Here's what the new ban on surprise medical billing means for you

[Jilly_in_VA]

The new year brings new protections for patients with private health insurance who will no longer be blindsided by "surprise" medical bills when they unknowingly receive out-of-network care.

The No Surprises Act, passed by Congress in 2020 as part of the coronavirus relief package, takes effect Jan. 1.

It generally forbids insurers from passing along bills from doctors and hospitals that are not covered under a patient's plan — such bills have often left patients to pay hundreds to tens of thousands of dollars in outstanding fees. Instead, the new law requires health care providers and insurers to work out a deal between themselves.

Here's how the law will work and how it might affect insurance premiums and the health care industry.


https://www.npr.org/sections/health-shots/2021/10/14/1045828215/ban-on-surprise-medical-bills

[bucolic_frolic]

1. I take it the uninsured are still unprotected ./nt

[Celerity]

2. Yes.

[marie999]

5. Not only that, but they have to pay all their medical bills for the full amount.

What we need is a law that states that all medical bills can not be for more than Medicare allowable. We receive a memo from Optima that pays for our non-VA medical which gives the amount billed, how much they pay under Medicare allowable, and how much we owe which is always $0.00

[Celerity]

8. No other advanced nation would accept what Americans do in terms of the wealth extraction

via the rapacious for-profit US healthcare system.

It boggles my mind how even so many of poor or lower, lower middle class just accept it, or, in the truly brainwashed cases, adamantly fight changing it.

I see the pro big pharma/insurance/hospital doctor bullshit lying, fear-mongering adverts whenever I watch US cable streams. All of those would be not even exist in any other advanced nation. They would not be needed, and even if there was small niche they could aim for, those adverts would not be allowed in their American format because they lie.

Gaslit nation.

[Hekate]

3. Thanks, Jilly

May your new year be healthy and happy.

[ecstatic]

4. lol. I wonder if that's why I received a surprise dental bill yesterday

Supposedly from a visit back in March. I could have sworn I already paid whatever I owed but I couldn't find any emails or texts confirming a credit card purchase for that date. So I paid and I'm hoping I wasn't duped.

[Midnight Writer]

6. I had surgery where the doctor and the hospital was in-network, the anesthesiologist was not.

Cost me 3 thousand dollars out of pocket. I had no advance notice that I would have to pay the anesthesiologist separately.

That was certainly a surprise.

[Ms. Toad]

7. Excellent.

I've had to battle:

* Anesthesiologists (who have their own litle fiefdoms which - in my case - would have requried me to drive 50 miles away for an emergency appendectomy when I was 5-months pregnant)
* Dermatologists (somehow the surgical biopsy for suspected breast cancer is covered, but the surgical biopsy to remove a skin growth that meets all of the ABC criteria for suspicious activity is cosmetic)
* Ultrasound fibroscan to evaluate progression of my daughter's liver disease - covered under her 2018 plan, but treated as experimental under her 2020 plan & the doctor never bothered to check
* The infusion process for my daugher's entiviyo infusion because althogh the drug was covered the doctor forgot to renew the approval for hospital infusion (after 6-months, during which the process is considered very risky, they shift you to at home infusions - leaving us with a $20,000 bill.)

I've won them all - but it will be nice to avoid the battle process.

[smirkymonkey]

9. Good to know.

Well, that's one positive thing I can think of for 2022. Thanks, Jilly!