(NYT) Life in the post ACA World–Big bills When E.R. Is in Network but Drs. Arent

When Jennifer Hopper raced to the emergency room after her husband, Craig, took a baseball in the face, she made sure they went to a hospital in their insurance network in Texas. So when they got a $937 bill from the emergency room doctor, she called the insurer, assuming it was in error.

But the bill was correct: UnitedHealthcare, the insurance company, had paid its customary fee of $151.02 and expected the Hoppers to pay the remaining $785.98, because the doctor at Seton Northwest Hospital in Austin did not participate in their network.

“It never occurred to me that the first line of defense, the person you have to see in an in-network emergency room, could be out of the network,” said Ms. Hopper, who has spent months fighting the bill. “In-network means we just get the building? I thought the doctor came with the E.R.”

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4 comments on “(NYT) Life in the post ACA World–Big bills When E.R. Is in Network but Drs. Arent

  1. KevinBabb says:

    This isn’t exclusively an ACA issue. Earlier this year I had cataract surgery and found ,as the bills came in, that the anesthesiologist was out of network from my plain vanilla, pre-ACA group health insurance plan.

  2. Dan Crawford says:

    We may have the most sophisticated tools and talented medical technicians, but we also have a system governed by the most primitive of human vices. ACA doesn’t even begin to deal with that because it encourages and enhances the present corruption. The latest issue of Consumer Reports provides more evidence of the effect corporate medicine and pharma has on a country that refuses to regulate its abuses.

  3. Katherine says:

    Consumer Reports has been pushing for nationalizing medical care for decades. They won’t stop.

    I hold my Democratic Senator, a deciding vote in favor of the ACA, directly responsible for the fact that my younger daughter, who has employer-provided health insurance, had just been quoted a $750 co-pay every three months for her basic asthma maintenance drug, Symbicort. And that’s with the online pharmacy discount. This is on top of a high deductible for doctor’s care which means unless she is hospitalized she will pay all of her medical costs out of pocket.

  4. Dave B says:

    By limiting options the ACA limits costs. For those of you who don’t like the corperate medicine pharmacy mentality I am sure you will LOVE the government run health care, the VA is just a harbinger of things to come. Latest scandal I read about involved a female purchasing agent, a corrupt supply company and a married boy friend covering up the mess. Yes the government with illegal double waiting lists, bonus rewarded incompetence etc will be just so much better!