can you cite me one of the larger insurance companies who have this as their policy? i just looked at 4 of the biggest and this is not the case for any of them.
im specifically referring to you saying that "out of network" usually means that the insurance company will not cover any of the expense.[/QUOTI
I said "or very little of it". Is that not correct? Did you find that out of network means the insurance does cover it? With the cost of medical care these days, people can barely afford their usually copay. I am sure that the hospital would rather have a child there whose total costs are covered.
PPOs will usually cover out of network at 70% of the usual & customary amount.
HMOs usually do not cover out of network, but many companies will agree to cover at least at a reduced rate in special circumstances.
Admin staff will usually help with the insurance process prior to and during intake, especially at larger and specialty hospitals.
Also, as far as state custody and full coverage, yes Justina would have coverage, however, the reimbursement rate that is paid to practitioners for Masshealth (state Medicaid) patients is far lower than rates paid by insurance companies or out of pocket by patients. In fact, many providers sadly don't take Masshealth patients at all due to this. So I'm not really sure that the hospital would stand much to gain if all this is some sort of conspiracy to get money.
As with everything else in this case, without having all the info (this time regarding what kind of insurance Justina has) we can't know the situation for sure.
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