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What will you pay for health care? Sticker price is rarely the real price you pay

New year, new deductible on your health insurance and the same worries about what you’ll actually pay for your health care.

Believe it or not, the federal government is trying to help. As of Jan. 1, hospitals are required to post on their websites what they charge for services and procedures. The new rule comes from the Centers for Medicare & Medicaid Services, which is trying to promote price transparency.

But the prices you see on the sites for Rochester Regional Health and UR Medicine in response to the edict aren’t necessarily what you will pay for care. That charge is akin to the manufacturer’s suggested retail price on a car. Almost no one pays that, what with rebates and discounts.

Health care is similar, with some exceptions.

Your bill is determined by what your insurer has negotiated with the hospital (and with your doctor if he or she is in private practice) and your specific plan. Even if you don’t have insurance, you aren’t likely to pay the charge because you may qualify for financial assistance.

Tammi Imm of Rochester Regional Health is the vice president of Revenue Cycle, and she oversees hospital charges. She said the CMS rule could add confusion because patients can check a hospital website, see charges for about 80,000 procedures and think that is what they will get billed for the ones they need.

Instead, she said patients should use the health system’s own cost estimator, which takes insurance into account and is closer to what the actual bill will be.

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