No Surprises Act Leading to New Surprises for RVers
On January 1, 2022 the “No Surprises Act” will become law. The law was written to prevent consumers from being caught by surprise medical billing, particularly after emergency medical services were provided. For example, you have a hospital or emergency room visit, which was covered under your policy, but the orthopedist or anesthesiologist on call was not in your network, so you received a huge out-of-network bill, called “balance billing”.
Surprises to RVers Aren’t New
We have found during our 13 years dedicated to helping RVer’s insure their health, that when there is an action taken to protect us, it can have a bit of a Newton effect, causing an equal and opposite reaction that may make utilizing your health insurance on the road more cumbersome, or worse yet, impossible.
Looking back to 2014 when nearly all Affordable Care Act Plans became HMO’s, RVers were deeply impacted because their health plan only covered them for a medical emergency “as deemed an emergency by the health insurance carrier”, when outside their plans’ service area.
For example; imagine you are a Texas resident in the state of Washington for the summer, hiking trails in the beautiful Northwest. You fall or stumble, and believe you may have broken your ankle. You head to the nearest emergency room and the x-rays reveal you have only sprained your ankle. That sprain is NOT a medical emergency, so your HMO would not cover that “out of network” ER visit.
Eliminating Surprise Billing is Good….Right?
Eliminating surprise or balance billing when you do not have the ability or time to secure an in-network physician is a good thing. When you are unconscious or need emergency medicine and you are a thousand miles away from your “network”, getting the help you need is important. Not getting hit with thousands of dollars in unexpected medical expenses is a good thing as well.
National Law Review states it quite nicely here:
Under the No Surprises Act, a health plan that provides emergency coverage must provide that coverage without prior authorization, without regard to whether a facility is in-network or out-of-network, and regardless of other terms of the plan, except for exclusions or coordination of benefits. Health plans also cannot deny claims for emergency coverage based on an after-the-fact assessment of the care provided, any purported delay between when symptoms began and when the patient sought care, or based on how long the symptoms were present.
National Law Review – October 19, 2021
Note however the text in bold. These new laws apply to “a health plan that provides emergency coverage”. So what if your insurance company’s way of skirting this law is simply to eliminate coverage for out of network hospital stays…regardless of where you are. If your health plan does not provide emergency coverage for out of network hospital stays to begin with, then it has no law to conform to.
This is going to impact all RVers who carry an HMO Affordable Care Act plan for medical emergencies.
RVers Could Be At Financial Risk
We have not yet reviewed all 50 states’ summary of benefits; however, looking at the states commonly utilized by RVers as a domicile state, we are finding that the insurance company’s HMO’s are choosing to not cover “out of network hospital stays”. This could have serious consequences on your ability to travel anywhere that is outside your network.
This reaction to the No Surprises Act by Health Insurance Carriers’ makes your RV toilet paper more valuable than your Affordable Care Act HMO policy. Regardless of whether you receive a tax credit or not, you no longer have peace of mind that you are covered for a “medical emergency”.
If your health insurance policy no longer covers out of network hospital stays, you are at risk every time you leave your local network coverage area.
Open Enrollment Extension Gives You Time To Find Alternatives
The open enrollment for the Affordable Care Act plans was extended this year, and continues until January 15, 2022. This gives you additional time to make changes, and find alternative solutions. Our RVer health insurance agents can help you with true, affordable health insurance options that are filed with each state’s department of insurance. These policies travel with you. Our agents are real RVers, helping RVers, and are licensed health insurance agents who are trained to assist RVers with the unique needs that our lifestyle behests.