LymeNet Flash: Emergency Room Insurance?

This is topic Emergency Room Insurance? in forum Medical Questions at LymeNet Flash.

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Posted by canefan17 (Member # 22149) on :

Is there such a thing?
Does anyone here have just Hospital Insurance?

I don't have regular insurance but after talking it over with my family we think it'd be wise to have an emergency room type insurance plan.

And for the record I'm still doing great since my update post a few months back! [Big Grin]

The Rhodiola (Gaia Herbs Adrenal Health formula) has been so good to me!

I'm back to lifting weights and playing basketball a few times a week. An unreal improvement considering months before that I was having a tough time walking up a flight of stairs.

Hope everyone is doing well!
[group hug]

Posted by girl (Member # 18022) on :

I have a really high deductible insurance. I mainly got it in case I have to go to the hospital. The deductible is $3000.00 but after that, 100% of a hospital stay would be covered. I have this insurance through my job. I do get one free physical per year, but have to pay in full for regular doctor's visits.

Posted by Lymetoo (Member # 743) on :

Is that the same thing as "major medical?"

Posted by glm1111 (Member # 16556) on :

Don't know about E.R. insurance, but just wanted to say I am soooo happy to hear you are doing so well. [Smile]

Gael

Posted by trimom (Member # 25843) on :

I've never heard of this type of insurance.

Does your insurance not cover ER visits?

We have a high deductible plan and once that is met in network pays 90%. Could be Dr, test, labs, X rays, ER, surgery or what ever is covered.

Many ER visits could be avoided by going to primary care or urgent care which tends to be much less expensive.

Any ortho issue, ER usually does nothing but take X Rays and tell you go follow up with Orthopod.

Can you get regular insurance?

Posted by droid1226 (Member # 34930) on :

Most hospitals are non-profit (trying to keep a straight face). But seriously the big ones run as a non profit so if you make under something like 15-20k you get everything for free. What a country......Just a thought because I think you said you were part time. Might qualify...

Posted by chaps (Member # 25286) on :

Health insurance has traditionally included coverage for emergency room visits.

But since the 70s, in the ongoing effort by all corporations in this country, (insurance companies included) to increase profit, this has changed.

The vicious cycle happens thusly: The insurance company hires a new CEO. During the hiring process, this new CEO negotiates a compensation package that rewards him with huge, obscene bonuses if he hits a particular profit target. These bonuses are enough to support him the rest of his life when he resigns after two years.

So to achieve this profit target, the CEO says, "Hey, if we stop paying for emergency room visits but keep the premiums rising at the current rate, we can make X-amount more profit. HELLO BONUS!"

Of course, they combine this service-cutting with laying off employees. Sure, service declines, but profits rise. ALL HAIL TO THE MIGHTY CORPORATE PROFITS!

So one CEO tries this, then all the other follow suit.

And where do these profits go? Two places: The CEO's pocket and the pockets of stockholders who turn tail on the company and pull their money out any time they feel like it.

In two years, the CEO leaves his job after collecting his bonus and doesn't worry about the consequences of robbing Peter to pay Paul to get the short-term gains that paid for his bonus, so now the long term stability of the insurance company is at risk. But what do they do to survive? They just cut payouts more and raise premiums.

The net result is that today, emergency room coverage varies from one insurance plan to the next. Some don't cover it at all. Some cover only a portion. Some have a deductible for each visit. Some cover it fully. It varies all over the board.

Posted by poppy (Member # 5355) on :

Chaps excellent explanation reminded me of the BX plan in a state where I used to live. It was non-profit at the time but wanted to go to for profit status instead. This switch included a nice fat sum of money for the top guys who were shepherding this switchover. Not that that was the motive. Of course not, how could you think that? It was so that would have access to a larger pool of money to help patients. But from a lyme patient perspective, it would have been a disaster as the for profit BX they wanted to join was known to have lousy policies about lyme disease. Don't pay for lyme treatment and that increases profits.