Health Law

Unconscious woman with medical insurance is taken to out-of-network hospital, owes $50K

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When Megan Rothbauer had a heart attack in 2013, she was, luckily, covered by medical insurance.

Unfortunately, she wound up in the emergency room of a Madison, Wisconsin, hospital outside her Blue Cross Blue Shield insurance network. Ironically, another hospital a few blocks away was in-network. Now the 30-year-old is contemplating bankruptcy because of the $50,000 she is being asked to pay as her share of the hospital bill. Had she been at the other hospital, her share of the bill would have been $1,500, WISC reports.

The 30-year-old is somewhat philosophical about her situation, even though it has caused her to postpone marriage plans as she tries to get her financial situation straightened out.

“I was in a coma. I couldn’t very well wake up and say, ‘Hey, take me to the next hospital.’ It was the closest hospital to where I had my event, so naturally the ambulance took me there. No fault to them. It’s unfortunate that Meriter is in network and was only three blocks away from St. Mary’s,” Rothbauer said.

She would, however, like to see the health insurance system changed, so others don’t take the same financial hit she did.

St. Mary’s points out that its care saved Rothbauer’s life and says the hospital has taken a loss, too, by writing off tens of thousands of dollars from Rothbauer’s bill.

“When you’re looking at saving a life, you’re not looking at whether or not you can save them money,” Cyn Gunnelson of Managed Care Contracting for SSM Health Care’s Wisconsin region told the station. “I can only do so much. The hospital can only do so much. And I think the best outcome is the person walked away from the emergency room.”

Hat tip: Daily Mail.

See also: “New York Times article on hidden hospital costs sparks calls for change, suggestions for consumers”

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