Medical bill surprises are hitting hard right now. About 38% of Americans say they are “very worried” about receiving surprise medical bills for their treatments. That ranks higher than those worried about food, gas, or even rent expenses. So what is truly happening with medical expenses?
People find surprise bills resulting from utilizing a doctor or facility that is not within their insurance plan’s network. Insurance companies have in-network rates and out-of-network rates. The Affordable Care Act tries to mitigate this effect in emergency situations. But people do not always understand what is or is not an emergency.
So what is an emergency situation? According to Healthcare.gov, the definition of an emergency situation is, “An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm.” But that leaves a vague description for people to go by. The result is an unexpected medical bill in your mailbox.
Emergencies are not the only reason for a surprise medical bill.
While emergencies are a primary cause for surprise medical bills, another problem is doctors that are in a covered facility but not in-network. Hospitals often bring in a doctor that is not covered by your insurance plan. You probably don’t even know this is happening. After all, who checks each doctor that sees them while they are in the hospital for network coverage? Nobody. The result? Another surprise medical bill.
Solutions to surprise medical bills?
The question many people ask is, “What is being done about surprise medical bills?” There are two answers to this. The first is what Washington is trying to do. The second is what you can do now.
Congress is making several proposals to deal with the medical expense issues. Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) introduced a bill called the Lower Health Care Costs Act. It goes to markup this week in the Senate Committee. This plan would try to change bills to “median rates” for other providers in the area. However, there are warnings that this would cause doctors and hospitals to have shortages of staff for various reasons. There are other plans available as well, but nothing is gaining much traction.
The second, and better, option is to not rely on Washington and to make sure you have adequate coverage. When an emergency situation arrives, it is a good idea to have supplemental plans in place to cover unexpected charges. Supplements are, in most cases, inexpensive. Almost all of these plans have no network restrictions or requirements.
We offer these supplemental plans at Health Insurance Today. Get a free quote today to see how these plans can help you avoid surprise medical bills.