Does insurance cover emergency room visits

DOES INSURANCE COVER EMERGENCY ROOM VISITS SERIES

DOES INSURANCE COVER EMERGENCY ROOM VISITS SERIES

This series of articles will expose what lengths insurance companies will go to are doing to protect their profits and coming changes to health insurance, changes that could leave you footing the entire bill of an emergency room visit even if you have health insurance. By refusing to cover the cost of care, insurance companies are only looking to increase their own profits by shifting the burden of cost of healthcare mostly on the patient and further limit your access to timely healthcare. As one of the nationвЂ™s largest health insurance providers, other insurance carriers are likely to follow BCBSвЂ™ example by implementing similar policies of their own serving to increase your cost of healthcare.ДЄmericaвЂ™s ER wants the public to be aware of what their insurance carriers are trying to do so they can speak up and fight back instead of getting caught in the middle of these dangerous and illegal policies. He says a panel of doctors will assess claims to make sure everyoneвЂ™s getting fair coverage.Д«ut Palmisano and Hockenberry say theyвЂ™ll have to wait until the policy is implemented to see how effective it really is.Blue Cross Blue Shield (BCBS) of Texas is putting some of its policyholders at risk and on the hook for Emergency Room visits. Remember that scenario about the man who thinks heвЂ™s having a heart attack, but itвЂ™s just indigestion? Fusile says that falls into the gray area, too. вЂњThere are lots of gray areas where the diagnosis wasnвЂ™t so bad after all, but you have to look at the situation the person was in at the time they were in it,вЂќ Fusile says. It puts that added stress because youвЂ™re dealing with a loved one and youвЂ™re putting parents in a very difficult situation,вЂќ Palmisano says.Д«ut FusileВ ofВ BCBS says he knows, in medicine, itвЂ™s not always black or white. вЂњI have four children, and if thereвЂ™s an injury and itвЂ™s hard to determine the pain theyвЂ™re experiencing, itвЂ™s hard to determine whether to go to the emergency room or not. Palmisano says this policy also might disproportionately affect the elderly, those living in rural areas and adolescents over the age of 14. Because theyвЂ™re like, you know, youвЂ™re putting the patient, who doesnвЂ™t have the clinical background, to determine whether their condition is of an emergency nature,вЂќ Palmisano says. вЂњThatвЂ™s where our physicians are concerned. But this time, itвЂ™s a heart attack, and he dies. So the next time he has chest pains, he thinks, in case itвЂ™s just indigestion, he wonвЂ™t go to the ER. Under BCBSвЂ™sВ new policy, he gets charged for using the emergency room inappropriately. But it turns out that it was just indigestion. He thinks it might be a heart attack, so he goes to the ER. Blue Cross is clearly staking a claim here that weвЂ™re going to try to change patient behavior,вЂќ Hockenberry says.Дonald Palmisano, president of the Medical Association of Georgia, paints a different picture when it comes to this policy: Imagine a BCBS member has chest pains in the middle of the night. Emergency departments are expensive theyвЂ™re there for a different reason. Hockenberry says, in his research, heвЂ™s found many people often use the emergency room inappropriately, for urgent care rather than emergency care. But you donвЂ™t need to go to the emergency department to get tested for whether or not you have the flu and to get a Tamiflu prescription,вЂќ says JasonВ Hockenberry, who teaches health policy at Emory University. вЂњWhat this policy is directed at is regular, run-of-the mill colds, maybe even influenza.

We have got to find a better way to do some of this stuff, taking some of that unnecessary spending out of the system,вЂќ says JeffВ Fusile, president of Blue Cross Blue Shield.ДЇusile says BCBS wants patients to use urgent care, retail health clinics and their LiveHealth app, which are all cheaper than an ER visit. вЂњThe cost of careвЂ™s been going up so much faster than peopleвЂ™s earnings. Blue Cross Blue Shield is enacting this policy because it doesnвЂ™t want people to use the emergency room as their primary health care.

Does insurance cover emergency room visits