Best Practices

Cost of an Emergency Room Visit

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Learn more about the cost of an emergency room visit.

Fear of your emergency room visit cost should never keep you from getting the medical care you need. If you think you need to see a doctor, you should make it happen, no matter the expense. That said, it helps to know your emergency room cost so you can plan for it.

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Over 140 million Americans visit the ER each year. Many ask, “How much is an emergency room visit?” Here is how much it costs.

Emergency Room Bill

The average cost of an emergency room visit is $50 to $100 if you have insurance. If you do not have coverage, you can expect your emergency room cost without insurance to be $150 to $3,000. If you require additional medical assistance outside of the emergency room, you should expect that bill to be even higher.

If possible, you should try to visit a non-profit hospital. The Affordable Care Act limits the amount a non-profit hospital can charge to families making less than $92,000 a year or individuals making less than $48,284.

Sarah Kliff, a writer for Vox.com, reviewed over a thousand ER bills to try to figure out why the prices are so high. Here’s what she learned:

  • Over-the-counter medicine administered in the emergency room may cost multiple times what you would pay at a drugstore. E.g., one patient received a $238 bill for eyedrops that would have been $15 to $50 at the drugstore. A Seattle hospital charged a patient $76 for an ointment that goes for $1 at the pharmacy.
  • You may still receive a bill if you are denied treatment. Patients who visit the ER and never make it past the waiting room can be charged thousands of dollars simply for visiting the facility.
  • It is very hard for patients to negotiate their own bill or advocate for their own care.

Your emergency room visit cost may have you searching for emergency payday loans for bad credit. One option for that is through a payday loan online. It can work even if you have poor credit. Short-term lenders often use a risk-assessment model that is relatively kind to borrowers with bad credit.

The Worst-Case Scenario Happens More than You Think

You should go to the doctor if you think you need to. The risk of not going outweighs whatever costs you may have to endure by going. You just have to hope that you do not end up getting overcharged like some of those cited in a recent PBS.org article:

  • In Virginia, parents took their one-year-old girl in for treatment on a cut on her toe. After a thirty-minute appointment and only needing a dab of antibacterial ointment, the family was charged over $900.
  • A baby girl in Connecticut ended up just needing a Band-Aid but was still charged $629 for her ER visit.
  • A man in Texas went to an ER within his insurance network for help with a broken jaw, and he ended up paying nearly $8,000.

One reason the average cost of an emergency room visit is so high is because of the facility fees. One hospital may have a much higher facility fee than a hospital down the street. What makes matters worse, it’s impossible to know what the facility fee will be until you receive your bill. You can’t even call ahead and ask how much a hospital charges for this because the fee is privately negotiated between insurance companies and hospitals.

Another reason for the high costs is that you’ll sometimes receive out-of-network service while visiting an in-network hospital. That’s what happened to the guy from Texas who had to $8,000 even though he went to a hospital within his network – the actual surgery he received was performed by a doctor who was out-of-network.

Avoiding the worst-case scenario is harder than you might think. Shopping around is not always possible. If your child is injured when your pediatrician’s office is closed, chances are the urgent care won’t see your child and your only realistic option will be the ER.

Emergency Room Bill Negotiation

Consumers sometimes negotiate their emergency room medical bill.

If the cost of your ER visit is higher than you thought it would be, you might be able to protest the bill. You should reach out to the hospital in writing to have a record of the conversation. Ask why the bill was coded the way it was. You may pay less if you figure out that one of your charges was coded wrong (like if you were charged for a complicated procedure when your treatment was not very complex). Ask about each individual fee. Ask if you can get a prompt care discount.

You may need to dispute the bill. Then, you would negotiate a payment plan to pay off the smaller charge. Small financial aid may help you pay less as well.

If all else fails, you might want to reach out to a local news station. If your story is especially striking (like the $629 bill for a Band-Aid), then they might do a story on you. Hospitals have been known to reverse bills when the media gets involved.

Ways to Avoid Your Emergency Room Visit Cost

If you do not pay your ER bill, then the hospital will send it to a collection agency. This will ruin your credit, which will make it very difficult to find funding in the future. However, there are ways you may be able to avoid a high bill from the ER.

  • What to do right now: sign up for health care that is affordable and offers good coverage.
  • Just before you go: if your symptoms are non-life-threatening, see if your in-network doctor’s office or urgent care center is open. It will likely be cheaper to see your regular doctor.
  • While you’re at the ER: make sure the doctor who sees you is in-network.
  • After you leave: seek out any government assistance that may be available to you.

Government help for an emergency room visit is an option available to many Americans. Medicare Part B tends to cover emergency services. Even with Medicare, you will need to pay some of the bill: the copay and 20 percent of the doctor’s services. You should also look into Medicaid and CHIP for government help with health care.

Tips for Paying Emergency Room Bills

Paying back your ER bill can be more painful than the injury that got you there. Here are some tips to help dull the pain:

  • If you are successfully able to negotiate a payment plan with the hospital, be sure to make each of your payments on time. Failure to do so may result in a penalty, which can make it harder to pay off the bill.
  • If you use a short-term or long-term loan to pay off your medical expense, do your best to pay the debt off fast. The faster you pay off the loan, the less interest you are likely to pay.
  • Consider meeting with a financial advisor to help you figure out how to best budget for your expense.

Overpriced health care is a major issue in the U.S. As politicians continue to try to figure out how to bring emergency room visit costs down, we hope you can avoid the place altogether for as long as possible.