NASHVILLE (WSMV)- For 39-year-old Catherine Perkins, life’s constantly brought challenges her way.
“I basically have lost all of my muscle usage that I had all of my life,” Perkins said.
Perkins has a genetic muscular disorder called Spinal Muscular Atrophy, or SMA, a muscle-wasting disease that confines Perkins to her bed.
“Alot of people who have this are on ventilators. So, I feel very fortunate in one way, and in another way, it’s been really hard living with this kind of genetic disease,” Perkins said.
Her insurance takes care of most of her needs, but she remembers one when her family had to help her pay for a ride to the ER.
“They said we had to pay a percentage. I don’t remember what it was, but I think it was paid for by my mom. It was like $400 for a ride to the hospital,” Perkins said.
It’s an issue so many Americans face, getting an unexpected bill or being told that you have to pay “out of pocket” for hospital visits, doctors or other providers who don’t accept your insurance.
Now there’s a law that’s putting a stop to it.
Starting January 1st, the No Surprises Act gives consumers protection against unexpected bills.
“I think it’s a great step in the right direction, and to try and help people and protect them against medical debt,” Kinika Young, Senior Director of Health Policy & Equity at the Tennessee Justice Center said.
The federal law basically helps to make sure you are not charged more than it would typically cost you for in-network services. Kinika Young with the Tennessee Justice Center says this new law is a win for people across the country.
“In fact, medical debt is the leading cause of personal bankruptcy, and Tennessee has among the highest rates of personal bankruptcy in the country,” Young said.
There are situations where a patient may be asked to consent to the out-of-network charges.
While Young says the act is a huge step, there are a couple of things that she says the law overlooks.
“So the No Surprises Act states that the person can’t be held responsible for any amount above the copay would pay for in-network services, but there may be a copay that’s dependent on the negotiated rate between the plan and the providers,” Young said.
Also, if you need a ride to the ambulance, the law covers air ride transportation, but not ones made on the ground.
“Ambulance services were not included. They’re carved out. So if people call for an ambulance, they may still get a huge bill if that ambulance isn’t contracted with their insurance plan to provide the transportation that they need in emergency situations,” Young said.
Perkins hopes this act is the first of many.
“It’s a long time coming in my opinion. They waited too long to get on it and get it done soon. Cause people are suffering. A lot of people, not just me.
Giving people one less headache to worry about, long after they exit the hospital doors.
For more information on the No Surprise Act, click here: https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bills