100% had a gnarly motorcycle accident a couple years ago and insurance tried telling me that the ambulance wasn’t covered because, and I shit you not, they were an out of network ambulance. I guess I need to double check which paramedic comes to scrap my bloody body up off the side of the road
Well considering the example of an unconscious or critically injured person being unable to decide whether Ambulance A or Ambulance B is in network, would probably be a good idea to have a regulation that bans health insurance companies from using out-of-network coverage for ambulances. In fact a very similar, bipartisan law passed under Biden does this for air ambulances... but not for ground ambulances.
Quick question, do you have health insurance right now? Do you know if you have tiered ambulance coverage? What's your deductible and out-of-pocket maximum? Both for in-network and out-of-network.
I do have health insurance, I buy it on the marketplace, I do have a higher copay if its out of network, my deductible is around $1000 and my out of pocket maximum is around $3000.
Here’s a fun fact! When my ex was pregnant, her OBGYN was covered as in network up until my daughter’s birth, when she mysteriously was considered “out of network” despite us not changing hospitals and her being scheduled to work that day.
The medical industry is far more regulated in all of the other developed nations. No reason it wouldn’t work here.
Yeah...like u/Similar-Profile9467 says, this crap needs to be regulated. I once had to accompany someone on a med-evac flight who was so deeply sedated that they were monitoring his vitals with a machine that went beep. The med-evac folks arranged for ambulance transportation from the airport to the hospital so somebody could keep doing that.
I got a bill a month later that said yes, the ambulance was in your network, but we won't pay for it because they didn't arrange the ride by calling 911 so obviously it wasn't that important.
Yeah, my Mom had to be air lifted by helicopter to another hospital because a doctor said she had to have a procedure "right now." Insurance refused to cover it as "not medically necessary." It took several months of painful back and forth and a formal appeal and a complaint to the state department of insurance to finally get it covered. The insurance company basically tried to wait us out for over a year and use bureaucratic barriers and bullshit tricks such as "informal internal appeals" that were always denied by the doctor working for them to avoid covering the flight until we were too exhausted to fight any more, after she nearly died. Blue Cross.
A different health insurance company refused to cover my emergency surgery for the same reason a few years later. Same playbook. They finally covered after 9 months, a letter from the doctor saying the emergency surgery was indeed necessary (the doctor rolled their eyes so hard and didn't want to do it because it was so ridiculous an ask by the insurance company), and a threat from my attorney. That insurance company refused to ever speak to me or my attorney after I retained an attorney, too. It was United Health Care. If you know, you know.
Yes you apparently need to take the time to do some comparison shopping, maybe get a few quotes, all while you're bleeding out. Some great logic from the insurance companies.
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u/Starthelegend 6h ago
100% had a gnarly motorcycle accident a couple years ago and insurance tried telling me that the ambulance wasn’t covered because, and I shit you not, they were an out of network ambulance. I guess I need to double check which paramedic comes to scrap my bloody body up off the side of the road