Patti,
I have been reviewing my Mom's plan all day after reading about your ordeal.
I don't know the circumstances of your emergency visit & if your husband was admitted to the hospital or not.
My Mother has United Advantage HMO, not PPO. (I'm not sure if you have actually have an Advantage plan PPO or if you have the Original Medicare with Medigap/supplement policy)
Her policy regarding emergency room visits state a $50 co-pay and if non-network providers treated the emergency her insurance will work with providers to have network providers take over after the emergency is over, but she is entitled to care ANYWHERE in the case of emergencies.
I really think your insurance & hospital dropped the ball because they should have realized the Dr. was not an in-network provider. |