If you go to the ER for a ‘minor ailment’, you may be on the hook for the bill

Credit: MGN Online

(NEWS10) – Anthem is beginning to enforce a policy across a number of states that refuses payment for certain visits to the emergency room.

According to the St. Louis Post-Dispatch, beginning this summer, if someone shows up to the emergency room with a minor ailment like a cold or sprain, they may have to pay the entire bill.

Anthem told the newspaper that it is trying to change emergency room usage behavior. The insurer says the policy is already part of members’ coverage contracts but is rarely enforced.

Missouri is the third state where the second-largest insurer is enforcing the policy. It’s also being enforced in Virginia and Kentucky.

Exceptions to this policy includes:

  • ER services for children under the age of 14
  • Urgent care facilities are further than 15 miles from the patient
  • A patient was referred by another physician
  • Visits on Sundays or major holidays will also be covered.

Anthem published a blog post to help members decide if a trip to the emergency room is warranted or if the condition can be treated at an urgent care facility.

Locally, Anthem has not announced if it is enforcing this policy.

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