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Can I declare no insurance at the ER if I do have coverage? Texas

Discussion in 'Health Insurance, HMO, HIPAA & Disability' started by Doncor Leon, Oct 25, 2019.

  1. Doncor Leon

    Doncor Leon Law Topic Starter New Member

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    About a month ago, I took an ambulance to the Emergency Room for chest pain and panic like symptoms. In the end, the doctor told me I was just having anxiety. Anyhow, I told both the ER and ambulance I did not have insurance. At the time, I was panicked and had not had to do this before. I paid all my bills including ER services, Ambulance, and Physician charges out of pocket, albeit discounted.

    As it turns out, my parents have me under their insurance plan still (I am 18). Now I’m worried that it may constitute as insurance fraud of some sort?

    I payed the ambulance in full out of pocket, and the separate bill for the physician who attended me was discounted by 50% after I called them and asked. However, the ER bill, when mailed to me, already had a significant discount taken off, labeled as “insurance adjustment.” It was originally ~$5500, but I payed $190 at the ER the day of the incident for ‘registration’ and the remainder of the bill that was $158 when it came in the mail. I’m fairly certain this “insurance adjustment” was not my insurance being used, as it was not on my file and I didn’t give them any info. on insurance. Instead, I recall telling them that I didn’t have any insurance.

    Does this constitute as fraud? They discounted the ~$5200 without me asking for a discount, quite possibly because I was ‘not covered.’ I did sign an agreement at the ER that states I am responsible for paying the bill. I have heard of self-paying patients, though I did not intentionally mean to be one.

    In short: I went to the hospital and told them I had no insurance. Hospital sent me a bill with a huge discount, but I was covered under my parents insurance plan. I am wondering if this can get me into trouble with the law or the hospital.
     
  2. Red Kayak

    Red Kayak Active Member

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    "Insurance fraud" is when you are trying to rip the insurance company off by making a fraudulent claim.

    You've not submitted an insurance claim.
     
  3. Zigner

    Zigner Well-Known Member

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    You didn't do anything wrong by not utilizing your insurance.

    You might want to submit the bills to insurance in case you have some reimbursement available. I would suggest that you review your plan thoroughly before deciding whether or not to do this though.
     
    Red Kayak likes this.
  4. army judge

    army judge Super Moderator

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    Most honorable of you to pay your debts.

    No, you paid the debt.
    The hospital has no claim against you.
    There is no law (TODAY) that says a person MUST carry health insurance.
    I know many people who choose to pay for their medical care without the involvement of an insurer.

    I commend you for paying your debts.
    I wish you continued good health, prosperity, and a long, happy life.
     
  5. adjusterjack

    adjusterjack Super Moderator

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    No, it's a mistake.

    Quite possibly the same discount that they give to insurance companies.

    Neither.

    Have your parents submit all the bills ASAP, explaining that you didn't realize you had coverage. They can see about getting you reimbursed.

    Don't sweat it. You did nothing wrong.
     
    Red Kayak likes this.
  6. Doncor Leon

    Doncor Leon Law Topic Starter New Member

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    Thank you, I didn’t want a collector ruining my debt.
     
  7. Doncor Leon

    Doncor Leon Law Topic Starter New Member

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    Thank you for your input. I figured that because the discount was labeled as “insurance adjustment”, it came from the hospitals insurance or something like that. I know I know, I’m slow. But you can never be too certain
     
  8. adjusterjack

    adjusterjack Super Moderator

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    You're not slow. You're 18. You're still learning stuff.
     
  9. mightymoose

    mightymoose Moderator

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    Agreed. You paid the bill. Nobody cares anymore. It is over with.
     

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