Will Health Insurance Cover Emergency Room Visits?

Going to the emergency room is something that happens to almost everyone at some stage in their life. Whether you fall out of a tree is a kid and break your arm or you come down with a serious illness or disease as an adult, the emergency room is available to save lives. But will your insurance company cover your emergency room visits? That’s a question that people with health insurance often ask, and the truth is, it is a lot better to know before you have to go to the emergency room then to have to look it up later and find out. Let’s get into what you need to know about emergency rooms and health insurance coverage.

The Importance of Emergency Room Coverage

It is extremely important that you have emergency room coverage as part of your insurance plan. Emergency room visits can be extremely expensive, and if you get seriously injured you don’t have a lot of say over what is being done to save your life – plus you probably don’t have too big a problem with a no matter what it costs. The later on when you get the bill for an emergency room visit, it could be in the tens of thousands or hundreds of thousands of dollars range depending upon what was done to diagnose you, what treatments were performed and how long you had to stay in the hospital. If you had to have emergency surgery or treatment by specialist, the bill could climb to epic proportions.

Most insurance plans out there covers emergency room visits to a certain extent. However, you want to be really careful and read your policy beforehand because not every insurance plan is the same. For example, you may have a huge deductible that you have to meet before the insurance company will start paying on your emergency room visit. In addition, you want to make sure that all of the normal diagnostic tools and procedures are covered, and that your stay in the hospital’s covered for at least a few weeks.

How to Know Whether Your Health Insurance Covers an Emergency Room Visit

To determine whether or not your insurance policy covers emergency room visits, the easiest way is just simply to ask your insurance agent. They will usually direct you to the page in your policy that clarifies all that. Insurance policies are made to be dense and unreadable, so you may want to get someone who is well-versed in these type of documents to explain to you in basic terms what is covered. Hiring a lawyer may be outside the scope of what you want to spend to find out whether you are covered or not, but you definitely want to understand whether or not you are going to be paying for an emergency visit yourself before an accident happens.

The reason for this is fairly simple. If your insurance plan lays out which emergency rooms you are able to visit, then you want to make sure that you have instructions to go to that emergency room if you are in an accident and rendered unconscious. A life alert bracelet made be able to provide this information. In addition, you can tell your family members which diagnostic tests are covered in which are not so that your doctor does not order anything unnecessary that you’re going to pay for later.

Diagnostics, Admittance & Other Considerations

There may be other considerations as well the need to look at your health insurance plan for. Being admitted to the hospital and having to stay for length of time is obviously one of those, but diagnostic machines like MRIs and CAT scans may not be covered by your insurance either. You definitely want to find out what is covered before you have any emergency room visits, and you might want to get supplemental health insurance that covers you if you have to stay in the hospital for any length of time for example or covers an MRI or other diagnostic tests that normally cost thousands of dollars.

The Bottom Line

The bottom line is that there are so many things to think about when it comes to emergency room visits and your health insurance that it can be really confusing. But most health insurance plans to include some sort of provision for you to visit the emergency room. You may only Be able to visit the emergency room a certain number of times in the year, and they may not cover everything that is done to you while you are there, but for the most part, insurance companies know that you need to be covered in case something happens that requires a trip to the ER.