Health insurance is a necessity for families, but it's not always easy to get or to navigate what some insurers will pay for and what is not covered. Anthem Health, an insurance company that includes thousands of families, has recently changed some of their policies to limit emergency room visits. Typically, being seen in the emergency room is more expensive than being seen by a primary care provider in an office setting. Some conditions cannot wait, however. One patient, in this video, has life-threatening allergies. She often has trouble breathing when an attack happens and must use the ER. Anthem has denied more than $12,000 in claims for these visit, saying they were "avoidable" and "inappropriate."
Anthem is currently enforcing limits on ER visits in six states where it sells insurance. Not everyone is a fan. Doctors worry that if patients fear being stuck with a hefty bill, they will not seek treatment. Depending on the issue, if care is delayed, there could be serious health complications. The policy on ER visits covers conditions that are deemed "routine" like cuts, bruises, flu and respiratory illnesses. If patients go to the ER for these complaints, there is good chance the charges will be denied, but often there is no other available option.
