New insurance policy will force Ohioans to think twice before going to the ER

Anthem won't cover non-emergency trips to ER

CLEVELAND - A major insurance provider in Ohio is set to institute a policy that critics say could make people twice about getting help during a critical medical moment.

Beginning on Jan. 1 Anthem Blue Cross Blue Shield of Ohio says it will no longer cover trips made to the emergency room in non-emergency situations.

Anthem claims the change is in response to an increase in emergency room visits for things like in-grown toenails and itchy eyes from seasonal allergies.

But some critics say the new policy forces the patient to decide if what they're experiencing is life-threatening or not.

"It takes us seven years to get trained to make that decision,” said Dr. Purva Grover of the American College of Emergency Physicians (ACEP). “Do we really think it's fair for a patient to decide that?"

Grover says she is worried the change will lead to patients getting sicker, or even dying, trying to decide what to do.

"They have no knowledge in that sense to say is this symptom worthy of an emergency department or not." 

According to ACEP, the plan that could also leave patients on the hook with hefty bills for wanting to quickly get their health checked.

"What this policy does is it discourages patients," Grover said. "...our patients are going to be in danger."

Anthem says it will cover non-emergency ER visits in the event a person was directed to the emergency room by another medical provider, if services were provided to a child under the age 14 or if the visit occurs between 8 p.m. Saturday and 8 a.m. Monday, or on a major holiday.

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