Premium Health Exchange plan not so premium for some- (a warning from Washington State)

[nationalize the fed]

Make sure you know where to go in an emergency

SEATTLE -- Alex Szablya just wants the best health care she can get for her children. So she got a gold plan, the highest level possible with the Washington Health Benefit Exchange. She picked a plan with Lifewise, an affiliate of Premera Blue Cross.

In early March, her 16-year old daughter had a medical emergency. Alex drove her to the nearest hospital, which was Seattle Children's. Alex says doctors there felt her daughter's situation was so dire she needed to be admitted to the hospital immediately. She was there for nine days.

Then came news that her stay, which involved specialized mental health care for adolescents, was going to cost $36,000 and her insurance would only pay for half because Seattle Children's was considered on out-of-network facility.

She thought by going for the highest premium PPO gold level coverage offered the state exchange, a majority of the bill would have been covered...

Full story: http://www.komonews.com/news/local/Premium-Health-Exchange-plan-not-so-premium-as-user-thought-251614801.html

If you get stuck with a bill like that and aren't well off you might have trouble paying the next mandated insurance payment. Then you lose it all.

[Hoyt]

1. The Out-of-network hospital can always choose to accept the plan's payment. If they are greedy

they will not, but they can. Differences in payments for in vs. Out-of-network care have been around long before the ACA.

[WillowTree]

2. Ah.....assumptions are so dangerous.

Why people don't research something as critical as health insurance to be sure they know what they're getting before signing on the dotted line is just plain foolish, as this unfortunate woman has just found out.

[VanillaRhapsody]

3. Another problem falsely blamed on the Affordable Care Act?

If you choose an HMO....that is how it always has been...

The Gold plans are NOT subsidized....they are intended for those that are more well off....the Silver plans are equivalent to what MOST people who have always had good health insurance are getting...