Billing & Insurance

Jefferson Healthcare sets prices comparable to other hospitals in the area and considers the resources needed to provide each service. Resources include staffing, time, equipment and materials used for service. Jefferson Healthcare reviews every line of the Chargemaster (list of charges with corresponding procedure codes) to ensure prices are comparable, match the complexity of the service and correspond to the resources needed to provide the service.

The Chargemaster is the complete list of prices across all departments and service lines. This list includes procedure codes for care and the price per unit. Some units are obvious (per visit, per procedure), while others are based on diagnosis or a less straightforward unit (minute per surgery, duration of recovery).

The list is a valuable tool for understanding prices, though most services involve a combination of prices. Understand that in many cases, it is impossible to predict final charges because of variables that affect services.

Please contact the department with which you are scheduled to discuss your visit and an estimate for all components of your visit, or contact our Financial Counseling office at 360.385.2271

Patient responsibility varies by the payor and can include deductibles, copays, coinsurance, or other patient responsibilities. Insurance companies determine the portion of the bill the member is responsible for, and the Jefferson Healthcare Financial Counselors team is available to help you understand these terms.

As a public hospital with very low tax support compared to other public hospital districts, it is important to set prices sustainably to maintain very important services to our community. Jefferson Healthcare does not go above the market median to achieve this priority.

Jefferson Healthcare works to keep prices the same across different settings, although billing requirements result in variances in how these services are billed. Services are priced the same, though they may be broken into two components in specialty clinics.

Jefferson Healthcare is a partner to help patients understand the prices and potential patient responsibility. Questions and/or concerns can be directed to the Financial Counseling team at 360.385.2271.

Jefferson Healthcare offers an option for a prompt pay discount off total charges for uninsured patients. Jefferson Healthcare also offers a generous financial assistance program for those who qualify, regardless of insurance status.

Medicare’s Annual Enrollment Period is October 15 to December 7.  

It is important to choose a plan that considers Jefferson Healthcare in-network. Services provided outside a plan’s network may have a higher out-of-pocket cost.  Please note that Jefferson Healthcare accepts all forms of Medicare Supplement Insurance, also known as Medigap.

Get Support: State Health Insurance Benefits Advisors (SHIBA)
Olympic Area Agency on Aging runs our local State Health Insurance Benefits Advisors (SHIBA) program for Jefferson County. Call a SHIBA volunteer to get your Medicare questions answered at 1-800-562-6900 or 360.417.8555. Or visit SHIBA online.

Additional Support: Jefferson Healthcare Financial Counselors
To learn about the Medicare insurance options available to you, you may also contact our Financial Services Office.

• Call us: 360.385.2271, 9:00 am to 4:30 pm, Monday through Friday.

• Visit the Financial Services Office: 803 W. Park Ave. in Port Townsend.

What is Medicare Advantage?

Medicare Advantage is an insurance option that replaces traditional Medicare benefits with insurance plans administered by private companies under contract with the federal government.

Choosing the Right Plan
At first glance, Medicare Advantage plans appear to offer similar coverage to that provided by traditional Medicare in a simpler package. However, it is important to evaluate your own medical needs against plan coverage to determine which plan is right for you.

Pros and Cons
Refer to this comprehensive checklist to ensure you’ve considered budgets, provider locations, and what-ifs.

Option One: Return to Original Medicare

Because you are involuntarily losing your Medicare Advantage plan, you will be automatically reinstated with Original Medicare starting on January 1. 

If you go back to Original Medicare, you won’t need medical approval for any Medicare Supplement (Medigap) plan you want. If you choose this option, you will not have to go through medical underwriting. (Medical underwriting is when insurance companies try to determine your health status by asking questions about your health history. They do this to decide if they should accept your insurance application, what price they should charge, and what limitations they should implement.)  

If you go back to Original Medicare, you may also decide to purchase a standalone Medicare Prescription Drug plan. 

Option Two: Shop for a Different Medicare Advantage Plan

You may choose a Medicare Advantage plan during the Medicare Advantage Annual Enrollment Period, which lasts from January 1, 2026 to March 31, 2026. Be sure to verify that your doctors and medications are covered by your Medicare Advantage plan of choice.

If you receive your Annual Notice of Change (ANOC) letter from your Medicare Advantage plan and you notice changes being made to your coverage, here are your options:

Option One: Return to Original Medicare. Contact your Medicare Advantage plan directly, and they will initiate the disenrollment process (or call 1-800-MEDICARE for assistance).

If you wish to purchase a Medicare Supplement plan (Medigap), you will likely need to pass the plan’s medical underwriting requirements.

You may also decide to purchase a standalone Medicare Prescription Drug plan.

Option Two: Shop for a different Medicare Advantage plan.

You may choose a Medicare Advantage plan during the Medicare Annual Enrollment Period, which lasts from October 15 till December 7. Be sure to verify that your doctors and medications are covered by your Medicare Advantage plan of choice.

Medicare Prescription Drug plans may experience noticeable changes next year. This may include plan premium increases or changes to the drugs covered by the plan. For a complete list of Medicare Prescription Drug plans available in your area, visit the plan finder tool on Medicare.gov. There, you’ll be able to compare and enroll in the Medicare Prescription plan of your choice.