'Low-cost' health insurance plan can carry high-risk costs PITTSBURGH (AP) — Richard Sankovich is not happy about the $6,035 invoice he recently got from West Penn Hospital for what turned out to be a pulled stomach muscle, but his experience likely says more about the risks of buying a low-cost health plan than it does about high hospital costs. The so-called "metal" platinum, gold, silver and bronze plans offered through the federal marketplace offer a range of premiums and coverage, and provide a means for previously uninsured Americans to obtain health coverage. The plan also holds him 100 percent responsible for emergency room care, which, combined with the deductible, means he's now going to pay more than a year's worth of his $473 monthly premium payments for the two-and-a-half hours he spent at West Penn. Dan Laurent, spokesman for West Penn parent Allegheny Health Network, said he could not discuss a specific patient's case but maintained that the hospital's charges fall "in the middling range" for the local market and that rates are negotiated with insurers. Stephen Foreman, associate professor of health care administration at Robert Morris University, said his nurse practitioner students who work at local hospitals tell him they are starting to see lots of patients who come for an initial assessment — which most plans cover — "but then don't show up again for the follow up" because of the cost. Foreman suggests the ACA plan regulations should be modified so that "the amount hospitals charge for an emergency room visit should be no more than the lowest cost they accept from any insurer."