Payment & Insurance

An HMO is a health maintenance organization, and a PPO is a preferred provider organization. The difference between the two lies in the policy holder’s ability to freely seek treatment from a specialist. An HMO typically requires a referral from a primary care physician while a PPO does not. The flexibility can be more costly. PPOs have higher deductibles and copays, though the network is larger and policy holders have more freedom. HMOs tend to have smaller networks and lower copays and deductibles.

Insurance companies typically create a network of doctors, hospitals, and treatment centers that are under contract with the company. These health care providers offer lower group rates, and in return, insurance companies incentivize policy holders to use those in-network providers by offering lower copays and more coverage. On the other hand, health care providers that are out-of-network can be more expensive because they are not under contract with the insurance company.

A deductible is the annual dollar threshold that you’re required to pay out-of-pocket before the insurance will cover your costs. Copays and monthly premiums do not count toward this amount. For example, if you have a $1000 hospital deductible and your hospital bill was $12,000, you must pay the initial $1000 and the insurance company pays the agreed upon percentage for health care services after that amount.

Coinsurance refers to the percentage of services you’re responsible for paying after your deductible is met. For example, if your coinsurance is 80/20, then the insurance company pays for 80% of the remainder of the cost after your deductible is met and you pay for the other 20%. It may also be 90/10 or 70/30.

A copay is a fixed sum that you’re required to pay to use a certain service. For instance, if you have a $50 copay for visits to your primary care doctor, that’s what you would pay regardless of the cost of your visit. Your insurance would cover the rest.

If you have insurance, admissions can verify benefits and discuss your estimated deductible, copays, coinsurance, and any noncovered costs. If you are self-paying, ask admissions which payment methods and arrangements are currently available. Final costs depend on the services provided and your plan.

Yes. Riverwalk Ranch can discuss self-pay options with people who do not have usable commercial insurance benefits. Ask admissions for the current cost and payment terms before treatment. Riverwalk Ranch does not accept Medicare or Medicaid at this facility; those programs may cover treatment at other participating providers.

Potential additional costs depend on your plan, level of care, and services. Before treatment, ask admissions for an estimate of your deductible, copays or coinsurance, any noncovered services, and optional expenses. An estimate is not a guarantee of your final responsibility.

Riverwalk Ranch is in network with Ambetter, Blue Cross Blue Shield, Beacon Health Options (now Carelon Behavioral Health), and Curative. We may also accept other commercial plans when applicable out-of-network benefits are available. Coverage, authorization requirements, and your share of the cost vary by plan and level of care. Contact admissions or use the form above for a plan-specific benefits check; verification is not a guarantee of payment.

Some retirement plans permit loans or withdrawals, but availability, limits, taxes, and repayment rules depend on the plan and your circumstances. Riverwalk Ranch does not provide tax or financial advice. Before using retirement savings to pay for treatment, speak with your plan administrator and a qualified tax or financial adviser. See the IRS guidance on retirement-plan loans.