Why are ER visits so expensive?
What can you do to lessen the number of visits to the ER?
How can you keep costs down?
Are there alternatives?
Why are ER visits so expensive?
The word EMERGENCY says it all! Emergency Rooms are designed to manage emergencies, and from the moment a caller rings 911 for an ambulance or arrives unexpectedly on the doorstep, the emphasis is on speed and the availability of expert staff and $ millions worth of highly specialized medical equipment. Suppose you have a traumatic wound, broken bones, significant burns, or severe heart palpitations; then, of course, these are the services you may need and can be justified. But they come at a price!
According to MEPS (Medical Expenditure Panel Survey), the average ER visit cost was $1,150 (2020). The median (typical) cost is approximately $850. It is important to remember that certain groups of people, E.g., children up to age five and seniors, are more frequent visitors to the ER, and many procedures are far more costly. For instance, a broken bone needing surgery may cost $10-20,00, and even a sprain or strain can cost between $1000 and $2000.
What can you do to reduce visits to the emergency room?
Nobody invites or expects life-affecting traumas, but when they do occur, 911 and ER may be the right but most expensive option.
In an emergency, 911 is the first number that comes to mind. This is why 70% of calls to the ER could be avoided. “I didn’t know who else to call” is the most common response,
- Does your physician’s office number come to mind as easily as 911?
- Do you know the number (address) of your nearest Urgent Call branch?
- Do you know which of your local hospitals and service providers, e.g., hospitals, are in-network?
KEEP THIS INFORMATION TO HAND (on your phone!) because, in most cases, they offer less expensive options.
What are the alternatives to the ER?
The most common visits are for one of the following reasons:
Flu or cough Severe headache
Ear infection Diarrhoea
Fever (without rash) Minor trauma
You should not need to attend ER for these conditions. If you have a concern, do not wait to become an ‘emergency.’
Contact your local doctor (primary care provider) or neighborhood Urgent Call Clinic. Even if it is out of hours, there will be a doctor will be available to help you 24/7.
Many of these clinics accept health insurance, but not all. Check with your insurer. Even if not ‘in-network,’ you may find the cost is far less than a visit to the ER, including any co-payments you might incur. Based on national averages, an emergency room visit cost can be three times greater than for the same treatment at an urgent care clinic.
First, check that the facility, for example, the hospital to which the patient will be delivered, is ‘in-network.’ Your health insurance provider will have secured beneficial rates for the treatment, procedures, and prescription drugs you need.
Be aware that you can find ‘out of network’ doctors and other service providers that work at in ‘in network’ facilities. They may charge separately; their bills may come as a surprise!
This can be especially true of the ambulance service that transports the insured to the hospital. An ‘out of network’ service might charge $2000 or more, depending on where you live and the level of care delivered at the scene or on the journey.
FOR ANY OF THE FOLLOWING
Do not Think Twice- Go to the ER or Call 911
Broken bones Deep cuts/Profuse bleeding
New-born/ infant <3 months, Temperature >100.4
Sudden testicular pain Vaginal bleeding when pregnant
Severe Heart palpitations Severe breathing difficulty
Significant burns Fever over 105 or fever with rash
Events like these usually leave no alternative to the emergency room.
Your health insurance plan is designed to help face acute (short-term) and chronic (long-term) medical care costs. All ACA-compliant plans include preventive services for no additional charge. By taking advantage of these preventive measures, you are taking the first steps to reduce the likelihood of you or your dependents needing an expensive visit the ER.
- Screenings and counseling
- Routine immunizations
- Preventive services for women
- Preventive services for children and youth
In most cases, visits to the ER are unexpected and unplanned. Here are three suggestions to help you PLAN FOR THE UNEXPECTED
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- Check if your doctor offers Telehealth, which gives you personal access to a physician 24/7 from your phone, wherever you are.
- There are Mobile Apps that offer useful guides based on ‘easy to use’ decision trees to help the enquirer decide if an ER visit is the best choice. Ideal for dependents ‘away from home.’
- Talk to a qualified health insurance advisor with local knowledge of your area’s healthcare service provider networks. You may decide that when you come to renew your plan, a few more dollars on your premium could save you thousands in the ER.
