Rushing to the emergency room can be a nightmare. So can the bill at the end of the visit.
A recent study by Johns Hopkins analyzed billing records of 12,000-plus emergency medicine doctors across the U.S. and reported patients are routinely overcharged. “Adult patients are charged 340 percent more than what Medicare pays for services ranging from suturing a wound to interpreting a head CT scan,” the report cites. The report also noted the largest hospital markups are most likely made for minorities and uninsured patients.
The high costs can also come in the form of "balance billing," which is an unexpected bill you receive for services from a healthcare provider or facility that you didn't know was out-of-network until you were billed. This can happen when your hospital bills you for services like anesthesiology or lab tests, and you may not know the provider or facility is out-of-network until you're billed. The No Surprises Act, enabled in early 2022, protects consumers from many of these types of charges, but it's still a good idea for consumers to be aware that these services could come with an additional cost, and to keep that in mind when authorizing services while they're in the ER. Consumer Reports also notes that an ambulance ride can cost close to $2,000. This can depend on insurance coverage and what urgent services are performed in the vehicle en route (i.e. breathing tubes, oxygen, I.V., etc). Upon arrival, a typical insured co-pay at the ER runs between $50 to $100, while uninsured visits can skyrocket up to $3,000, according to The Balance, a personal finance website.
So, with these numbers in mind, what can we do to avoid that big bill?
Emergency visits without health insurance can be very expensive. And several hospitals may require immediate out-of-pocket payments. Health insurance card carriers pay less, but it’s good to know ahead of time what your specific insurance covers. Some insurance companies offer online tools or apps that can quickly calculate personalized estimates of what it will cost to treat a medical condition, ailment or potential emergency. Some can also offer suggestions for clinics and hospitals nearby.
If you or a loved one is having a heart attack, it’s clearly not a time to calculate costs. True emergencies (stroke, seizure, head trauma, blood loss, etc.) require immediate attention by calling 911 and often requesting an ambulance. In this case, there is no replacement for the emergency room – any and every service one could need is under one roof.
If you do end up at the ER, speak to the financial department on-site and in-person. By doing so, you will learn what the specific payment options are at that time and if there’s any flexibility.
Non-life-threatening conditions (think sore throat, earache, cold, rash, asthma) can be well tended to and less expensive if treated at an urgent care facility or walk-in clinic instead of the ER. Some insurance providers even offer a virtual, on-demand doctor option, which can be quick and affordable.
Keep a sheet of contacts for nearby clinics and hospitals along with a rough idea of costs and insurance fees associated with each institution. Have a nest egg in your savings account for the worst-case scenario. That way, the fear of paying the final bill at the hospital isn’t worse than the fear of being there.
Find the right U.S. Bank savings account option for building your emergency fund.