So I’m really confused. The affordable care act says that in case of an emergency, out of network and in network is the same. So if you have a car crash, or fall and break a leg, in and out of network is the same. That’s how I read it.
Yet there’s hundreds of resources online saying things like: You incur $15,000 in hospital bills. You have already met your annual deductible and must pay 30 percent coinsurance, as outlined in your policy—that’s $4,500. However, your insurance company will only pay $5,000 because that is what such services would be billed in-network. You now owe an additional $5,500 for a total of $10,000. (Example taken from here)
Why would you have to pay the extra 5500 when the affordable care act says that’s not the case? I’m looking at anthem PPO and the emergency table says “same as in-network” for ER visits. So that seems to agree with the ACA, but the entire internet disagrees, so I must be misunderstanding
Then I also saw places saying that a broken bone may not be an emergency. Evidently, whoever wrote that, has never broken a bone.
submitted by /u/MacaroonPickle8793
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So I’m really confused. The affordable care act says that in case of an emergency, out of network and in network is the same. So if you have a car crash, or fall and break a leg, in and out of network is the same. That’s how I read it. Yet there’s hundreds of resources online saying things like: You incur $15,000 in hospital bills. You have already met your annual deductible and must pay 30 percent coinsurance, as outlined in your policy—that’s $4,500. However, your insurance company will only pay $5,000 because that is what such services would be billed in-network. You now owe an additional $5,500 for a total of $10,000. (Example taken from here) Why would you have to pay the extra 5500 when the affordable care act says that’s not the case? I’m looking at anthem PPO and the emergency table says “same as in-network” for ER visits. So that seems to agree with the ACA, but the entire internet disagrees, so I must be misunderstanding Then I also saw places saying that a broken bone may not be an emergency. Evidently, whoever wrote that, has never broken a bone.
submitted by /u/MacaroonPickle8793 [link] [comments]Read Morer/HealthInsurance