Insurers Can No Longer Pay Less For ‘Out Of Network’ Hospital Care

[Mr Lee]

I am not sure how This New Law in the US might affect current or future US expats in  the Philippines that might be covered by US plans, but I thought it might be worth posting for those expats to ask their insurance companies once the dust settles, and they are then all aware of it reaches. Now the only thing is it says it is for new policies but it is possible that it may end up going retroactive because that would only be fair to many of us who have polices via our former work. Some of us might have to push for this to be given to earlier issued policies. Hope this helps someone.Insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: insurance companies can no longer pay less for emergency care at “out of network” hospitals — the hospitals with which they don’t have prior financial arrangements. The equal coverage guarantee “was a major victory for us,” said Angela Gardner, president of the American College of Emergency Physicians. "People often can't stop to check to see if a particular hospital or doctor is in- or out-of-network when they are having an emergency," she said. The new law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the "prudent layperson" rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.