“We have a mortgage, we have bills, we have student loans,” says Cloyd, who works for the Kentucky government and has a 7-year-old daughter. “There is absolutely no way I could pay a $12,000 bill. I don’t even have $1,000 sitting around.”
Cloyd has her health insurance coverage through her husband’s job. His company uses Anthem, one of the country’s largest health insurance plans. In recent years, Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.
The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them, like in Cloyd’s case.
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