How is the cost estimated?
Your visit cost is estimated using your insurance details, visit type, and available billing information, but it’s only a good-faith estimate—not a final price. The exact amount is determined after your insurance processes the claim.
Quick Answer
- Cost estimates are based on your insurance info and visit type
- You may see an estimate before your visit
- Final cost is determined after insurance claim processing
- Actual price may differ due to deductibles, copays, or coverage rules
- If not covered, the visit defaults to $129 self-pay
How Your Cost Is Estimated
When you book a visit, you enter your insurance information in the app. Based on that, DrHouse generates a pre-visit estimate using:
- Your insurance provider and plan details
- Typical copay ranges for similar services
- The type of visit (e.g., urgent care, primary care)
This estimate helps set expectations, but it is not guaranteed.
What Happens After Your Visit
After your consultation:
- DrHouse submits a claim to your insurance provider
- Your insurer reviews the visit and determines coverage
- An Explanation of Benefits (EOB) is issued
- Your final cost is calculated based on:
- copay
- deductible
- coinsurance
If there’s a remaining balance, you may be billed after the claim is processed.
Why the Estimate May Change
Your final cost can differ from the estimate because:
- DrHouse may not have your current deductible balance at booking
- Your plan may have different rules for telehealth visits
- The claim may be processed as in-network or out-of-network
- Certain services may be partially covered or not covered at all
Limitations and What to Know
- The estimate is not a guaranteed price
- Insurance coverage and pricing vary by plan
- You may owe more (or less) than the estimate
- If your claim is denied, you may be responsible for the full $129 visit cost
- Additional services like lab tests or medications are billed separately and may not be included in the estimate
Content on the DrHouse website is written by our medical content team and reviewed by qualified MDs, PhDs, NPs, and PharmDs. We follow strict content creation guidelines to ensure accurate medical information. However, this content is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment. For more information read our medical disclaimer.
Always consult with your physician or other qualified health providers about medical concerns. Never disregard professional medical advice or delay seeking it based on what you read on this website.
If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.
