Emergency room insurance is often included in health insurance plans, but some people choose to purchase supplemental policies. Insurance companies may limit coverage for non-emergency visits, but laws may require comparable coverage for emergency room care. Some health insurance policies have minimal coverage, and supplemental emergency room insurance can provide additional coverage.
Emergency room insurance covers the costs of an emergency room visit. In many health insurance plans, emergency room care is part of the standard coverage of a policy. However, because some insurance companies treat emergency room costs differently from other medical expenses, some people choose to purchase a supplemental emergency room insurance policy. Other types of health care plans, including those that provide limited coverage, may also include an emergency room benefit. People with health insurance should clarify with their insurer any restrictions on emergency room coverage, as well as the procedure for notifying the insurance company, to avoid having to pay out-of-pocket for costs that would otherwise may be covered by emergency room insurance.
Visiting an emergency room can be expensive, so many insurance companies try to discourage people from visiting an emergency room for non-emergency cases by restricting the amount of money paid on claims for care in the room emergency services when it is not clear that an actual medical emergency existed. In some places, laws limit the extent to which insurance companies can engage in this practice, often requiring them to offer a comparable level of coverage for emergency room use as they provide standard medical care, as long as the patient can demonstrate that the trip to the emergency room was a reasonable action. However, some insurance companies require that policyholders contact them within a certain period of time after seeking emergency room care to receive maximum coverage. For this reason, policyholders should take steps before an emergency occurs to find out what to do if they or a family member is admitted to an emergency room.
Some health insurance policies may offer minimal coverage for both non-emergency and emergency medical care, providing significant coverage only for major medical problems that are very expensive to treat. In these large deductible medical or high deductible plans, policyholders are expected to pay out-of-pocket for much of their medical care until a certain threshold is reached during the year. An emergency room supplemental insurance policy can provide additional coverage, often in the form of cash payments or reimbursements, for emergency room care that is not covered by the patient’s health insurance policy. Other types of emergency room insurance include limited coverage policies that provide predetermined cash payments to people who may not be able to get standard insurance but need help paying medical bills.
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