Health Insurance Articles
How ER Visits Are Covered By A Basic Health Plan
2011-12-28
A basic health plan is necessary for all Americans in order to avoid massive bills assessed by both ERs and ambulances in cases of emergency. By 2014, such plans will be required for everyone in the country under the Affordable Care Act created by the Obama administration. While a basic health plan will never cover the cost of things such as specialist treatments or cutting-edge prescription drugs, they are the front line in defraying the cost of emergency services if an issue arises. Plans may vary in exactly how much they will cover, but ER visits are often covered in very similar ways.
Coverage for an ER visit on a basic health plan begins with the ambulance ride - if necessary - to the hospital. Some plans will pay the entire cost of this trip and a client will never see a bill, but other will require a copayment to be made immediately or during the next monthly billing cycle. These basic plans will also typically cover the cost of seeing an ER doctor, along with whatever treatment is prescribed. Most will also provide for surgery or other procedures that are needed at the time of admittance to the hospital, but how much they will cover overall and how much will be covered during a single sitting can vary significantly. In addition, it is worth noting that any extras during a stay in the hospital - such as extra food or even more bedding - will likely not be covered by a basic health plan.
The goal of any basic health plan is not to entirely cover the cost of treatment for an emergency, but rather defray the cost to a point where a consumer is not bankrupted by a single unexpected event. Good basic plans will cover several of these events a year and will have a large enough annual maximum that patients never end up having to pay the full cost for their emergency treatment. If a chronic condition presents itself, however, or a temporary problem begins to worsen, it may be time to consider moving from a basic health plan to something more robust; often, this can be done through the same provider.
ER visits are typically covered by a basic health plan without the need for a patient to obtain doctor or plan approval, and any partial bills that must be paid should be sent directly to the customer along with an explanation of charges. While these plans are not able to provide for long-term care needs, they are an excellent way to ensure that the cost of emergency services do not overwhelm a client or leave them with larger bills than they can pay.
