Hospitals increasingly demand large upfront deposits as patient cost-sharing rises

Thomas Zordani traveled from Denver to the Mayo Clinic for a specialist visit, only to be told he must provide a $5,000 pre-service deposit because his plan was out-of-network, despite having out-of-network benefits. After the appointment was cancelled, he sued and was awarded $47,500 for violating Arizona consumer fraud law. The incident reflects a growing pattern in which hospitals, including Johns Hopkins Medicine and MD Anderson, collect sizable deposits before non-emergency services, driven by rising patient deductibles and insurers shifting costs.

Industry leaders say the practice will likely expand, raising concerns about patients’ ability to afford care and the complexity of reimbursement for overpayments. State regulations vary, with some requiring prompt refunds for excess payments, while others lack clear protections. Consumer groups advise patients to verify coverage and request itemized estimates to avoid surprise charges.