Fainting spell resulted in $16K bill for patient with short-term health insurance, Pa. Insurance Commissioner says
A fainting spell left a woman who had short-term health insurance stuck with a bill of more than
Altman, who has repeatedly expressed concern about the Trump administration's decision last year to expand the plans that are cheaper than major medical insurance but may not cover many things people expect them to, said her department works to protect consumers but it's difficult, "as our authority under state law regarding these plans is limited."
A spokeswoman for the department said
The woman who fainted hit her head, Altman said, and the plan paid
"After considering cost-sharing, to include the payable benefits being applied to the consumer’s deductible and coinsurance," Altman said, the plan "covered just over
Altman also said the department is working with a man who was diagnosed with a heart condition while enrolled in a short-term plan, then had his payment request denied because it excluded pre-existing conditions.
"Even though the consumer had never sought or received care for his condition previously, the insurer indicated that the claim manifested in such a way that an ordinary prudent individual would have sought medical advice and treatment in the twelve months prior to purchasing the STLDI plan for that condition," she said.
In another case, she said, a person purchased short-term insurance for five consecutive terms and was hospitalized for a virus.
The insurer demanded three years of medical records to determine "if the hospital admission in any way related to a pre-existing condition, significantly delaying payment of the consumer’s claims," she said. "Claims payments totaling over
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