What would happen if I went to a non-network hospitals emergency room because I thought I was having a heart attack and it turned out to be just a pulled muscle?
New York State has a Prudent Layperson law which requires health insurance plans to cover an emergency room visit. Your symptoms must be sudden, severe, or painful enough that a “prudent layperson” could expect that not receiving immediate medical attention would cause serious health problems. Therefore, your emergency room visit would be reimbursed at the network level of benefits, and you would only be responsible for the emergency room copayment.
Related Questions
- What would happen if I went to a non-network hospitals emergency room because I thought I was having a heart attack and it turned out to be just a pulled muscle?
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