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Why call my insurance company before going to the ER?

Dr. Michael Roizen, MD
Internal Medicine

The Affordable Care Act of 2010 says you no longer need to call your health insurance company before going to an emergency room that’s out of your network, but it may still be a good idea for you or a significant other to call as soon as possible. If you have a health emergency, your insurance company wants to know about it right away. As in ASAP, even before your mom knows.  Read the fine print in your policy, and you’ll see that, in some circumstances, they can refuse to cover you if you don’t call them before you head to the ER, or within several hours of arriving.  Considering that an ambulance ride can cost just slightly less than a Space Shuttle mission, it’s a good tidbit to remember. Plus, having your insurance ID number handy will smooth your experience at the ER, so the phone call could prevent a common hold-up.

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Consider your health insurance company to be a family member. If you have a health emergency, your insurance company probably wants to know about it right away. As in ASAP. Before your mom knows, even. in some circumstances--they can refuse to cover you if you don't call them before you head to the emergency department

Why? If you read the fine print in your policy, you'll probably see that--in some circumstances--they can refuse to cover you if you don't call them before you head to the emergency department or within several hours of arriving. Considering that an ambulance ride can cost just slightly less than a space shuttle mission, it's a good tidbit to remember.

And really, what's the trouble with phoning them? Once you get a finger on your bleeding artery, just use your other hand to dial the phone. To make it easier, why not put the 24-hour claims hotline on speed dial, right below your favorite pizza joint?

In being practical, having your insurance ID number handy will smoothen your experience at the ER anyway, and you can be sure that your insurance card will magically vanish from your wallet or purse because it's the first time you've really needed it in the last 15 years. So the phone call could prevent a common hold-up. And your relative or friend can do it for you (your health care advocate, if available, would naturally be the best choice).
YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

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YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

Everyone needs to become a smart patient. In fact, in the worst cases, your life may even depend on it. Number one bestselling authors and doctors Michael Roizen and Mehmet Oz have written this...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.