Manchester Medical Center – Financial & Billing Policy

Insurance Required at Time of Service

All patients must present valid insurance at the time of service.
If no insurance is provided at check-in, or if the patient has out-of-state Medicaid, they will be treated as Self-Pay and billed accordingly.

✅ Insurance Accepted

Manchester Medical Center (MMC) is In-Network with the following insurance providers:

  • Medicare

  • Green Mountain Care / Dr. Dynasaur (Vermont Medicaid)

  • Aetna

  • MVP

  • First Health

  • Blue Cross Blue Shield of Vermont, including:

    • Accountable Blue

    • BlueCard (out-of-area programs)

    • CBA Blue

    • Federal Employee Program

    • Medicare Advantage (Vermont Blue Advantage)

    • Medicare Supplemental (Vermont Blue 65)

    • The Vermont Health Plan

🌐 Out-of-Network Insurance

MMC is an Out-of-Network provider with most other commercial insurance companies. We will:

  • Collect your Urgent Care copay at the time of your visit

  • Electronically submit your claim to your insurance company

  • Once your insurer processes the claim, you may be balance billed for any amount they do not cover

    • You may be responsible for up to an additional $395 out-of-pocket, beyond what your insurer allows toward your deductible

    • You are also responsible for any deductible amounts, per your plan

⚠️ We do not accept out-of-state Medicaid. Patients with Medicaid from outside Vermont will be treated as Self-Pay.

💳 Self-Pay Policy

If you do not have insurance, do not present insurance at the time of service, or have out-of-state Medicaid, you will be treated as a Self-Pay patient.

Self-Pay Charges:

  • A $125 down payment is required at check-in

  • The maximum total charge for your visit is $475

  • The $125 down payment is applied toward that cap

    • You may be billed for up to $350 more, depending on the services provided

Important:
This cap only applies to services provided directly by Manchester Medical Center.
✅ Services included in the cap: in-house urgent care, clinical exams, and medical treatments
❌ Services not included in the cap: outside labs, imaging, or referrals — these are the full responsibility of the patient

Example:

You pay $125 at check-in
After your visit, your total is $600

Normally, you’d owe $475 more to cover the $600 balance.
But because of the $475 cap, you only owe $350 more — bringing your total to $475.

💰 Other Payment Information

If MMC is In-Network with your insurance:

  • Copays and estimated coinsurance are due at registration

  • Claims are submitted electronically

  • Payment for any prior unpaid balances is due at registration

If MMC is Out-of-Network:

  • Copays and estimated coinsurance are due at registration

  • Claims are submitted electronically

  • You may be responsible for uncovered balances per your insurance plan

If MMC does not accept your insurance or you choose not to use insurance:

  • Full payment is due at checkout unless a payment plan is arranged

  • Prior unpaid balances are due at registration

  • If paying in full at the time of service, you may qualify for a 15% cash discount

💼 Health Savings Accounts (HSAs)

We accept payments from all major Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs).

🧾 Know Your Coverage

With the wide variety and complexity of insurance plans, it is ultimately the patient’s responsibility to understand their own insurance coverage — particularly regarding out-of-network benefits.

MMC staff can assist with general questions, but we cannot guarantee coverage details or outcomes of insurance claims.

💬 Questions?

📞 Contact us at 802-768-1718 (EXT) 1 with any questions.