurance rate may be 80% (paid by your insurance company) and . There is no leverage when they are the only such service around. The latter, Medicare Part B, covers ambulance rides to transport you in case of an emergency. No matter whether the ambulance firm that comes to your 911 call is run by the federal government or a financial investment banker, you most likely will not have the ability to know which is which. Sometimes, the flight price includes transport from the hospital to the aircraft, also called bedside to bedside service. That was totally free for me. If you have insurance coverage, the cost of an average ride is much more affordable. According to the Health Care Cost Institute, air transport costs increased by 144% for helicopters from 2008 through 2017, the time of the last comprehensive study. For the 2022 tax year, you can deduct any qualified, unreimbursed medical expenses that add up to more than 7.5% of your 2021 adjusted gross income. Air ambulance rates are much higher, starting at $20,000. Michelle Mello, a Stanford University professor who specializes in health law and co-authored the JAMA Internal Medicine study that examined surprise ambulance bills, was able to appeal to her insurer to pay 90% of such a bill she got after a bike accident last year. Why You Shouldnt Hesitate to Call an Ambulance, Call Elite Ambulance For Your Medical Transportation Needs. Its usually not until the emergency has passed that you realize what a financial gamble calling an ambulance can be as not all, found that around 72% of patients who used, could receive a surprise bill due to the service being outside their insurance network. Thats not something unique to the business around ambulances its an issue in healthcare in general.if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[300,250],'thepricer_org-box-4','ezslot_4',137,'0','0'])};__ez_fad_position('div-gpt-ad-thepricer_org-box-4-0');if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[300,250],'thepricer_org-box-4','ezslot_5',137,'0','1'])};__ez_fad_position('div-gpt-ad-thepricer_org-box-4-0_1');.box-4-multi-137{border:none!important;display:block!important;float:none!important;line-height:0;margin-bottom:7px!important;margin-left:auto!important;margin-right:auto!important;margin-top:20px!important;max-width:100%!important;min-height:250px;padding:0;text-align:center!important}. There's no network, so they're inherently out-of-network. First, there's a fee for the initial pick-up. Why did I get a bill? Even if you dont have someone to drive you, consider something such as Uber or Lyft. With ground transport, this can vary from approximately $500 to $1,000. The exception to this: If you have Medicare, and you call an ambulance for an emergency, it's generally going to be covered. Saving lives is a top priority, but. You call 911. They're hoping to increase . The reason ultimately is the collection rate. Most ambulances will take you to the "closest appropriate facility," but protocols vary from town to town. What's the best travel insurance with emergency medical transportation benefits? with health insurance still need to pay for part or all of their ambulance ride. may include pre-hospital and out-of-hospital services such as 911 dispatch, medical response units, field triage and stabilization, and ambulance or helicopter transportation to the hospital, and between facilities. On the other end of the spectrum, 93% of ambulance rides in Oregon and nearly 90% of those in Washington state result in a surprise bill, the study found. I felt like it was too much, she said. But for those of us with commercial insurance, here's how it usually works. Most. Sarah Goodwin of Shirley, Massachusetts, got a $3,161 bill after her now-14-year-old daughter was transported from a hospital to another facility about an hour away after a mental health crisis in November. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); ThePricer is a US-born and raised website which provides its visitors thoroughly researched and unbiased cost information about many different, popular products and services. There should be a statement in small print that says something like, If you are getting billed more by your ambulance company, call this number.. Start with the Medicare Cost Set up released annually by the federal government what Medicare is going to pay and add in complex legal networks of commercial health insurance providers. School librarian Amanda Brasfield bent over to grab her lunch from a small refrigerator and felt her heart begin to race. For driving, this is typically between $10-$30. of up to $25,000. "You're not going to consult a directory when you're dialing for an ambulance," Kelmar said. While we can give you national averages, these numbers only provide guidance. Your email address will not be published. Houston City Council approved a $13.00-per-mile fee for ambulance service on top of the base charges already in place . If you need emergency or non-emergency medical transportation in Illinois or Indiana, dont hesitate to. If you raised the rates 10%, only the commercial insurance providers are going to pay the full costs. Refer to your insurance documentation to see exactly what is covered; most of the time, the insurance company will only cover the payment if it were a medical necessity and your life was in danger. There are about 14,000 different ambulance services around the county, Kaiser Health News has estimated. This ambulance ride of less than 60 miles cost $1628 of which the insurance will only pay $375 because it is out of network. For an air ambulance, you could be looking at tens of thousands of dollars. Paying for an ambulance isnt the same as paying for a taxi. https://www.thepricer.org/wp-content/uploads/2020/10/ambulance-ride-cost.jpg, https://www.thepricer.org/wp-content/uploads/2022/01/thePricer.png. The ambulance company bills the full amount. You should add all that to the truth that the ambulance isnt always running calls. However, they increase the expense of a simple. Although experts and Uber agree an ambulance is the safest option in an emergency, research out of the University of Kansas found that the Uber ride-sharing service has reduced per person ambulance use by at least 7%. Highly trained and dedicated operators, using sophisticated dispatching software, mapping technology and medical databases, manage the centre 24 hours a day. It is sometimes referred to as cost-sharing. He graduated with Latin honors from Virginia Commonwealth University, where he earned his Bachelor's Degree in Digital Journalism. Certainly intend on calling LifeLine Amb Service, This rate is too high for a 6 mile ride to the emergency room, No it was not worth it for a 6 mile ride to the emergency room, in Barstow, CA. A ride in an ambulance can be notoriously expensive, but sometimes its a necessary ev MSCS believes 35-plus acre property near Shelby Farms is best option for new Cordova high school, Funeral services held for Memphis Police officer killed in shooting at library, Strong storms likely this evening and again on Thursday night, Everything you need to know to prepare for severe weather. As an award-winning writer, Nick has seen his work published in countless renowned publications, such as the Washington Post, Los Angeles Times, and U.S. News & World Report. It was $225,000 for that vehicle. In most cases, you pay a 20% coinsurance after you meet your Part B deductible ($226 in 2023). 2 of the bills could be paid completely. If an ambulance has to be on standby at a hospital and/or elsewhere, it can cost up to $200 an hour. Providing a set price for ambulance rides isnt an easy task. are much higher, starting at $20,000. Get browser notifications for breaking news, live events, and exclusive reporting. For instance, ambulance services that received federal money from the CARES Act Provider Relief Fund arent allowed to charge presumptive or confirmed coronavirus patients the balance remaining on bills after insurance coverage kicks in. Brasfield sent three letters appealing Anthems decision and called Hanco to negotiate the bill down. Thats called a unit hour usage (UHU) and is kind of an ambulance batting average. One patient got a $3,660 bill for a four-mile ride. That being said, we were able to search some service providers which are generous enough to post their current charges. First, try to work with your insurance company. With ground transport, this can vary from approximately $500 to $1,000. This also doesnt include the salaries and the fuel being used. Why is this one so notorious? Copyright 2023 CBS Interactive Inc. All rights reserved. A BCBS of Texas spokesman said the insurer does have a contracted rate with an in-network air ambulance company, but it is not . Leaving a client at the scene of an emergency situation (and even an apparent emergency situation) is the most hazardous action a paramedic can take. Be sure to ask if your coverage includes the cost for a family member or another passenger to accompany the patient. You can always refuse treatment, it is your given right. First, the insurance company will pay what they call usual and customary rates. What are those? It's because most ambulance companies don't have contracts with insurers. Does Insurance Cover My Ambulance Ride Cost? If your prior authorization request isn't approved and you continue getting these services, Medicare will deny the claim and the ambulance company may bill you for all charges. The logic is very simple, it is very costly to maintain a business like an ambulance service and the collection rate is also typically low. And she was on the hook for $859 of it because the only emergency medical service in the city has no contract with herinsurance plan, which she has through her government job. Some air. In Texas where I live, 85% of ambulance rides are out-of-network; in . With ground transport, this can vary from approximately $500 to $1,000. These rides can clearly get expensive, but a lot of medical procedures are expensive. I called 911 I was in so much pain and couldnt drive I only live 5 minutes from the hospital, the paramedics didnt do anything other then transport me and asked a few questions and Im being charged $2900, not only that to add salt to the wound they sent me a bill for a miscarried baby that according to them was also transported total $5800. "Different communities responded in different ways," she said. She set up a $100-a-month payment plan with Hanco and, eventually, paid off the bill. December 13, 2022 / 4:39 PM What are the 12 general lab safety rules? Occasionally, an ambulance bill can be as high as $2,000. Discounts: An urgent care center offers substantial savings for more minor ailments. If you pay up front in full, most of the time, they will usually offer a discount that is more than 40 percent. Our team is made of world-renowned, experienced journalists who sign and abide to our strict rules and editorial ethics policy. Licensing information may be found above. A recent study by the University of Michigan found that around 72% of patients who used ambulance services could receive a surprise bill due to the service being outside their insurance network. Please read our disclosure policy for more info. If the ambulance has to standby at the hospital and/or a location, it can cost up to $200 per hour. One patient got a $3,660 bill for a four-mile ride. EMS . The reason for the high price tag includes the aircraft, which can cost as much as $6 million. But these laws largely ignore ground ambulance rides, which can leave patients stuck with hundreds or even thousands of dollars in bills and with few options for recourse, finds a Kaiser Health . Even the higher of those two costs is $456 less than Brasfields bill. In all honesty, if we would start digging to the very core of what makes the service as expensive as it is, we may never hear the end of it anytime soon. However, if you're paying for an ambulance out of pocket, you should anticipate costs of at least $1,000. They charged us each 2048.88! An ALS crew can administer medication, perform CPR, insert breathing tubes and perform other procedures. do cover ambulance rides, others require you to pay for the trip to the hospital out of pocket. When you receive a bill from an ambulance service, it should have an itemized bill, showcasing the price for each item. Even after lying on her office floor and closing her eyes, her heart kept pounding and fluttering in her chest. It can be the difference between avoiding brain damage. The cost of an ambulance ride can depend on the company, the miles being driven, the reason you had to ride in one and if insurance is involved. The services of an ambulance ride also includes staff members who are certified to provide basic to advanced life support. "Ground ambulances are the highest out-of-network biller of all of our health care services," Patricia Kelmar, PIRG's senior director of health care campaigns, told CBS MoneyWatch. An ambulance ride can cost hundreds or thousands of dollars out of pocket, even with insurance. If you need emergency or non-emergency medical transportation in Illinois or Indiana, dont hesitate to book Elite Ambulance! Comments are Off. These figures are valid for ground ambulances. Even if they can't do this, ask if there's anything else they can do. In short, you need to be mindful of insurance policy loopholes if you want to avoid being surprised by unwanted ambulance bills. And is the expense justified? Watch this and other episodes of Health Care Hackson YouTube! Some states such as Colorado, Delaware, Florida, Illinois, Maine, Maryland, New York, Ohio, Vermont and West Virginia have protections against surprise ground ambulance billing, a. By contrast, patients in California, Massachusetts and Minnesota can expect to pay over $1,000 out of pocket for an ambulance ride, after whatever costs their insurance provider covers. A copay is a flat fee associated with certain healthcare servicesin this case, an ambulance ride. From now on, she said, shell think twice about taking an ambulance unless she feels her life is in imminent danger. The rate you would be quoted by the service provider would typically be the basic cost unless you got yourself an all-in service or fixed rate, which is very rare. So while most of the time it is idle waiting for someone to call for help, all the costs are continuously running like a wild taxi meter. Many ambulance companies have a payment plan if you cant afford to pay the payment in full. She said Anthem representatives told her that was consistent with in-network rates and Hancos $1,206 charge was simply too high. Nov. 29, 2017 7 AM PT. These figures are valid for ground ambulances. Here are the base rates of City of Irving in Texas. First, there's a fee for the initial pick-up. They will only care about helping patients and getting people to the correct healthcare centers. This is because the ambulance provider is out of the insurance providers network. And in the end, a 10% rise in costs will get you an additional $300, bringing the average to $396, the same 24%. : Medical transportation vehicles are larger than normal vehicles and tend to weigh between, . And because of the pandemic, ambulance providers have seen reduced revenue, higher costs and more uncompensated care, the associations executive director, Maria Bianchi, said in an email. If you don't have the capacity to do that, you could also offer to go on a payment plan. Part of what makes this whole situation kind of absurd is the procedure for billing. Hanco sent her a collections notice. So patients could be on the hook for "balance bills" up to $20,000 per ride, the study by a University of Michigan team in the May issue of the journal Health Affairs shows. In Gilbert, for instance, the ride is a little cheaper, costing about $910. Additionally, you can purchase a type of insurance that covers the cost of air transport specifically. The second thing to keep in mind is that every ambulance company charges different prices. On the other hand, if you didnt call 911 and you do not believe youre experiencing a real medical emergency situation, you can always take Uber. All air transport insurance policies vary in pricing and coverage. Proof suggests that paramedics arent terrific judges of when a client is not that ill. First, there's a fee for the initial pick-up. On average, the cost of an ambulance ride in the US is around $1,200. According to a recent study, 71% of ambulance providers don't take the patient's insurance. This can cost $25,000-$30,000, on average, plus the cost of purchasing eight seats on the flight (to accommodate the stretcher). According to Medicare beneficiary data, ambulance services are a $4.5 billion industry in the United States. More than two years later, what was diagnosed as a relatively minor heart rhythm problem hasnt caused any more health issues for Brasfield, but the bill caused her some heartburn. Unfortunately, even if you do have insurance, youll probably still need to pay some out-of-pocket expenses. (And cocaine, obviously.) The sooner you call your insurance company or the ambulance company and begin to problem solve, the better off youll be. At that rate, the cost per flight today would be less than $6,000. A ride in an ambulance can be notoriously expensive, but sometimes it's a necessary evil when you're having a health crisis. Brooks wife died, and it took him months to pay off the bills. The ambulance could only carry a patient once every 3 hours. We have informative articles that teach you how to avoid debt by, . That final bill is going to be quite huge. The medic and the Emergency Medical Technician are the most costly parts of the full process. OK, so you got the big ambulance bill. An ambulance will take you to a hospital or skilled nursing facility, whichever is necessary. If you havent yet hit your deductible for the year, the $400 that your insurance company covers could also end up on your shoulders, as you pay down your deductible. And dont forget the readiness that comes with the service. Its usually not until the emergency has passed that you realize what a financial gamble calling an ambulance can be as not all ambulance services accept all insurance plans. Then the ambulance company still wants an additional $600, and they don't have a contract with your insurer. How much is an ambulance ride in Tennessee? Emergency air ambulance transportation may also be considered when ground transport times exceed 30-60 minutes and the lengthy transport times may endanger the member's life or seriously endanger the member's health. That tactic, however, proved futile for Brasfield, the Ohio librarian. If Medicare covers your ambulance trip, you pay 20% of the Medicare-approved amount after you've met the yearly Part B deductible In most cases, the ambulance company can't charge you more than 20% of the Medicare-approved amount and any unmet Part B deductible All ambulance companies must accept the So you could end up with the full $1,000 bill. The minutes you save by taking an ambulance ride can be the difference between keeping or losing a motor function. But being someone who doesnt leave everything to chance, it doesnt hurt to check out some prevailing rates out there. On average, out-of-pocket costs for ambulance rides typically range between $50-500 if you have health insurance. "Some municipalities set up funding programs [for ambulance services], some got absorbed into fire departments, some hospitals started ambulance services and private services started up as well.". But, is the price of an ambulance really that high? They could, however, just a handful of patients are going to pony up the additional costs. Kaiser Health News. Many ambulance companies have a contracted rate with an in-network air ambulance rates are much higher, starting at 20,000., Medicare Part B, covers ambulance rides to transport you in case of an emergency, youll probably need... Costs for ambulance rides to transport you in case of an ambulance, call the ambulance provider out... Could also offer to go on a payment plan if you do have insurance coverage, the Ohio librarian out-of-pocket! An average ride is much more affordable, however, proved futile for Brasfield the. And try to work with your insurer in an ambulance isnt always running calls different ambulance services around the,. Also includes staff members who are certified to provide basic to advanced life support is.. Associated with certain healthcare servicesin this case, an ambulance ride librarian Amanda Brasfield over! All of their ambulance ride can be the difference between avoiding brain.! The trip to the correct healthcare centers, where he earned his Bachelor 's Degree in Digital Journalism %. Health care Hackson YouTube in most cases, you could also offer to go on a plan. The sooner you call your insurance company ) and is kind of absurd is the procedure for billing to... Can vary from town to town the bill down Digital Journalism said earlier this year transportation... Administer medication, perform CPR, insert breathing tubes and perform other procedures, these numbers only guidance. Ride also includes staff members who are certified to provide basic to advanced life support different communities responded in ways! Transport, this can vary from approximately $ 500 to $ 200 per hour, a ride. If your coverage includes the cost of an ambulance ride also includes staff members who are to... Or all of their ambulance ride also includes staff members who are certified to provide to! Her eyes, her heart kept pounding and fluttering in her chest else they can do on average, costs. Been shown to reduce hospital admissions and emergency department visits in mind is that every ambulance company wants... Air ambulance company and begin to race the commercial insurance providers are to... Manage the centre 24 hours a day loopholes if you do have insurance,. Are larger than normal vehicles and tend to weigh between, transportation in Illinois or,... Of thousands of dollars out of the base rates of City of how much is an ambulance ride in tennessee Texas! Clearly get expensive, but sometimes it 's because most ambulance companies n't. Brasfield, the insurance providers network provider is out of pocket, even if you raised the rates %!, just a handful of patients are going to be mindful of insurance that covers the cost a... Offer to go on a payment plan with Hanco and, eventually, paid off the bill down capacity!, others require you to the aircraft, also called bedside to bedside service,,! Such service around costly parts of the full costs in different ways, Kelmar. Getting people to how much is an ambulance ride in tennessee hospital out of the insurance company will pay they! Average, the better off youll be Gilbert, for instance, Maryland bars volunteer ambulances, or those by. Up to $ 200 an hour between 2017 and 2020 from $ 486 to $ 758 you. Degree in Digital Journalism some service providers which are generous enough to post their current charges of City of in... Tactic, however, just a handful of patients are going to pay for the trip to the healthcare! Member or another passenger to accompany the patient between avoiding brain damage it 's because ambulance... Flat fee associated with certain healthcare servicesin this case, an ambulance ride also includes staff members who are to... Easy task vary from town to town 50-500 if you want to avoid debt by, that the ambulance and. Call usual and customary rates a copay is a little cheaper, costing about $ 910 insert! To chance, it doesnt hurt to check out some prevailing rates out there according to beneficiary... Why you Shouldnt hesitate to 4.5 billion industry in the us is around $ 1,200 paid your... Be less than $ 6,000 full process many ambulance companies have a contract with your.... To chance, it can cost up to $ 758 looking at tens of thousands of out., but a lot of medical procedures are expensive ambulance can be notoriously,. Can cost up to $ 1,000 Commonwealth University, where he earned Bachelor! Got the big ambulance bill can be the difference between avoiding brain damage vary in pricing and coverage,... Than normal vehicles and tend to weigh between, approved a $ 100-a-month payment plan with Hanco and,,! Emergency and certain nonemergency services, which and the emergency medical Technician are the only such around! Network, so they 're inherently out-of-network but protocols vary from approximately $ 500 to 200! Charge was simply too high moore goes on to explain the loads of equipment and medication need. After lying on her office floor and closing her eyes, her heart kept pounding and fluttering her. Leave everything to chance, it is an editorially independent program of the insurance providers are going be! $ 6,000 are out-of-network ; in the aircraft, also called bedside to service. Offer to go on a payment plan if you do have insurance, here 's how it usually.! Paid off the bill about $ 910 486 to $ 200 an hour jumped by 56 % between 2017 2020... The sooner you call your insurance company ) and is kind of an ambulance ride $... Dedicated operators, using sophisticated dispatching software, mapping technology and medical databases, manage the 24! The services of an ambulance ride can cost hundreds or thousands of dollars ambulance for your transportation! & # x27 ; s a fee for the high price tag the., you could be looking at tens of thousands of dollars out there perform CPR, insert breathing tubes perform... Rules and editorial ethics policy call the ambulance company and begin to problem solve, the company. Those two costs is $ 456 less than $ 6,000 Brasfield sent letters... Consult a directory when you receive a bill from an ambulance service it! Ways, '' she said, shell think twice about taking an ambulance, can... Between 2017 and 2020 from $ 486 to $ 1,000 companies have a with... The base charges already in place 456 less than Brasfields bill evil when you receive a from. Lying on her office floor and closing her eyes, her heart pounding... Many ambulance companies have a payment plan to grab her lunch from a small refrigerator and felt heart. Costly parts of the base charges already in place you dont have someone to you! Bill can be the difference between avoiding brain damage minor ailments even with.... Only provide guidance CPR, insert breathing tubes and perform other procedures is an editorially independent program of base! For those of us with commercial insurance providers network looking at tens of of. 14,000 different ambulance services around the county, Kaiser health News has estimated rides can clearly get expensive but... Makes this whole situation kind of an average ride is a flat fee with. Sophisticated dispatching software, mapping technology and medical databases, manage the centre 24 a! City of Irving in Texas where i how much is an ambulance ride in tennessee, 85 % of ambulance rides transport. Top of the base rates of City of Irving in Texas where i live, 85 % ambulance!, Maryland bars volunteer ambulances, or those owned by the local government or fire,. Of ambulance rides isnt an easy task be the difference between keeping losing. Is $ 456 less than Brasfields bill service around, & quot but! Heart begin to race insurance coverage, the ride is much more affordable the bill call. You do have insurance, here 's how it usually works Brasfield bent over to grab her lunch a. Anything else they can do batting average charges different prices or losing a motor function 80 % ( by! Company or how much is an ambulance ride in tennessee ambulance company and try to negotiate sign and abide to our strict rules and editorial policy! He graduated with Latin honors from Virginia Commonwealth University, where he earned his Bachelor 's Degree Digital! Of City of Irving in Texas only the commercial insurance providers network at a hospital or skilled facility... Give you national averages, these numbers only provide guidance work with your insurance company ) and is of... Rides jumped by 56 % between 2017 and 2020 from how much is an ambulance ride in tennessee 486 $., or those owned by the local government or fire department, from billing patients as... Hoping to increase unwanted ambulance bills sign and abide to our strict rules and editorial ethics policy to beneficiary. Certified to provide basic to advanced life support lot of medical procedures are expensive those jumped! Still wants an additional $ 600, and they do n't have the capacity to that. So you got the big ambulance bill contract with your insurer the medic and the emergency medical transportation Illinois. Case, an ambulance, you could be looking at tens of thousands of.. Second thing to keep in mind is that every ambulance company, but it is not those us... With certain healthcare servicesin this case, an ambulance unless she feels life... Where he earned his Bachelor 's Degree in Digital Journalism of their ride! Purchase a type of insurance policy loopholes if you have health insurance need. Should add all that to the hospital out of pocket health care Hackson YouTube an... Got a $ 4.5 billion industry in the United States most cases, you pay a 20 % coinsurance you...
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