ER visit leads to financial emergency

| Jan 30, 2018 | Medical Debt

Medical debt is typically very different from other kinds of debt. No one chooses to become ill or to be injured in a car accident, fall or other mishap. In many cases of medical debt, the person who was sick or injured did not have health insurance, so there was no one to cover their medical costs.

In other situations, a person has insurance but their claim is denied. They’re then saddled with hospital bills, doctor costs and medical debt as if they had no insurance. A recent news report says health insurers are increasingly denying coverage for emergency room visits unless the person is bleeding or having a stroke or heart attack or similar life-threatening emergency.

A woman who went to an ER with a worsening fever and severe pain in her right side worried that she had appendicitis. Doctors ordered a CT scan and ultrasound and determined that she had ovarian cysts, not potentially life-threatening appendicitis.

They sent her home with pain meds and advice to see a gynecologist. Emergency averted? Not quite. The real pain hit a few weeks later when her insurer denied her claim for the $12,596 ER bill.

The 27-year-old was stunned. “We have a mortgage, we have bills, we have student loans,” she said. “There is absolutely no way I could pay a $12,000 bill. I don’t even have $1,000 sitting around.”

Anthem explained in a letter that her ER visit was “inappropriate” because, as it turned out, there was no real emergency.The letter listed “stroke, heart attack, and severe bleeding” as legitimate emergencies.

Fortunately, the company reversed its decision after it heard from the reporter writing about the woman’s plight. Not everyone can expect similar treatment from the media or insurer, of course.

If you are struggling with medical debt, you can speak with an attorney experienced in negotiating settlements that can help you avoid bankruptcy and pay off your debt at the same time.