In the Texas Community

Prudent Layperson

Most Texans know that the emergency room isn’t the right place to go for head lice, an ingrown toenail or other minor mishaps. But what about those trickier situations when you’re having trouble breathing or think you might have a broken bone? 

We want to help you make smarter choices on where you receive health care. Listen to the message above from BCBSTX President Dr. Dan McCoy and visit www.smartercaretexas.com opennewwindow for more helpful tips.

You can also view or listen to our Blue Promise series on emergency care:

Blue Promise is an online video blog and podcast that aims to address complicated health issues with candid conversations from subject matter experts. New editions are published regularly and are hosted by Dr. Dan McCoy, President of Blue Cross and Blue Shield of Texas.

 
Show Transcript

SPEAKER: DR. Dan McCoy

Most Texans know that the emergency room isn’t the right place to go for head lice, an ingrown toenail or other minor mishaps. But what about those trickier situations when you’re having trouble breathing or think you might have a broken bone?

Texas has something called the ‘prudent layperson standard’ that protects patients when they believe they’re having a true medical emergency. If someone with average medical knowledge believes that their life or limb is in jeopardy, their insurers must cover the emergency treatment provided. Unfortunately, though, some ER facilities are trying to change this standard. They’re demanding insurers pay full-price anytime a patient decides to seek care at an ER - whether it was an actual emergency or not. That demand increases health costs for all Texans.

The current prudent layperson standard has protected you for 30 years.  Let’s keep this safeguard in place and make sure it isn’t abused by ER facilities.

Hello, I’m Dr. Dan McCoy, president of Blue Cross and Blue Shield of Texas. We want to help you make smarter choices on where you receive health care. Visit www.smartercaretexas.com .

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