Many of you reading this right now may be worried about a surprise medical bill. One usually arrives after a medical emergency -- where you find out your insurance won’t pay because of an out-of-network medical provider. While Congress is finally helping by passing new legislation, Consumer Reports warns something important was left out of the new law that could cost you thousands of dollars out of your own pocket.
Consumer Reports writer Donna Rosato got one of those surprise medical bills. Last March, she found herself in a serious health emergency: She had a fever and a cough and after going to her local ER was rushed to a larger hospital by ambulance.
“I had a cough that wouldn’t go away, and a mild fever spiked to 103° F. I went to the emergency room, where I suddenly became unable to breathe,” explained Donna Rosato with Consumer Reports. “I was put on a ventilator for 10 days and spent a few weeks in an intensive care unit, where I slowly recovered from the flu and pneumonia.”
When Rosato was finally able to go home, she was greeted with a pile of medical bills. It might be surprising to learn that the biggest bill she owed was for the ambulance ride which was not covered by her insurance company.
Unfortunately, those bills are not likely to go away anytime soon because they are not part of new federal legislation called the No Surprises Act, which takes effect in January 2022 and is aimed at eliminating surprise medical bills that can arise from out-of-network providers.
“If we’re protecting patients from surprise billing once they get to the ER, why not protect them for the surprise bill on their way to the ER?” asked Consumer Reports Advocacy Expert Chuck Bell.
Consumer Reports says ambulance providers and insurers often disagree on what is a fair rate for this essential lifesaving service.
Ambulance companies say they provide costly, labor-intensive services, and insurance reimbursements are too low for them to be in-network. That means patients like Rosato are often left footing a hefty bill.
The good news is there are some ways to fight back. Consumer Reports suggests:
- Ask your insurer to review the claim.
- If it’s still not covered, contact the ambulance company and ask if the charge can be lowered or if the company offers a payment plan.
“Talking to my insurer did the trick,” said Rosato. “A few weeks later, I got a notice that Aetna paid the ambulance provider an additional $1,500, covering all but $283 of the original $3,000 bill.”
Consumer Reports provides a free Insurance Complaint Tool to help you fight a surprise medical bill. You can search by state to find contact information and resources.