Access to Emergency Care

How does the law make emergency care more accessible?

Plans will not be able to charge higher copayments or coinsurance for emergency services that are obtained out of network.  Currently many plans charge more if you have an emergency and do not get prior approval for care or go to the closest emergency room even if it is not in your plan network.

Who decides what is an emergency?

It is generally what “a person with average knowledge of health and medicine would think the injury or situation would, without immediate attention, cause serious harm to the person.” 

Do the new emergency care changes apply to all plans?

No, grandfathered plans do not have to include these protections.