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Aetna health insurance are we covered? Help I'm so confused!?

First off i want to say i know almost nothing about health insurence and related issues.... My husband recently well drinking jumped off a balcony... When I called to find out when the insurance company was going to pay the hospital bill they started asking me tons of questions... I really didn't know how to answer then... should I tell the truth? fully or not? I took him to the er and then later he has had a surgery and many doctor visits... because this was alcohol related will it be covered by insurance? it took place at a friends apartment building and the insurance is talking about looking into the complex to pay... I told them he slipped on wet steps not wanting to be left with over 60,000 in medical bills... but what do i tell them? How do i deal with all of this? Will I be left with the bill?

Public Comments

1. WE can't tell you. we don't know your plan. call your benefit rep or h r department. just because you have the same insurance company as someone else does not mean each plan covers the same things.
2. For your husband's sake, you need to tell the truth. Most of the time, suicide attempts and alcohol related injuries ARE covered under your health insurance. The problem is, if he slipped on wet steps, then the apartment could very well be liable for his injuries. But if he jumped from a balcony, they are NOT. The friend could ALSO be dragged in to be responsible for paying for injuries from a slip and fall. You made a major error, lying about how he got his injuries. Before, he would have had coverage. Now, you've committed insurance fraud. Better tell them, or have him tell them, the truth, as soon as possible. The ONLY WAY this isn't covered, is if his coverage is on a private policy, and he has a drinking problem he lied about, or there's an exclusion for alcohol/drug use injuries (not common unless he has a history of abuse). If this is through his employer, then it's going to be covered . . .but the lie about what happened, could jeapordize that coverage. If you don't straighten out the lie, and 'fess up, the health insurance company will eventually sue the friend and the complex over the "slip and fall", which friend and complex will deny, and things could get REALLY ugly.
3. You must either tell the truth or pay the entire bill yourself. If you lie, they can and will use that as a reason to refuse to pay. You are not covered for anything if you lie. The reason for the questions is that they want to know if someone else was at fault. If they knew that it was his fault, then they probably would pay. Because you made up a story about wet steps, they think that the person who was responsible for keeping the steps should pay and they should not.