About Insuring Your Health
KHN contributing columnist Michelle Andrews writes the series , which explores health care coverage and costs.
To contact Michelle with a question or comment, .
QUESTION: I went to an out-of-network hospital but my insurance case worker told me I would be covered since I was admitted through the ER. Can my insurer now deny coverage? — Michael
ANDREWS: It’s unlikely that your insurer would deny coverage altogether if you were admitted to an out-of-network hospital. But it might refuse to cover your hospital care at in-network rates. Consumers now have better protection for emergency care they receive at out-of-network facilities. Under the health care overhaul, in most instances insurers can’t charge higher copayments or coinsurance if people wind up getting emergency care at an out-of-network hospital. However, if you’re admitted to the hospital following a visit to an out-of-network ER, you’re no longer protected from higher cost-sharing. The insurer can charge you for your hospital care based on your plan’s regular out-of-network coverage rules.