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UCLA Health - Health Insurance and Patient Billing | UCLA Health

Thumbnail of the video “UCLA Health - Health Insurance and Patient Billing | UCLA Health”
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Author: UCLA Health
Categories: Health
Tags: health
Views: 2 · Last viewed: 2026-10-16 15:02 UTC

Short Summary

Main recommendation: Understand your health insurance out-of-pocket costs (deductible, copay, coinsurance) and check whether your doctor is in-network before scheduling, so you can predict what you will owe. The video also explains how to read a UCLA Health physician statement and how to pay online.

Key Points

  • Health insurance works like car insurance: you pay a monthly premium whether or not you use it, and insurance covers only part of the cost when care is needed.
  • Out-of-pocket costs come in three forms: the deductible (amount you pay before insurance starts paying), the copay (fixed fee per visit, even after the deductible is met), and coinsurance (a percentage of the bill).
  • Coinsurance is harder to predict than copays because it scales with the cost of the service.
  • Plan type changes your costs: under an HMO, specialist care requires a primary care referral, or you pay the full charge; under a PPO, you can see any doctor without a referral, but out-of-network doctors can cost considerably more.

Details Worth Noting

  • Concrete instructions:
    • Before booking an appointment, check with your insurance plan whether the doctor is in-network.
    • If you have an HMO, get a referral from your primary care physician before seeing a specialist, so you owe only the copay.
    • To estimate coinsurance, multiply the service cost by the coinsurance percentage (for example, 20% of a $200 visit is $40).
    • To read your physician statement, check the supervising physician, service date, the standard procedure code and description, the charge, amount paid to date, amount insurance paid, any discount, the pending insurance amount, and the amount you owe.
    • If a line shows zero insurance payment, it may still be pending insurance or may have been applied to your out-of-pocket expense.
    • To pay online, go to myuclahealth.org, create an account, and click the billing tab.
  • Questions about a specific service line can go to the UCLA Health billing office at 310-318-8860.
  • General billing questions can go to customer service at 310-301-8860.
  • Services may be performed by a technician, nurse practitioner, or resident, but the supervising physician is still listed on each statement.
  • Plan details such as deductibles, copays, and coinsurance vary by insurance plan.

Bottom Line

Knowing your plan's deductible, copay, and coinsurance, plus whether a provider is in-network, is the most practical way to anticipate medical bills before they arrive.