Insurance & Financial Information

Financial InformationThe medical concerns of cancer treatment can sometimes be accompanied by financial concerns. Our financial counselors are available to offer assistance in obtaining grant funding for patients or working with health insurance companies to work through financial challenges. Please call (970) 569-7525 to speak with one of our financial counselors. If you have additional financial concerns, please call Margaret Brammer, our social worker, at (970) 569-7606.

Shaw's Financial Assistance Guidelines (pdf) establish the financial requirements for payment of services based on consistent compliance criteria incorporating individual patient financial conditions and circumstances.

ESTIMATE YOUR COST OF CARE

Our Insurance Support Team is available to provide estimates of anticipated charges for diagnostic testing, surgery, oncology services and rehabilitative therapies. Call an insurance support representative at (970) 777-2902 or email insurancesupport@vvmc.com with the following information (available from your physician's office):

  • Are outpatient or inpatient services scheduled?
  • What is your chief complaint? If you have the primary ICD-9 (International Classification of Diseases) diagnosis code for the scheduled services, please provide this information.
  • What is the name of the procedure to be performed? If you have the CPT (Current Procedural Terminology) five-digit code for the scheduled services, please provide this information.

Please be aware that the estimates provided through this service are a range of costs. A person’s medical needs may require more or less care than estimated, and a patient will be billed for the specific services and care delivered. For a more specific estimate, we recommend patients contact their insurance provider directly. All estimates are confidential.

FINANCIAL ASSISTANCE

There are several nonprofit organizations that can assist cancer patients in covering expenses such as co-pays, deductibles, or other medical costs.  These organizations are not a part of Vail Valley Medical Center and each organization has its own set of criteria for eligibility. To learn more and determine if you qualify, it is best to contact the organization directly.

  • The Cancer Financial Assistance Coalition helps cancer patients experience better health and well-being by limiting financial challenges through:
    • facilitating communication and collaboration among member organizations.
    • educating patients and providers about existing resources and linking to other organizations that can disseminate information about the collective resources of the member organizations.
    • advocating on behalf of cancer patients who continue to bear financial burdens associated with the costs of cancer treatment and care.

For more information, visit www.cancerfac.org.

  • Colorado Peak is an online service for Coloradoans to screen themselves and apply for medical, food and cash assistance programs. Eagle Care Clinic in the Edwards Pavilion is a certified application assistance site. To apply, visit Colorado Peak online, or stop by Eagle Care Clinic for assistance.
  • CancerCare Co-Payment Assistance Foundation helps people who cannot afford insurance co-payments to cover the cost of medications for treating certain types of cancer. For more information, visit www.cancercarecopay.org.
  • The Healthwell Foundation helps patients living with chronic and life-altering illnesses pay their share of prescription drug co-payments, deductibles and health insurance premiums. For more information, visit www.healthwellfoundation.org.
  • Patient Access Network Foundation is an independent, national 501(c)(3) organization dedicated to providing underinsured patients with co-payment assistance through disease-specific funds that give them access to the treatments they need.  For more information, visit www.panfoundation.org  or call (866) 316-7263.
  • Patient Services is a national nonprofit organization committed to supporting people with expensive chronic illnesses and conditions through locating solutions with health insurance and assisting with premiums and prescription co-payments. For more information, visit www.patientservicesinc.org or call (800) 366-7741.
  • Peak Wellness provides screening and referrals to low-income, uninsured and under-insured women ages 40-64 with chronic disease risk factors in an effort to prevent cancer, diabetes, heart disease and stroke. Visit www.tchd.org/peakwellness.htm for more information.

FINANCIAL ASSISTANCE FOR MAMMOGRAPHY

Most insurance companies cover a portion or all the cost of a screening mammogram; however, not all diagnostic mammograms are covered by insurance. Because each insurance plan varies, patients are encouraged to call their insurance company to verify their benefits. Additionally, a range of costs may be supplied by our Insurance Support Team by calling (970) 777-2902 or emailing insurancesupport@vvmc.com.

Patients who cannot afford a mammogram are encouraged to call the Eagle Care Clinic at (970) 569-7520 to determine if they are eligible for a free mammogram through The Komen Foundation or The Women's Wellness Connection. In addition, The Vail Breast Cancer Awareness Group (VBCAG) has granted the Sonnenalp Breast Center a fund to help support women in need of diagnostic imaging and genetic counseling services. Eligible women are gifted $500 to help offset medical bills related to diagnostic services at the center. Additionally, eligible women in need of genetic counseling services are given $300. Patients must be Eagle County residents, have a $2,000 or higher deductible and indicate that they are in need of the financial assistance. For more information on VBCAG funding, please call (970) 569-7695.

PRESCRIPTION ASSISTANCE

  • Needy Meds is a 501(c)(3) nonprofit information resource devoted to helping people in need find assistance programs to help them afford their medications and costs related to health care. They aim to be a source of accurate, comprehensive and up-to-date information on programs that help people facing financial stress in paying for medications and health care.  For more information, visit www.needymeds.org.
  • Partnership for Prescription Assistance helps uninsured and financially struggling patients who lack prescription coverage get access to prescription assistance programs that offer medicines for free or nearly free. They offer a single point of access to more than 475 public and private programs, including more than 180 offered by pharmaceutical companies. Visit www.pparx.org for more information.

INSURANCE ASSISTANCE

  • CoverColorado provides health insurance to individuals with pre-existing medical conditions who have had insurance within the previous six months. Participants are not subject to a waiting period, so coverage for all health conditions is available to qualified applicants upon approval into the plan. Visit www.covercolorado.org for more information.
  • GettingUsCovered is a new comprehensive health plan created by the federal government for individuals with a pre-existing medical condition who have been uninsured for at least six months. This is not a low income plan, however, it does not cost any more than the price of insurance for healthy individuals. Participants are not subject to a waiting period, so coverage for all health conditions is available to qualified applicants upon approval into the plan. For more information, visit www.gettinguscovered.org.THE FEDERAL GOVERNMENT HAS SUSPENDED THIS PROGRAM EFFECTIVE MARCH 2, 2013 UNTIL FURTHER NOTICE. PLEASE REFER TO WWW.PCIP.GOV FOR ADDITIONAL INFORMATION.
  • Vail Breast Cancer Awareness Group (VBCAG) strives to ease the financial and emotional burdens faced by women in Eagle County who are battling breast cancer.  For more information, visit www.vailbreastcancerawareness.org.