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New policy impacts emergency room visits for customers of BCBS in Georgia

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CHATTANOOGA, TN (WRCB) -

The Affordable Care Act may survive next year, but North Georgia patients who depend on it are now learning there's a catch. Starting in July, the health insurance provider Blue Cross Blue Shield of Georgia will stop covering emergency room visits it deems unnecessary.

The insurance provider sent letters explaining the new policy to patients. It said if patients with individuals policies go to the ER and it's not an emergency they will be stuck footing the bill. 

“Everyone's definition of an emergency is totally different,” said Travis Marler.

Blue Cross Blue Shield of Georgia customers have a lot to say about a new policy meant to lower the number of ER visits. “They'll try and get you. The hospitals will get you, for a tiny aspirin, they will get you for it,” said Kristie Digges.

The company is steering patients who do not need emergency care to their personal physicians or urgent care clinics. They don't want people to use the emergency room as their primary health care.

"They are supposed to accept any kind of patient. Whether it is minor, whether it is major, or a child being born, they are supposed to expect.”

There are some exceptions to the new policy. It won't apply to kids under 13 years old, members who don't have an urgent care clinic within 15 miles of their address, or visits on Sundays and major holidays. “If a baby is sick, it is an emergency to a young mother. But if my son's hurt at his rodeo and stuff it might not be an emergency to me,” said Marler.

A spokesperson with the company said patients should use their best judgment. But some people are worried patients who belong in the ER may not go. “I think it is crazy. If you get a cut this big and they are saying it is not an emergency and they expect you to pay, I think it is stupid,” said Digges.

The company said it was forced to take action because of the rising cost of health care. North Georgia residents said the restrictions are one more challenge in affording health care. “It is not fair how insurance is today. It is hard for most people to afford it with they make.”

Channel 3 checked with Blue Cross Blue Shield of Tennessee. A spokesperson here in Chattanooga said no one with Blue Cross Blue Shield of Tennessee coverage will be impacted by this change.

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