A Pennsylvania man's dangerous allergic reaction to bee stings was bad enough without having to fight his insurance company to cover the cost of the EpiPen that saved his life.
Dan Cook, of New Castle, burst into his local pharmacy calling for an EpiPen, WPXI reported.
Cook's generic EpiPen was expired. He was covered in hives and his throat was swelling.
His pharmacist handed Cook a prescription EpiPen, seemingly ending his ordeal, but hours later he learned his insurer, Highmark, wouldn't cover the $600 cost of the EpiPen. Cook normally pays only $6 for the generic version, but the panicked situation left no time to be choosy.
Cook called up WPXI and filed an appeal with Highmark. In an update posted Thursday, WPXI reported that Highmark agreed to cover the cost of the EpiPen.
What to do with a big medical bill
Medical emergencies are stressful enough. Unfortunately, they can also be expensive.
But there are a few ways to avoid a big bill. You don't necessarily have to go to the news, but you can get in touch with your insurer or healthcare provider if you get a big medical bill. Often, you can negotiate the balance.
Aaron Billger, a spokesman for Highmark, couldn't comment on Cook's specific case, citing federal medical privacy laws, but said members had the right to appeal claims decisions. The form for filing such an appeal is available on the Highmark website.
"When members have an experience, they have a process that they follow," he said.
You can also ask if the provider will agree to a payment plan. Offering to pay a portion of the debt up front may help your cause.
In any case, it's a bad idea to let an unpaid medical bill linger. Healthcare providers readily sell unpaid debts to third-party collectors, who make their living hounding debtors until they pay up.
And if you wait long enough (180 days to be exact) medical debt can end up on your credit report, which can hamper your ability to buy a house, a car or even get a job down the line.
The best way to deal with a big medical bill is to not get one in the first place. The first step is to know what's covered.
Your health plan comes with an explanation of benefits that lays out what the plan costs, including deductibles, copays, costs for going out-of-network and the cost of emergencies. Get familiar with it so you can avoid high-cost situations.
Looking over this explanation of benefits may lead you to realize your plan is inadequate for your needs. If you find yourself shelling out often for medical emergencies, it could be time to move on from a high-deductible health plan.
You can use our primer on shopping for health insurance if you want help looking for a more comprehensive plan.
If you do have a high-deductible health plan, you should also consider loading up a health savings account or flexible spending account. These accounts are specifically aimed at helping people afford out-of-pocket medical expenses.