principiatheologica
New member
Let's say I have a HMO policy I bought on the marketplace from South Carolina and I'm on a road trip across the country. While I'm in New Mexico, I go to the ER for an emergency (not in network) and I am admitted or even have surgery during the admission.
EDIT:
I believe I found the answer to all questions. Leaving this up if it helps anyone else. Questions 1 and 3 in this document and question 2 is addressed here.
EDIT:
I believe I found the answer to all questions. Leaving this up if it helps anyone else. Questions 1 and 3 in this document and question 2 is addressed here.
- Would the hospital admission or surgery be covered under the no surprises act? If they are covered, I'm assuming the no surprises act stops as soon as the patient is safe to be discharged- is that a correct assumption?
- Would my copayment/coinsurance for my ER visit/admission count against my out-of-pocket max? My insurance has no out of pocket max for out of network coverage, but does the no surprises act supersede this in the case of an emergency?
- What determines the definition of emergency care? Is it based on certain billing codes or other parameters?