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Super simple. You can call your insurance company, and they will tell you--the number on the back of your insurance card. Or, if you are tech savy--I personally find this to be the easiest-check online via your insurance's portal--which are usually also all accessible via a smartphone. The majority of insurance companies have these portals and they give you all the information and more, you could need. Even cost estimates, based on where you are or are going.
So, you are run over by a car. They take you to the nearest Emergency Room and you are unconscious. How do you call the insurance company?
You are having a heart attack and you go to the hospital in your plan. But the doctor on duty in the ER that night isn't in your plan. Do you refuse service until the next doctor comes in for their shift?
You fell and broke your leg and go the the ER in excruciating pain. They ask you if you have an orthopedic surgeon to call or should they call the one on-call? Do you pull out your phone and look up your insurance website to search for someone to set your leg that is in your plan?
Your appendix bursts and you need it out. Do you ask the ER personnel to bring you a laptop to look up an in-network surgeon before they take you up to the OR? How many calls do you need to make? How long does this take? What if it is 2 AM?
Should I give you more scenarios? I think you get the picture. You obviously have never been in any of these situations. Your suggestion that you "can call your insurance company" is a pipe dream.
Super simple. You can call your insurance company, and they will tell you--the number on the back of your insurance card. Or, if you are tech savy--I personally find this to be the easiest-check online via your insurance's portal--which are usually also all accessible via a smartphone. The majority of insurance companies have these portals and they give you all the information and more, you could need. Even cost estimates, based on where you are or are going.
It's not always easy or convenient to call the insurance company, see the answer right above this. Most people wouldn't even know that a hospital that's in network has doctors that are out of network until this happens to them.
AND... the service that this ER doc works for appears to be in network with my insurance (I looked them up online when I got the bill from them), but the individual doctor is out of network. Luckily he is only asking for another $800 from me.
Super simple. You can call your insurance company, and they will tell you--the number on the back of your insurance card. Or, if you are tech savy--I personally find this to be the easiest-check online via your insurance's portal--which are usually also all accessible via a smartphone. The majority of insurance companies have these portals and they give you all the information and more, you could need. Even cost estimates, based on where you are or are going.
Oh sure you are going to call your ins co when you are in the ER bleeding, having a heart attack, broken leg etc. the system stinks, even Medicare is just as bad. Needs reform from the grd up.
So, you are run over by a car. They take you to the nearest Emergency Room and you are unconscious. How do you call the insurance company?
You are having a heart attack and you go to the hospital in your plan. But the doctor on duty in the ER that night isn't in your plan. Do you refuse service until the next doctor comes in for their shift?
You fell and broke your leg and go the the ER in excruciating pain. They ask you if you have an orthopedic surgeon to call or should they call the one on-call? Do you pull out your phone and look up your insurance website to search for someone to set your leg that is in your plan?
Your appendix bursts and you need it out. Do you ask the ER personnel to bring you a laptop to look up an in-network surgeon before they take you up to the OR? How many calls do you need to make? How long does this take? What if it is 2 AM?
Should I give you more scenarios? I think you get the picture. You obviously have never been in any of these situations. Your suggestion that you "can call your insurance company" is a pipe dream.
Please don't make assumptions or attack me. I have literally been in these types of situations. I've also had cancer, and I have an autoimmune disease, that requires a lot of care.
First off--as patients and subscribers, it is OUR responsibility to know what our insurance covers, from the day we chose (or, are approved for, in Medicare or Medicaid's case) our insurer. It is also our responsibility to have a PLAN in place, for as much as we can. I have preferred hospitals and doctors, not only behind my license (as an EMT WILL pull it out to ID you) but I also have my blood type, allergies, disease, and preferences on the medical card in my phone--and a note ON that paper behind the license about that. Your phone can be locked and this medical card can STILL be accessed. I will 100% agree that there are situations where you may be separated from your wallet--but a GOOD EMT/firefighter/etc will look to ID you and can find that information. That covers where you want to go.
Unfortunately, things like anesthesia are not always in-network for a lot of people, so that part can be a pain, when it comes to surgery. There are also the obvious things--like a heart attack--where you may not be able to control. However, depending on the level of your attack, you could always insist your personal doctor be called (or whomever is on call that evening at your practice) to the hospital. Additionally IF you have to deal with a ED doctor, you can later work with your insurance to potentially have that not in network doctor's fee covered as "medically necessary," especially with something like a heart attack, car accident, etc.
As for going to the ER in excruciating pain--yes, actually, when I broke my wrist, in an area that was not familiar to me (to the point of needing surgery, so I'm sure you can imagine that pain) I DID pull out my phone (and this was a huge pain, but I also was aware of what a huge pain medical bills area.) And, where they had brought me, not all the doctors were covered. I took a sling, took a script for the pain (which I filled at Walgreens) and went right to an Orthopedic that was in network, as soon as they were open the next day. The ER had actually wanted to set my wrist that night and I refused...and my orthopedic told me that was the right thing, since I actually needed surgery and setting it would have made it worse.
I've also INSISTED that my doctors be called, when I've landed in the ED, relating to my disease. We have these choices. I will obviously agree there are certain situations that can be out of your control--but there are at least things you can do, to attempt to help them.
I will admit, I'm also much more aware of my health and options, than 95% of people (and I've had numerous medical professionals tell me this) due to both my own health issues and the field I work in.
Oh sure you are going to call your ins co when you are in the ER bleeding, having a heart attack, broken leg etc. the system stinks, even Medicare is just as bad. Needs reform from the grd up.
Obviously not. That's why I have a plan in place, as I stated in my previous post. I was simply answering a question, initially, in the simplest way possible.
I will also add, that my parents are both on Medicare and they too, are their own health advocates and taught me to be my own. So, I see the costs and complexities first hand regarding Medicare, via them.
It's not always easy or convenient to call the insurance company, see the answer right above this. Most people wouldn't even know that a hospital that's in network has doctors that are out of network until this happens to them.
AND... the service that this ER doc works for appears to be in network with my insurance (I looked them up online when I got the bill from them), but the individual doctor is out of network. Luckily he is only asking for another $800 from me.
Recent scam? This is the way it's been for at least 20 years. Probably longer.
I got hit with the same BS in the early 2000s. Most ER doctors are out of network for most peoples' plans. This is why I stopped buying medical insurance and just started paying out of pocket. Well, that is until Obama decided that people shouldn't have a choice.
"Paying out of pocket"? You've either not had a serious illness or trauma or you are independently wealthy. Those events will bankrupt the average person very, very quickly. Obamacare seems expensive until you start looking at what one of those events will cost you. Part of the reason is that as an individual you won't get a group rate discount. You will pay full retail.
They have you in the box from every angle, don't kid yourself. Since there is essentially no regulation, they will keep raising the ante, every year. Health care is a market with inflexible demand. If you are serving that market, and the regulations are essentially nonexistent, your potential for profit as a "health care provider" is unlimited. The end goal of our "health care system" is to extract every last dollar you earned over your lifetime, from every asset you might own. End of story.
"Paying out of pocket"? You've either not had a serious illness or trauma or you are independently wealthy......
So true! I had a ruptured appendix with a 4 day hospital stay in 2006 and the bill was about $45,000... I paid probably $500 of that? I can't imagine what that bill would be today.
So true! I had a ruptured appendix with a 4 day hospital stay in 2006 and the bill was about $45,000... I paid probably $500 of that? I can't imagine what that bill would be today.
Hospitals invent those prices knowing that the full amount is never paid by so-called insurance companies. A relative of ours is poor bordering on indigent. They had a two-day hospital stay with a bill of $26,000. When he told the hospital he was unemployed and had no assets, they magically lowered the total to $2,200. My guess is the $2,200 is probably close to the actual cost for their services, so why do they get away with asking for 12X that amount?
Hospitals invent those prices knowing that the full amount is never paid by so-called insurance companies. A relative of ours is poor bordering on indigent. They had a two-day hospital stay with a bill of $26,000. When he told the hospital he was unemployed and had no assets, they magically lowered the total to $2,200. My guess is the $2,200 is probably close to the actual cost for their services, so why do they get away with asking for 12X that amount?
Of my 45k bill, my insurance settled for about $5000, so yes they are billing 10x what they think they will get from insurance. Something needs to change --- should they bill closer to actual cost and should we pay more???
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