Pennsylvania consumers report surprise costs not covered by their health insurance

Pennsylvania health insurance exchange

Consumers are receiving unexpected bills from medical professionals that are not covered by their insurance policies

Unexpected medical bills are proving to be a surprise to many consumers in Pennsylvania. Many consumers have reported surprise charges for their medical care, though they believed that their health insurance policies would cover these costs. The issue is placing some consumers under greater financial strain, as they were unprepared to cover the costs associated with medical care. The problem may be out-of-network care providers, which consumers are unaware of at the time that they receive medical services.

Consumers are unaware that some care providers are out of their networks

For some people seeking out medical care, they found that their surgeons and hospitals were in network, but anesthesiologists and radiologists were not. As such, the services that these professionals provided were not covered by their health insurance policies. This means that consumers are left with costly medical bills as insurers will not honor claims for out-of-network services that are being provided to policyholders.

Survey shows that 37% of consumers have received unexpected medical bills

Pennsylvania health insurance exchangeA recent survey from the Consumer Reports National Research Center found that some 37% of consumers have reported receiving “surprise” medical bills. For these people, their health insurance policy covered less of the costs associated with medical care than they had expected. Approximately 25% of these surprise costs involved medical professionals that consumers did not realize were out-of-network. On top of this, health insurance premiums are also on the rise, which is also introducing more financial strain to consumers. Overall, health insurance is becoming a costly problem for many consumers throughout the state.

State officials may look into the issue in the coming months

The Pennsylvania Insurance Department notes that the problem is not restricted to certain parts of the state. Instead, the issue is occurring throughout Pennsylvania, with more consumers reporting issues with what their health insurance policies cover. The state’s Insurance Commissioner is expected to address the issue and the Insurance Department may seek out a solution if the problem persists and becomes more severe for consumers.

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