Beware this insurer’s sneak attack on emergency care coverage

From STAT:

Most people buy insurance to protect financially against potentially catastrophic events and emergencies. But if you have health insurance through Anthem, a health insurance company that covers an astounding 1 in 8 Americans, watch out: You may be on your own in an emergency.

Anthem has introduced a restriction on emergency care coverage, effectively denying most if not all coverage if they decide after your ED visit that you didn’t have an emergency condition. Say you went to an emergency department for severe abdominal pain and nausea that sounded like your cousin’s appendicitis, only to find out the cause was a nasty stomach virus.

After the dust has settled, Anthem reviews the bill and decides that your visit was inappropriate and could have been treated in your doctor’s office or at an urgent care center. The company then covers only a fraction of the cost, if any, and you are responsible for most of the bill. What’s more, this expenditure would not count towards your deductible or out-of-pocket limit.

Nurse Alone in Clinic Treats Himself for Heart Attack

From Medscape:

“The first electrocardiogram showed complete heart block, right bundle-branch block, hyperacute T waves in the inferior leads, and reciprocal ST-segment depression in the anterolateral leads.” The second, taken 50 minutes later “showed sinus tachycardia with 2 mm of inferior ST-segment elevation.”

When the nurse got the results, he self-cannulated and administered aspirin, clopidogrel, sublingual nitroglycerin, intravenous heparin, and opiates. He prepared for thrombolysis and was able to interact in real time with the ETS.

After thrombolysis, his ST-segment elevation and symptoms resolved.

The Royal Flying Doctor Service arrived and transferred him to a cardiology unit in Perth.