Ohio Health Insurance Advice: Emergency Room Insurance
Dear Ohio Life and Health:
We’re shopping around for Ohio health insurance plans. A colleague warned us to read each policy’s emergency room insurance guidelines before we buy. He had a health plan through a major Ohio insurance provider. But, when his son broke his leg, the insurance company rejected the claim. Is it true that health plans reject ER visits when they don’t deem the health issue to be critical?
Columbus, Ohio
Among the critically ill and Ohio health insurance plans, medical emergencies are a subjective issue. What may seem like a life threatening situation to one, is sometimes not deemed as a medical emergency by the insurance provider. The reason many consumers end up paying higher out of-pocket-expenses is that by the time they learn about their emergency room insurance benefits, they are in the height of a medical misfortune.
Although emergency room medical providers are not allowed to defer care due to insurance coverage and payments, from provider to provider, Ohio health insurance have different and sometimes very limited emergency room benefits. Nonetheless, family plans with reasonable emergency room benefits are critical for households with children, five years or under.
FACT:
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law, requiring hospital departments to extend care regardless of the patient’s emergency room insurance status or financial means to pay.
After obtaining a health quote, use the following questions to determine what type of Ohio health insurance plan’s emergency room insurance guidelines are suitable for your family’s medical needs.
1. Which medical conditions are defined as an emergency?
2. What are the policies for calling an ambulance?
3. Does the health plan require medical emergency care to take place at a specific medical facility?
4. When the physician’s office is closed, does the policy require telephoning a specific after hours office for an emergency approval?
5. How high is the out-of-pocket co-payment? Is it so exorbitant that it serves as a deterrent to seek emergency care when necessary?
For additional professional advice, regarding emergency room insurance and Ohio health insurance, dial 1-866-522-5953.
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