Are medical insurance companies required to pay medical bills if you check out of the hospital against medical advice?

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Are medical insurance companies required to pay medical bills if you check out of the hospital against medical advice?

When I checked out of the hospital the nurse told me that my insurance may not pay the bill because I was leaving AMA. When I spoke with my insurance company they said that they are required by law to pay the bill and that AMA doesn’t matter. I have spoken to people who work for other medical insurance companies and they say the same thing. Is the hospital lying to patients to get them to stay longer? I was informed by a hospital administrator that they are required to tell everyone that insurance may not cover the bill.

Asked on September 26, 2011 under Insurance Law, Missouri

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 10 years ago | Contributor

Whether or not medical insurance companies are required to pay the medical bills of a covered patient if he or she checks out of the hospital against medical advice depends upon the terms of the policy of each given insured.

As such, you need to carefully read your policy of insurance in that its terms and conditions control the obligations owed to you by your insurance carrier and vice versa in the absence of conflicting state law.

Most likely, assuming the claim is a covered medical claim under one's insurance policy for the hospital stay, your carrier will pay the hospital bill even if you checked out against medical advice. The concern of hospital personnel is that leaving too early from the hospital may create complications and be a hazard for the patient.


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