MedicAlert bracelet restricting care to in-network doctors?

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dailybagel
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MedicAlert bracelet restricting care to in-network doctors?

Post by dailybagel » Tue Feb 10, 2015 9:17 pm

I recently received a written letter from my insurance company, announcing that three area hospitals were no longer "in network" for 2015.

This letter made me think, does it make sense to wear an MedicAlert-like bracelet that lists my insurance information, in case I am injured and become unconscious?

Many sites offer engraving of custom messages. I was thinking about a message that would restrict my care to in-network hospitals only. Something like, No consent given for medical care outside of my insurance network.

I'm really worried about being injured as a pedestrian, becoming unconscious, and being taken to one of the out-of-network hospitals.

Image

Before people respond that I'm crazy, here are a few links about the problems of unexpected out-of-network medical costs:

Patient Faces Bankruptcy After Ambulance Takes Her To Out-Of-Network Hospital

Out-Of-Network Ambulance Rides Can Bring Out-Of-Pocket Expenses

Medical Bankruptcy in the United States, 2007 (PDF)

After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know

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Phineas J. Whoopee
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Re: MedicAlert bracelet restricting care to in-network docto

Post by Phineas J. Whoopee » Tue Feb 10, 2015 9:29 pm

I bet your insurance company follows the letter of the law on covering emergency care wherever the ambulance driver takes you.

I wouldn't be surprised if, once you're stable enough to be moved, it covers ground (or if necessary, air) ambulance to bring you to a covered facility.

Balance billing is a problem, but I'm not sure I'd agree instructing the out-of-network ambulance crew not to staunch the bleeding from the accident, just in order to avoid a charge which would be illegal anyway, is a rational decision. :happy

PJW

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Watty
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Re: MedicAlert bracelet restricting care to in-network docto

Post by Watty » Tue Feb 10, 2015 9:40 pm

There is an old saying that goes something like; "Be careful what you ask for, you might get it." Or in this case not get it.

I have a relative that was in a bad car accident last year in a rural area and was taken to the hospital by a life flight helicopter.

She is still fighting with her insurance company about an bill that she got for that for using an "out of network" helicopter where her part of the bill is $19,000.

She barely survived the accident but now she is doing relatively well all things considered. Even if she has to pay the bill it was will have been well worth the cost.

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Ged
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Re: MedicAlert bracelet restricting care to in-network docto

Post by Ged » Tue Feb 10, 2015 9:44 pm

It depends on the state you live in and how your particular plan is regulated. Some have laws requiring coverage for emergency care. Others not.

The doctor may have a legal obligation to save your life anyway. And if you die what happens? Your widow sues him?

ResearchMed
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Re: MedicAlert bracelet restricting care to in-network docto

Post by ResearchMed » Tue Feb 10, 2015 9:45 pm

Watty wrote:There is an old saying that goes something like; "Be careful what you ask for, you might get it." Or in this case not get it.

I have a relative that was in a bad car accident last year in a rural area and was taken to the hospital by a life flight helicopter.

She is still fighting with her insurance company about an bill that she got for that for using an "out of network" helicopter where her part of the bill is $19,000.

She barely survived the accident but now she is doing relatively well all things considered. Even if she has to pay the bill it was will have been well worth the cost.
An "out of network" life flight helicopter!??

Where in the world is the list of IN network life flight helicopters (just in case we have time to sort through the list depending upon where we happen to be, etc.)?

This sounds like a joke, but obviously it isn't.

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celia
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Re: MedicAlert bracelet restricting care to in-network docto

Post by celia » Tue Feb 10, 2015 9:56 pm

I suggest you call your insurance company and talk to them about this. I have found that ER doctors and anesthesiologists don't belong to a "network" where I live. They are independent contractors. When I had a surgery and the ER doctors and anesthesiologists weren't in the network (even though I requested it when I entered the ER), their claims were originally denied. After calling my insurance, they filed an appeal for me, then later paid the bills, knowing I had no choice. It may have helped to say I requested in-network when I entered. But in the ER, they are focused on giving you the care you need, not sorting through their list of doctors to find an in-network one. Our local ER gives the same care to everyone, whatever the insurance (or none) and asks for your insurance when you exit. I supposed that is so they can't be blamed for giving "inferior care" to those with poor/no insurance.

Another person to check with is your primary care doctor. If possible, ask to be taken to the hospital affiliated with the medical group. That is also useful as that hospital will probably have someone who can access your records at the medical group.
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msi
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Re: MedicAlert bracelet restricting care to in-network docto

Post by msi » Wed Feb 11, 2015 12:59 am

dailybagel wrote:I recently received a written letter from my insurance company, announcing that three area hospitals were no longer "in network" for 2015.

This letter made me think, does it make sense to wear an MedicAlert-like bracelet that lists my insurance information, in case I am injured and become unconscious?

Many sites offer engraving of custom messages. I was thinking about a message that would restrict my care to in-network hospitals only. Something like, No consent given for medical care outside of my insurance network.

I'm really worried about being injured as a pedestrian, becoming unconscious, and being taken to one of the out-of-network hospitals.

Image

Before people respond that I'm crazy, here are a few links about the problems of unexpected out-of-network medical costs:

Patient Faces Bankruptcy After Ambulance Takes Her To Out-Of-Network Hospital

Out-Of-Network Ambulance Rides Can Bring Out-Of-Pocket Expenses

Medical Bankruptcy in the United States, 2007 (PDF)

After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know
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Re: MedicAlert bracelet restricting care to in-network docto

Post by Mudpuppy » Wed Feb 11, 2015 1:06 am

My gut instinct is such a clause about in-network providers would have no bearing on where emergency care is rendered or on which doctors provide the emergency care. The priority in such emergencies is on rendering life-saving care, not on decoding insurance intricacies. This makes me glad that my employer's plan has a maximum annual out-of-pocket amount, although I'm sure there are loopholes around that too.

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White Coat Investor
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Re: MedicAlert bracelet restricting care to in-network docto

Post by White Coat Investor » Wed Feb 11, 2015 1:41 am

celia wrote: Our local ER gives the same care to everyone, whatever the insurance (or none) and asks for your insurance when you exit. I supposed that is so they can't be blamed for giving "inferior care" to those with poor/no insurance.
It's not about being blamed. It's about following the law and good medical practice. Can you imagine if the first thing we did was a wallet biopsy? Do we get stiffed a lot? Sure. But it sure beats the alternative.
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Re: MedicAlert bracelet restricting care to in-network docto

Post by White Coat Investor » Wed Feb 11, 2015 1:43 am

dailybagel wrote:
I'm really worried about being injured as a pedestrian, becoming unconscious, and being taken to one of the out-of-network hospitals.

Image

Before people respond that I'm crazy, here are a few links about the problems of unexpected out-of-network medical costs:
Oh, and you are crazy. Seriously, if you are unconscious so long that an ambulance crew can get you to an ER without you saying anything, you should not complain about any price you are asked to pay. The likelihood of you having anywhere near a full recovery after an incident like that is extremely slim.
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HIinvestor
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Re: MedicAlert bracelet restricting care to in-network docto

Post by HIinvestor » Wed Feb 11, 2015 1:44 am

In our state, the ambulance takes you to the empty bed, PERIOD. If you are unconscious, you have even less say, but even if you are alert and able to comminucate, they cannot take you to a hospital where there are no beds and where the hospital says they have no vacancies.

Yes, it is NOT fun to argue with insurer when you have received care by a non-participating, non-preferred provider, but some risks are not readily under our control and to me it seems a bad idea to obsess about it. If it gives you peace of mind, call insurer and ask them what happens if you are taken to an out of network provider by ambulance in an emergency situation, just so you know. I prefer not to worry about it and let things evolve as they will.

I was able to get our insurer to pay for the out-of-network anesthesiologist as if he were IN network by some prolonged discussions about how it was outside our knowledge and control. It took time and persistence but it worked for us with our BCBS.

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Re: MedicAlert bracelet restricting care to in-network docto

Post by dolphinsaremammals » Wed Feb 11, 2015 1:52 am

In my state, by law an ambulance has to take you to the closest ER. That is not too thrilling to me, since I'm like a fraction of a mile too far away from the hospital where my cardiologist, etc. practice. But it is what it is.

I'm glad I have Medicare/Medigap with no network nonsense, although obviously people feel more comfortable with their "own" doctors anyway.

I wonder what the savings is in terms of premiums for a network plan. I know some people are lucky they can afford insurance, but this is just another thing wrong with our health care system.

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Re: MedicAlert bracelet restricting care to in-network docto

Post by HIinvestor » Wed Feb 11, 2015 1:59 am

H has Medicare A & B plus insurance that pays whatever is left (if anything). It has been nice that he rarely has copayments any more. He still has to keep insurance for us, plus the coverage is great and it's withing our means to have all 3, just in case we have awful medical bills. I'm too young and healthy to qualify for Medicare and it is nice that kids under 26 are covered under H's plan.

tbradnc
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Re: MedicAlert bracelet restricting care to in-network docto

Post by tbradnc » Wed Feb 11, 2015 7:52 am

How are they supposed to know who the network providers are for your particular policy?

Maybe you could get a microchip that contains your network providers. :)

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Re: MedicAlert bracelet restricting care to in-network docto

Post by nisiprius » Wed Feb 11, 2015 8:19 am

YES, this sort of thing is a problem.

NO, there isn't any good solution to it.

In the United States as things stand at the moment, you are constantly vulnerable to the winds of medical-insurance fate. You are constantly at risk of receiving medical care your insurance doesn't cover, at times when you might well be unable to make a decision, and don't have the information to make the decision anyway. You just have to cross your fingers and hope for the best, and hope you can straighten it out if you get a surprise four-figure bill.
No consent given for medical care outside of my insurance network.
Sounds to me like a bad idea. You want the people who see you to be dealing with things that are familiar to them for which they know what they're supposed to do. Throwing them a surprise legal curveball can't be a good idea. Besides, you don't want them to stop to call a legal poobah when they are busy enough typing your blood and figuring out whether let you wait while they take care of that patient who just arrived with all the cops
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Re: MedicAlert bracelet restricting care to in-network docto

Post by drawpoker » Wed Feb 11, 2015 11:32 am

Mudpuppy wrote:....... priority in such emergencies is on rendering life-saving care, not on decoding insurance intricacies. This makes me glad that my employer's plan has a maximum annual out-of-pocket amount, although I'm sure there are loopholes around that too.
Yes, a very large loophole.

Your maximum out of pocket applies only to "covered services". If service is provided by an out-of-network provider, the claims are denied, and the insurance company is allowed to get away with it, you are on the hook, your policy's limit on OOP would not come in the picture.

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Re: MedicAlert bracelet restricting care to in-network docto

Post by magellan » Wed Feb 11, 2015 4:42 pm

nisiprius wrote:YES, this sort of thing is a problem.
NO, there isn't any good solution to it.
A partial solution is to choose an insurance plan with a solid provider network.

Unfortunately, you can't just go with a big name insurer known for their great network. Insurers are playing a new game of crafting special low-cost networks to make their plans look more price competitive to employers and individuals. You have to know the details of the exact network your plan includes.

The ID tag shown in the OP's photo is a good example of consumer confusion on this. You can't just put Anthem on the tag because Anthem offers many plans with many different networks. One Anthem policy may have a great network, while another has a terrible one.

I recently cancelled my individual Anthem coverage after being with them for nearly 10 years. In the individual market in my state Anthem switched from offering a great network that included all the big Boston hospitals to a terrible one that's riddled with gaps. I dropped them and got a similar policy from an insurer offering a solid nationwide network. The better network plan has identical coverage terms but comes with a 25% higher premium. IMO, sometimes you get what you pay for.

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Re: MedicAlert bracelet restricting care to in-network docto

Post by HIinvestor » Wed Feb 11, 2015 4:52 pm

Agree that it is worthwhile examining your medical insurance policy carefully and being sure to have one that considers most of the medical centers around you "in network." Saving money by buying a policy that has a very narrow and limited network may cost you more in out of network expenses than it saves you in premiums. I am fortunate that nearly all providers in our state are partciipating and preferred with my insurer, as well as most of the out-of-state providers.

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Re: MedicAlert bracelet restricting care to in-network docto

Post by ShiftF5 » Wed Feb 11, 2015 5:32 pm

EmergDoc wrote:
dailybagel wrote:
I'm really worried about being injured as a pedestrian, becoming unconscious, and being taken to one of the out-of-network hospitals.

Image

Before people respond that I'm crazy, here are a few links about the problems of unexpected out-of-network medical costs:
Oh, and you are crazy. Seriously, if you are unconscious so long that an ambulance crew can get you to an ER without you saying anything, you should not complain about any price you are asked to pay. The likelihood of you having anywhere near a full recovery after an incident like that is extremely slim.
I'd like to nominate this for "response of the day" (or the week or the month). :D

Good one.

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