Consumers In Indiana Hit By Anthem’s Emergency Room Coverage Cuts

By Consumers for Quality Care, on August 25, 2017

Consumers In Indiana Hit By Anthem’s Emergency Room Coverage Cuts

Indiana residents covered by Anthem will soon have to think twice before visiting the emergency room.  The insurer will notify customers that their ER visits might not be covered by their insurance, Fox 59 reports.

Last week, Consumers For Quality Care sent a letter to the Indiana Insurance Commissioner that urged him to reject the new policy because it would hurt consumers.

Anthem officials say they hope the change will entice patients to seek preventative care, before heading to the ER.  If they do not, their emergency room claim may be denied.

“If a member chooses to receive care for non-emergency ailments at the ER when a more appropriate setting is available, their claim will be reviewed using the prudent layperson standard and potentially denied,” the company said in a statement to FOX59.

Many doctors and hospital officials have objected to the policy decision.  They fear that patients may skip seeking necessary medical attention, if they fear getting an extraneous bill.

“Fundamentally there’s a concern about a policy that would call into question an individual’s instinct about whether or not they are going to seek care in the emergency department,” Brian Tabor said, president of the Indiana Hospital Association. “Emergencies are emergencies. And when an individual pauses or hesitates and has to go through that process, it can lead to some very bad outcomes.”

In Georgia, pushback against the change was so outspoken that the Department of Insurance issued a statement, saying they would monitor the effect on customers.