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Thread: emergency room catch

  1. #1
    New User Level 0
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    Default emergency room catch

    Here is the info, I have 5,000 deductible on my health policy.
    150 co pay for emergency room visit. If you get admitted you
    get stuck with 5,000 deductible. If they do the same treatment
    in emergency room it cost 150. Insurance company will not
    pay hospital if they admit you and will not separate the
    emergency room treatment from the charges that occur
    after being admitted. I think many people are getting stuck
    in this situation. I had to go to our state insurance commissioner
    to fight my case and won. The cost of the treatment I got in the
    emergency room was much more than the 1 day I had to stay
    in hospital, however the insurance company would not pay and
    argued that if your are admitted then it can not be claimed as
    a emergency room visit. If you fight it you will win.



  2. #2
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    Default

    I guess they have to draw the line somewhere.

  3. #3
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    Default

    Quote Originally Posted by OhioQuotes View Post
    I guess they have to draw the line somewhere.
    Yes and it seems very clear to me, emergency room treatment should be covered under to provisions of the emergency room coverage regardless of the fact that you had to be admitted.

  4. #4
    Member Level 0 iHealthBrokers.com's Avatar
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    Default

    Quote Originally Posted by jimlee View Post
    150 co pay for emergency room visit.
    Did you have a $150 ER copay or an ER access fee? Who's the insurance company?
    iHealthBrokers.com
    Toll Free: (866) 260-9829

    Small Business Health Insurance Quotes

  5. #5
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    I think there should be a change in the guidelines for the insurance companies.

  6. #6
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    I always urge people to appeal any insurance rejections. Keep at 'em. Don't give up.

  7. #7
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    I am glad to hear you won your case against blatant clutching at straws to save money.

  8. #8
    New User Level 0 janellelk's Avatar
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    Yikes! Scary! And I agree, always appeal!

  9. #9
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    Oh Well,
    Yea, and it seems very clear to me, emergency room treatment should be covered under to provisions of the emergency room coverage regardless of the fact that you had to be admitted.

  10. #10
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    If you think you are right, ALWAYS, ALWAYS, ALWAYS fight it. Insurance companies reject just about everything for any reason or no reason at all. Insurance companies are in business to collect premiums, not to pay claims. If you have appealed without success, I will be glad to help. NO CHARGE! Contact me at kitco@cox.net.

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