Question
My father-in-law was visiting us from Europe. We had bought visitors insurance here in the States to cover his stay here. He is an Asthma patient and had an acute Asthma attack while he was visiting us.
It happened during the weekend, so we took him to the nearest urgent care. The doctors at the urgent care realized that it was pretty serious and sent him to the nearest Emergency center attached to a hospital - they asked us to use an Ambulance rather than our car to take him there. Once he was taken there, the doctors at the Emergency care center ran tests and explained to us that he had an infection and had bronchitis as well as Asthma attack. They admitted him to the hospital and told us they can discharge him once his oxygen levels normalize, his bronchitis is under control and they make sure that it doesn't lead to pneumonia.
Our understanding is that the trigger for this Asthma attack was the bacterial infection. However the insurance company is refusing the pay the urgent care bill, the ambulance bill and the hospital bill.
At the time of the discharge the doctor gave prescription for medicines (Antibiotics as well as asthma medicines - they changed some of his Asthma medicines (that he had carried with him). The pharmacy does not accept visitor insurance, so we had to pay it out of pocket. When we sent a claim to the insurance company, they refused to pay saying its related to a pre-existing condition.
What should we do - its a lot of money (almost as much as our annual salary); is there a way to work out something with the insurance company/ hospital. Is it really our responsibility?
Answer
Hi Jane!
You can always appeal a denial. You need to prove that it was not a pre-existing condition. Call the hospital and/or Dr to see if you can get them to put it in writing.
On the denial form it will tell you how to appeal.....
Good Luck!
Tricia
