Billing & Insurance

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    SBUH Reaches Agreement with MagnaCare to Include
    Health Exchange

    Stony Brook University Hospital and MagnaCare have reached a provider services agreement effective February 15, 2014, resulting in in-network coverage for thousands of Long Islanders who are participating in health exchange plans.

    Over the past several months, Stony Brook has been in active discussions with several healthcare exchange providers in an effort to reach an agreement that is both beneficial for patients and fiscally responsible for Stony Brook and the insurance carrier. This amended agreement will allow members of these Exchange plans to visit Stony Brook as part of their in-network coverage options.

    “We are pleased to have been able to amend our existing agreement with MagnaCare which will allow the thousands of Long Islanders who are enrolled in Health Republic to access Stony Brook University Hospital and its physicians on an in-network basis,” said L. Reuven Pasternak, MD, Chief Executive Officer, Stony Brook University Hospital, and Vice President for Health Systems, Stony Brook Medicine. “It supports New York State’s mission to offer affordable care to our patients in a manner that is consistent with Stony Brook’s core mission as the safety net provider for the area and source of specialized and unique care for populations at risk.”

    "I am pleased that Stony Brook University Hospital has worked hard to resolve this issue," said Senator Kenneth P. LaValle, Chairman of the New York State Senate Higher Education Committee. “As the only State hospital in our region, it is imperative to ensure access to affordable, quality health care for our residents.”

    NOTE: For the most accurate information on what your insurance will pay for, please consult your insurance carrier. Stony Brook University Hospital supports the goal of universal affordable care and is in discussion with five additional plans in the New York State health insurance exchange. In the meantime, Stony Brook has been working with patients in those plans in need of our special services through individual negotiations with their respective exchange/insurance carrier. As we continue discussions with the exchange organizations, patients in need of assistance should call the Stony Brook University Hospital Healthcare Teleservices Office at (631)-444-4392; each caller will be guided by an expert in the Managed Care Department.

    Insurance by Location & Service
    For the most accurate information on what your insurance will pay for, please consult your insurance carrier. At this time Stony Brook University Hospital is in discussion with six plans in the New York State health insurance exchange. We support the goal of universal affordable care and anticipate reaching an agreement with one or more of the plans in the near future. In the meantime, Stony Brook has been working with patients in those plans in need of our special services through individual negotiations with their respective exchange/insurance carrier. As we continue discussions with the exchange organizations, patients in need of assistance should call the Stony Brook University Hospital Healthcare Teleservices Office at (631)-444-4392; each caller will be guided by an expert in the Managed Care Department.

    Need Health Insurance?
    Do you or anyone in your family need health insurance?

    Would you like to know if you are eligible for no or low-cost health insurance?

    If so, call Stony Brook University Hospital HealthConnect® at (631) 444-4000 to have a Child Health Plus/Family Health Plus Enroller contact you.

    Our Enroller will:

    • Describe the Child Health Plus, Family Health Plus, and Medicaid programs' benefits;
    • Help determine your eligibility for these health insurance programs; and
    • Assist you, if you are eligible, in completing your applications for these programs.

    Website Helps Uninsured Secure Health Insurance: www.coverage4healthcare.com

    Your Hospital Bill
    Click here to view an example of a Stony Brook University Hospital bill. As you roll your cursor or mouse over the bill a description of each section will appear. If you have received one of these bills and have questions about it, you can call (631) 444-4151 during office hours (Monday - Friday, 8 am - 6 pm).

    Prior Approval and the Pre-Authorization Process
    If you have managed care insurance and wish to be seen at Stony Brook University Hospital you must obtain a referral from your Primary Care Physician. Some services, for example Radiology and Therapy services, may require pre-authorization from your insurance company prior to your patient visit, test or procedure. You should refer to your insurance handbook or speak to your insurance carrier regarding pre-authorization policy and procedure.

    Financial Assistance
    Stony Brook University Hospital has a Financial Assistance Program to assist patients who have limited income, no health insurance, or are underinsured and have difficulty paying for services provided. The Hospital’s financial assistance program provides discounts to qualifying individuals based on income. Patients whose income is below 400% of the Federal Poverty Level may be eligible for a discount.

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    Family Size400%
     1 $46,680
    2 $62,920
    3 $79,160
    4 $95,400
    5 $111,640
    6 $127,880
    7 $144,120
    8 $160,360

     

    If you believe you may qualify please contact the Financial Aid Unit at 631-444-4331 for an application. Financial assistance applications may also be obtained at the cashier in the Emergency Department, the main cashier on Level 5 of the Hospital or at the Patient Accounts Office at 31 Research Way in East Setauket.

    The Hospital’s Financial Assistance Program is not intended to be a substitute for available insurance coverage. If you are currently covered by an insurance plan please forward the information to our Customer Service staff at 631-444-4151 to ensure your insurance is billed appropriately.

    In addition, you may be eligible for insurance coverage under the Medicaid program. Medicaid is a federal and state funded program that provides medical assistance to low income residents or those on public assistance. Please call your nearest Suffolk County Department of Social Services Medicaid Center to request a Medicaid application.

    Riverhead Center: 631-852-3710
    Hauppauge Center: 631-853-8730

    If you cannot pay your bill, regardless of whether you qualify for Medicaid or financial assistance, you may be eligible for a payment plan. Please call 631-444-4140 to speak to a representative to establish a payment plan.

    Contact Customer Service
    You may contact the Customer Service department by calling (631) 444-4151 during office hours (Monday - Friday, 8 am - 6 pm).