Insurance Coverage

We realize that health insurance coverage can be difficult to understand sometimes. It is always best to contact your insurer when you have specific questions about your plan’s coverage. Below are some general guidelines to help you understand your coverage.

Questions?

Please call our Financial Services office at 978-287-3432 between 8:00 AM and 5:00 PM, Monday through Friday.

Pre-admission Certification

Most insurance companies require pre-admission certification before they will cover your hospitalization. This means:

• You or your doctor must obtain advance approval from your insurer for non-emergency admission to the hospital or
• You must notify your insurer within 24 hours after an emergency admission

This pre-admission certification may be your responsibility for some commercial insurance. If you do not complete this process, you’ll be held responsible for the costs not covered by your insurance — so it is important to make sure you understand what’s required before you are admitted to the hospital.

You will be asked to provide current insurance upon hospital admission or office visit.

• Your insurance coverage, including Medicare/Medicaid and health maintenance organizations (HMOs), will be evaluated.
• If worker’s compensation is paying your hospital bill, we need verbal or written approval from the carrier before your claim can be processed.
• If your insurance does not cover any part of your bill, you will be responsible for paying the remaining balance. Before your scheduled admission, you can arrange payment by cash, check, credit card, or a payment plan by calling 978-287-3432.

Insurance plans accepted by Emerson Health:

We accept most major commercial insurance, including Medicare and Medicaid (MassHealth). A complete list of insurance companies accepted at Emerson Health can be found here.

Special help for Medicare enrollees

If you are enrolled in Medicare, the Commonwealth of Massachusetts provides free information, counseling, and assistance to you and your caregivers through the SHINE Program (Serving the Health Insurance Needs of Everyone). Specially trained counselors ensure that Massachusetts residents with Medicare and their caregivers have access to accurate, unbiased, and up-to-date information about their healthcare options. For more information, visit the SHINE Program website.