Changing health insurance after getting sick? - free market scenario

[farreri]

I pd the Hospital somewhere around 150 to 250 a yr American lump sum for one yr.Any urgent care I go there , zero bill .

What if you're really far from that hospital when you have a medical emergency?

 

[farreri]

What difference does it make?

Some of us are ld enough to remember a time when insurance policies were pretty much just major medical. In a free market, we would be able to choose that.
Changing insurance after getting sick means you do not actually understand insurance. Let's talk about cars. Changing policies after you've already had an accident? Good luck.

Read my scenario in my OP.

 

[oyarde]

What if you're really far from that hospital when you have a medical emergency?

Well in the years I spent in the Third World about the only place to seek any real medical care you did not perform yourself was A Hospital in a large City. Everything was so cheap though , you could pay cash with what was in your pocket at a Dr or Pharmacy if there was one .

 

[farreri]

Well in the years I spent in the Third World about the only place to seek any real medical care you did not perform yourself was A Hospital in a large City. Everything was so cheap though , you could pay cash with what was in your pocket at a Dr or Pharmacy if there was one .

I'm more concerned about in this country needing expensive emergency medical care away from the hospital you pre-paid at.

 

[Zippyjuan]

Currently, a hospital has to grant emergency treatment without concern about payment. Absent that rule, hospitals could institute some sort of reciprocal agreements to treat somebody covered by another hospital's plans- whether that takes the form of having the hospital with the policy to pay the other hospital or just to assume they end up treating as many of their patients as you treat of their patients and assume it balances out.

 

[angelatc]

Read my scenario in my OP.

You get what you pay for. If you pay for company A to insure you, then company A insures you. People with insurance don't have a right to change policies mid-treatment any more than the company does.

It isn't pre-paid medical care.

 

[farreri]

People with insurance don't have a right to change policies mid-treatment any more than the company does.

But my question is what happens if the insurance company goes out of business mid-treatment?

 

[MelissaWV]

But my question is what happens if the insurance company goes out of business mid-treatment?

If you cared to find that out, there are numerous examples out there right now. Companies go out of business, merge, change the terms of a plan (at renewal), etc., all the time. Providers change their participation in networks as well.

Usually the provider is left holding the bag.

Consider a third party administrator that acts as the facilitator for several insurance companies. It guarantees payment, it provides authorization and staffing services, and it negotiates contracts. Now consider that it goes out of business.

Several things start to happen.

The first is that some notice has to be given by the insurance company (or third party administrator) to the providers. Unfortunately, this notice doesn't have to be particularly long and since the company's going out of business it doesn't have much to fear.

The second is that patients will have to find someplace that directly accepts their insurance. This might be the same provider. It might not. Reasonable efforts have to be made not to interrupt care; there is no coldhearted turning off someone's IV because they cannot pay. That would be exceptionally bad for business even if it were no longer illegal.

The third is that the provider will try to work directly with the insurance company to make all debts whole. This is going to fail, but the degree to which it fails varies. In instances where the provider didn't used to take the insurance directly (hence the need for a third party administrator), it can sometimes lead to direct contracts that benefit both parties. Most of the time it's going to wind up reminding the provider why they didn't want to take XYZ Insurance directly to start with.

There might also be lawsuits involved to get the insurer or third party administrator to pay out, but good luck with that. By the time a health insurer is going belly up, there's not much to confiscate.

The long and short of it is that lifesaving care continues, other insurers will likely be willing to provide similar coverage at a similar rate, and providers get a much shorter end of that stick than the patients.

 

[oyarde]

But my question is what happens if the insurance company goes out of business mid-treatment?

Well , I would expect the provider to be stuck .