The insurance benefits information provided to you by USMD Hospital at Arlington is for your hospital bill only. It is your responsibility to verify with any other providers and your insurance carrier whether your insurance plan will pay in-network or out-of-network benefits. USMD Hospital at Arlington admits and treats all patients regardless of race, creed, sex, national origin, age, or handicap.
Below is a list of some of the major insurance companies that have contracts with USMD Hospital at Arlington. Please contact our business office at 817-472-3400 to verify participation with your specific employer's health plan. Medicare patients should review this important information about non-covered tests and services.
Medicaid/CHIP, STAR, STARKids
Essential/Balanced/Secure (EPO) and Ambetter Virtual
HMO, PPO, POS, Aetna Signature Administrators (ASA), Medicare Advantage PPO; Medicare Advantage HMO
Medicare Advantage I-SNP
Medicaid HMO: CHIP; STAR+PLUS; STARKids / Medicare Advantage HMO; MMP
HMO, PPO, POS, Trad
Medicare Advantage HMO and PPO
Medicare Advantage PPO, Medicare Advantage HMO
PPO, EPO, Medicare Advantage PPO; Medicare Advantage HMO
HMO, OAP, Network, PPO, Passive PPO, Indemnity; LocalPlus
Medicaid STAR, CHIP, STARKids
PPO, GEPO, ACCEL; Including Behavioral
Workers Comp / NonSubscriber
Medicare Advantage PPO; Medicare Advantage HMO
CHIP; STAR+PLUS; Star; Medicare Advantage HMO-SNP; MMP
Marketplace / Exchange
Medicare Advantage I-SNP
CHIP RSA, Foster Care, STAR, and STAR+PLUS; Medicare Advantage HMO; MMP
TriWest / Eff 8/1/2020
HMO, POS, EPO, PPO, Options PPO, Medicare Advantage PPO and HMO
All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the hospital's billing procedures and charges.
Original Medicare only covers tests/services it determines are reasonable and necessary for your care. We will tell you in writing if your doctor orders tests that Medicare may not pay for. However, you may not be told in writing if the test/service is already listed in your Medicare Handbook as a test that Medicare does not cover.
Look in your Medicare Handbook for information on tests/services that are not covered by Medicare. If you choose to receive the tests/services, you will have to pay for tests/services that are not covered and for tests/services that Medicare feels are not needed for your care.
An ABN is an Advance Beneficiary Notice form. The ABN form tells you in advance that Medicare may not pay for your test/service. This form tells you which tests Medicare may decide are not reasonable and necessary for your care and tells you that you will have to pay for those services. When we give you the form, you will be asked to sign it before the tests/services are done.
You have three options when an ABN form is given to you: (1) agree to pay for the tests/services that Medicare may not cover. The hospital will still bill Medicare and you will be responsible for payment if Medicare denies payment; (2) agree to pay for the tests/services that Medicare may not cover and the hospital does not bill Medicare; or (3) not get them done. If you meet the hospital's charity care rules, you may ask for help in paying for the test/service.
As a Medicare patient, you have rights. These rights protect you and help see that you get needed health care tests/services. Your rights include:
Your doctor will bill Medicare when you get tests in his or her office. But when your doctor orders tests from someone outside of his or her office, that person or facility bills Medicare for the test.
No. Your doctor decides what tests/services you need based on a wide range of factors like your prior medical care, and drugs you might be taking. Even if your doctor feels a test/service is "good medicine," Medicare may not consider it to be medically necessary for patients with your diagnosis. When this happens, Medicare will not pay for the test/service; we will ask you to sign an ABN form, and will bill you for the test.