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Anthem’s Insurance Policy Change Leaves Patients With Large Medical Bills

Written by Jared Staver

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Jared Staver is a Personal Injury Lawyer based in Chicago, Illinois and has been practicing law for over 20 years.

Jared Staver

CATEGORY: Insurance, Personal Injury


In an effort to curb what they consider to be frivolous visits to the ER, insurance company Anthem has revised some of their payout guidelines. The Anthem insurance policy change states that they will no longer reimburse claimants for ER visits if they conclude that the visit wasn’t a “true emergency”. A true emergency is generally only determined after the doctor has been seen and tests have been administered. As a result, patients who thought their policy covered such visits are now getting hit with ER bills costing thousands of dollars.

If you have suffered insurance issues due to Anthem’s new insurance policy change, you should contact a Chicago personal injury attorney at Staver Accident Injury Lawyers, P.C. We can help you with your case.

Call us today at (312) 236-2900 to schedule a free consultation.

Anthem States There are “Too Many Unnecessary ER Visits”

Anthem claims that a large number of ER visits are unnecessary. The company says people who go to the ER often get diagnosed with common colds, everyday rashes, or even ingrown toenails. These minor illnesses don’t need the expensive, time-consuming services of an ER when individuals can see their regular physician or treat themselves with over-the-counter medication. For those who feel they may be facing a medical emergency, Anthem offers a 24/7-customer service line, where an insured person can call and speak to a doctor about their symptoms.

However, the Anthem insurance policy change does have a few exceptions. They will be more inclined to reimburse an ER bill if the patient is:

  • Fifteen years or younger
  • Visiting a different state and therefore unable to see their doctor
  • Experiencing problems on a Sunday or holiday, when their doctor’s office and local urgent care may be closed

Controversy Over Anthem’s Insurance Police Change

Members of Anthem are understandably shocked and dismayed by the company’s new rules. Additionally, the Anthem insurance policy change has garnered negative attention from the healthcare community. Medical professionals point out the absurdity of asking a person who isn’t a trained doctor or nurse to determine on their own if the chest pains they are experiencing, for example, are indigestion or signs of a heart attack.

People usually go to the ER because they don’t know what’s wrong and they need help from a healthcare professional. While it’s true that ER visits do not always result in major diagnoses, there are times when patients choose the ER simply because they have nowhere else to go. Doctor’s offices generally do not operate on weekends or after 5 p.m. on weekdays, and it can be difficult to get an on-call doctor to return your call in a timely manner. Moreover, urgent care centers can be far away and are not open 24 hours. Some rural parts may not even have an urgent care within a 30-mile radius.

Let Staver Accident Injury Lawyers, P.C. Help You

Whether you’re dealing with a difficult insurance company or mistreatment from a medical professional, Staver Accident Injury Lawyers, P.C. can help. We have worked with numerous clients to help them get the compensation they deserve for their medical malpractice, personal injury, or wrongful death case.

Contact our attorneys today at (312) 236-2900 to schedule a free case consultation and see how we can help you.

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(312) 236-2900
(312) 236-2900
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