Many doctors and hospitals are adding on sneaky fees for services that used to be included with routine visits and treatments. And the fees typically are not covered by insurance.

Example #1: A patient who went to see a mental health therapist was billed an additional $100 “facility” fee for the room in which the visit took place.

Example #2: A woman who walked into an emergency room after a bicycle accident was charged a “trauma activation” fee of $2,457 for the hospital to alert trauma personnel, including a surgeon, none of whose services were ever used.

If you are covered by Medicare, the medical provider is required by law to clearly inform you in advance about any service that may not be covered and to estimate what the cost to you will be. However, private insurers are under no such obligation if patients don’t ask for this information.


Speak to your doctor and the person in charge of billing before you are treated. Ask: “Is everything you are going to do for me covered by my insurance? If not, you need to tell me in advance.” If they disclose an unexpected fee, check ahead of time whether your insurer will agree to cover it as part of the general treatment. If not, tell your doctor, “I’m not able to afford to pay anything beyond my co-pay and deductibles,” and ask to have the fee removed or reduced. Many doctors will comply.

Refuse to pay a bill if there’s a fee that was not disclosed even though you asked. File a report with the state insurance department requesting that it launch a fraud investigation. Many providers would rather dismiss a miscellaneous charge than endure an