Regardless of your health insurance status, if faced with healthcare bills you find impossible to pay, you are encouraged to contact Patient Financial Services for information on available financial assistance programs. The office is located next to the Outpatient Registration area. Hours are Monday through Friday 8:30 am to 4:30 pm and our telephone number is (508) 957-0157. There is an answering system 24 hours a day, seven days a week. Please leave a message at any time.

Financial assistance is available to residents of Massachusetts for medically necessary services. It is available to non-residents who come to the Hospital in life-threatening situations only. You are eligible if your household income falls within levels outlined by the Department of Health and Human Services. You may be eligible for 100% (no deductible) or partial (deductible based on income) coverage.

As part of the application process, patients are pre-screened for MassHealth and other services and programs. You are encouraged to apply if it is determined you may be a MassHealth candidate.

Mass General Brigham can assist uninsured and under-insured Martha’s Vineyard Hospital patients who have limited financial resources to pay their medical bills. Learn more here.

While payment of balances is due in full, the Hospital realizes this is not always possible. Therefore, payment plans are available. Payments and plan length are based on outstanding balances. Balances of $1,000 or less are payable in 12 months; balances over $1,000 are payable in 24 months. This method of payment is considered a contract with the Hospital and regular, on-time monthly payments are required to keep the plan in good standing. Learn more here.

If applicable, twelve consecutive on-time payments may make a payment plan account eligible for a contribution from the private Mayhew-Nevin Fund. These contributions are in addition to and do not replace required contractual payments. Since Mayhew-Nevin funds are limited and every effort is made to help those who are eligible, at no time can the Hospital guarantee a contribution to any specific account.

Following the Emergency Medical Treatment and Active Labor Act guidelines, the law prohibits us from discussing charges for our services prior to treatment, and we will not ask for payment up-front. Although the Hospital admissions staff does not have information about billing, after you have been treated they will do their best to direct you to the department that can best assist you.

Martha’s Vineyard Hospital cannot and will not deny or delay services for lack of insurance or ability to pay.

This information is available in other languages here.

It is your right to receive an estimate of the cost of your visit in advance of the visit. Please contact Partners Patient Billing Solutions (see below) at least two business days prior to your visit to get an estimate.

Patients can request a cost estimate for health care services at Mass General Brigham. Contact the Patient Financial Experience Team at 617-726-3884, option 2.

You also can generate a self-service estimate for select upcoming or potential services in real-time by using Patient Gateway and navigating to the Billing menu. If you do not have a Patient Gateway account, you can use our online guest estimate tool.

When contacting Patient Billing Solutions, be prepared to communicate the following information about the patient:

• Name
• Date Of Birth
• Medical Record Number (if applicable)
• Phone number
• Procedure Information and CPT Code
• Date of procedure (if scheduled)
• Expected location of procedure
• Physician’s name
• Physician’s phone number

Patient Billing Solutions will then provide this information to Patient Access/Financial Counseling which will generate the estimate and provide it to the patient.

Please do not contact Patient Billing Solutions with this sensitive information via e-mail.

The Centers for Medicare and Medicaid Services Price Transparency rule requires that hospitals provide cost information on 300 “shoppable” items per hospital. We provide access to this information through a cost estimator tool.

What is a Preventive Health Exam and is it Covered by My Insurance?
A preventive health exam is an Annual Physical during which your primary care provider will:

1. Ask you questions about your health
2. Do a physical examination
3. Give you advice about how to prevent health problems
4. Take care of minor health problems or a chronic illness that has not changed

Commercial Health Plans
Under the Affordable Care Act, commercial health plans are required to cover an annual Preventive Health Exam at no cost to the patient (no co-payment, co-insurance or deductible).

Medicare Advantage
Many Medicare Advantage plans will also pay the full cost of Preventive Health Exams as defined in this guide.

Medicare Part B
Annual Wellness Visit
Medicare Part B covers a different version of an annual visit, called a “Medicare Annual Wellness Visit.”

During your Medicare Annual Wellness Visit your provider will:

1. Ask you questions about your health, and family and social history
2. Provide advice about how to prevent health problems, including a plan for screening in the future
3. Screen you for depression and other mental health or safety concerns

A Medicare Annual Wellness Visit does not include a physical exam. If your provider does perform a physical exam during your visit to assess your health or treat any medical problems, you may be responsible for a co-insurance or a Medicare Part B deductible payment.

“Welcome to Medicare” Visit
During your first 12 months of enrollment in Medicare Part B, a “Welcome to Medicare” visit is covered, which includes a physical examination.

When would any of these Annual Health Visits Turn into a Sick or Chronic Disease Visit?
Sometimes, your annual Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit can turn into a “Sick Visit”.

During your visit, your provider may need to treat a new medical issue or a chronic problem that has changed. If that occurs, this part of the visit is called a Sick Visit and may result in additional services being billed to your insurance.

Most insurance companies will pay for Sick Visit evaluations, tests, and treatments, but your insurance plan may require you to pay a co-payment, deductible, and/or co-insurance payment for the Sick Visit, even when it is done during the same appointment as your Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit.

Are Lab Tests for Disease Screening and Immunizations Covered During My Annual Health Visits?
Medicare and many commercial health insurance plans cover certain screening tests (such as cancer and cardiovascular disease screening) and immunizations. Specific coverage depends on your age and health insurance plan. Some tests and immunizations may not be covered at 100% and some may not be covered at all. In those cases you may be responsible for a co-insurance or deductible payment.

When Will I Have to Pay?
We will request your co-payment when you check in for a visit. We will send you a bill if there is any unpaid balance after we receive payment for your visit from your insurance company.

It is important that you understand your health insurance benefits, and we encourage you to contact your health insurance plan if you have any questions about what is included in your Preventive Health Exam, Medicare Annual Wellness Visit or Welcome to Medicare Visit, or about charges for Sick Visits, lab tests, immunizations and other services that are performed during your Preventive Health Exam, Medicare Annual Wellness or Welcome to Medicare Visit.

Hospital Outpatient Billing
When your visit takes place in a hospital outpatient location, there will typically be two charges which may result in you paying more for your visit than if you are seen in a physician office. Your out-of-pocket costs could include the following:

1. You will be charged for the physician’s examination, which will usually be covered by your co-payment.
2. You will also be charged by the hospital for use of hospital space, equipment, and support staff. This is commonly known as a “Facility Fee.” Your health plan may apply these hospital charges to your annual deductible, and after using up your deductible, you may be responsible for a co-insurance payment.

You may receive a bill that combines the charges from the hospital and the physician on one line or these charges may be split into two lines, depending on the location. We will request your co-payment when you check in for your visit, and we will send you a bill for any unpaid balances after we receive payment from your insurance company.

Understanding Whether My Visit is a Physician Office Visit or a Hospital Outpatient Visit
You can find information about whether your visit is a physician office or hospital outpatient visit in notices in our waiting rooms, on the websites of our hospitals and physician groups, and in electronic appointment reminders for your scheduled visits.

Special Notice for Medicare Patients
If you are a Medicare beneficiary and your visit takes place in a hospital outpatient location, you will be responsible for a Medicare Part B out-of-pocket co-insurance payment of approximately $25 for the hospital facility charge. Procedure charges or other testing could increase your out-of-pocket expense.

Further Information
Please contact the Member Services department of your health insurance plan to verify your coverage and financial responsibility for services described on this page. This phone number is usually located on your insurance card.

If your physician ordered laboratory tests or imaging services (such as X-ray, CT or MRI), you may be billed for these tests by the hospital, clinical laboratory, or imaging center, and you may also be billed for the services of the physicians (usually pathologists and radiologists) who interpreted the test results.

As required by the federal government (Centers for Medicare and Medicaid Services), we publish information (a comprehensive machine-readable file) about the rates negotiated with insurance companies for all services and items offered by our hospital. This file is listed below and available for download. Please note: Because of the size of the file, you may need special computer software/speed to open the file.

The price information contained in this large file is NOT an estimate of the costs that you are responsible for paying. This file is not intended for patients and does not reflect your out-of-pocket costs. If you are a patient, you can request a cost estimate by contacting Patient Billing Solutions or using our online tool to view a cost estimate of common health care services (“shoppable items”). Read more about patient cost estimates.

Martha's Vineyard Hospital charge data

This file is updated once a year, but prices and contracted rates are updated during the year and these updates may not be reflected in this file.