What good is insurance if you can be denied when you seek emergency care?
When you think you are having a medical emergency, you should never question your instincts. Based on your symptoms, if you, as a prudent layperson, feel it is necessary to visit an emergency room, your care should be covered by your health insurance plan. This concept is known as the Prudent Layperson Standard, and legally, health insurers are obligated to cover your care at any licensed emergency medical facility.
Health insurance companies have made it a policy to erode this patient protection. They will regularly deny an emergency claim if the final diagnosis, not the presenting symptoms, turns out to be non life-threatening.