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Re:HHS announces rule to protect consumers from surprise med... by jrs235 on Friday July 02, 2021 @02:35PM (#27715099)
Should probably have gone to an ER. Emergencies are easier to argue and appeal. "Urgent" (yet less costly) and they assume you still could have waited... it wasn't an emergency yet. I hate our insurance/medical payment/determination system. It's a joke.
Re:HHS announces rule to protect consumers from surprise med... by vitaflo on Friday July 02, 2021 @03:12PM (#27715562)
>Should probably have gone to an ER. Emergencies are easier to argue and appeal.

ER visits for emergencies are also covered as in-network care under the ACA, even if you're half way across the country. I know cuz I was 1500 miles into a road trip when I went to the ER. My insurance covered it as in-network.

Re:HHS announces rule to protect consumers from surprise med... by ceejayoz on Friday July 02, 2021 @02:54PM (#27715346)
They're looking at clamping down on that, too.

https://arstechnica.com/science/2021/06/biggest-health-insur...

> Doctors and hospitals are condemning plans by UnitedHealthcare—the country’s largest health insurance company—to retroactively deny emergency medical care coverage to members if UHC decides the reason for the emergency medical care wasn’t actually an emergency.

Re:HHS announces rule to protect consumers from surprise med... by sidewndr46 on Friday July 02, 2021 @03:23PM (#27715702)
This was my experience as well. I went to the ER with tremendous chest pain, it turns out I have some issue with my ribcage. Not my heart. UHC decided I did not in fact need to see a cardiologist or an ECG since I wasn't having a heart attack and declined to pay for anything.

Multiple attempts on my part to resolve this yielded nothing. I contacted the state of TX, who brought suit against both parties (insurance & service provider). Somehow, the day before the court appearance they all agreed to settle the claim at no cost to me.

Re:HHS announces rule to protect consumers from surprise med... by yellow_lead on Friday July 02, 2021 @03:58PM (#27716090)
Good on you for being persistent.
Re:HHS announces rule to protect consumers from surprise med... by bradstewart on Tuesday July 06, 2021 @10:01AM (#27748667)
Perhaps unsurprisingly, I do indeed have United Healthcare.
Re:HHS announces rule to protect consumers from surprise med... by vinceguidry on Friday July 02, 2021 @02:49PM (#27715272)
I went to an in-network urgent care for a particularly painful pinched nerve and got worthless drugs, and the uncovered part of the bill came out more than the covered part. Next time I'll just suffer at home and hope I don't die. It'll amount to the same result.
Re:HHS announces rule to protect consumers from surprise med... by bradstewart on Tuesday July 06, 2021 @10:00AM (#27748640)
The nearest ER was still much, much farther away than the urgent care facility. I would have undoubtedly put myself at more risk by trying to drive a vehicle down a highway for an hour.

Thankfully the bill I did receive was somewhat reasonable, and I was able to pay it without much issue.

Re:HHS announces rule to protect consumers from surprise med... by Workaccount2 on Friday July 02, 2021 @02:45PM (#27715225)
Given the location and possible severity, the only viable way to an emergency room might have been a helicopter. Which insurance almost certainly would not cover.

So the insurance is saying "If you paid $80,000 for a medevac, we would have covered your hospital bill".

Re:HHS announces rule to protect consumers from surprise med... by FireBeyond on Friday July 02, 2021 @04:19PM (#27716381)
Hell, a few years ago UHC made the news because they were denying coverage for Flight EMS from serious car accidents due to "lack of pre-authorization".