Patients who do not have insurance coverage will typically spend $150 -$3000 or more on emergency room visits. The cost is dependent on factors such as the severity of your condition, what tests are performed, and what treatments will be recommended.
In more extreme cases where you may need urgent care or surgery, the cost could skyrocket to over $10,000.
Factors That Affect Emergency Room Costs
There is no one-size-fits-all when it comes to determining hospital bills. Several factors are considered when determining your ER visit costs. These factors include the staff employed, the location of the ER, and the facilities it uses. Some of these factors are within your control, and others not so much.
Insurance Coverage
Insurance policies significantly determine how much a patient has to pay out of pocket. For example, health insurance plans with low monthly premiums will have a low limit on the cost of emergency room visits.
Less extensive insurance plans may only cover the most basic ER visits. Additionally, patients note whether their preferred doctor or hospital is within their policy’s plan. Out-of-network doctors will not be covered by your insurance plan and will cost more than using an in-network doctor.
In certain cases, out-of-network doctors may work in in-network hospitals or clinics. Usually, you’d find out about this when you get the bill. In addition, knowing what doctors and hospitals your insurance covers, don’t be shy to ask some questions.
Little To No Price Transparency
Unlike most services, emergency rooms do not provide their pricing upfront. Suppose you need emergency care, the medical staff which best suits you. It is most likely that no matter what service you are provided with, you may not know the exact cost of the services until after your ER visit.
It is safe to assume that most individuals may object to receiving some services or postpone them if they know how much they cost.
Cost Of Running An Emergency Room
Emergency units handle virtually every type of medical ailment, from cuts to bruises and even surgeries. And the best thing about them is they are open 24/7.
This is one factor contributing to their cost; running an emergency room round the clock is expensive. In addition, these units have to pay for electricity, water, supplies, and their staff’s salaries.
This is the second factor that causes ER costs to be high. The unit is run by highly trained and skilled staff.
The Severity Of Your Condition
Naturally, health practitioners should attend to medically difficult situations in an emergency room. These situations include head trauma, severe bleeding, and fractured bones.
While we are not saying urgent care centers and clinics can’t cater to such injuries, we must point out that they may not be properly cared for in other facilities because of their severity.
Remember that emergency rooms are highly equipped to deal with all medical emergencies.
What Does Insurance Cover
The Affordable Care Act, sometimes referred to as Obamacare, mandates all insurance plans to cover emergency room services. However, this legislation does not permit insurance providers to charge you more for using the service of an out-of-network hospital or doctor.
It also does not permit insurance to request preauthorization before getting service. Usually, health insurance plans come in four packages; Bronze, Silver, Gold, and Platinum.
Following The Obamacare Plan, Your Coverage Percent Is
| Plan | % Insurance Covers | % You Pay |
| Bronze | 60 | 40 |
| Silver | 70 | 30 |
| Gold | 80 | 20 |
| Platinum | 90 | 10 |
How To Get Affordable ER Care Without Insurance
Insurance is the surest way to reduce your cost on medical expenditure, but what happens when you can’t afford insurance? Are you doomed to handle the steep costs accompanied by ER visits out of pocket?
The second best way to reduce your cost on Emergency Room visits is to determine whether the visit is necessary in the first place.
Medical emergencies that require immediate attention are sent to the ER but this depends on the severity. For less severe situations an urgent care center may be a better alternative.
Determining whether you need to go to an emergency care room or an urgent care center can be a confusing task.
Less severe issues like flu, fever, and nausea can be treated in an urgent care center at a more affordable rate than in emergency rooms.
Although urgent care centers are a great alternative to emergency rooms, medical emergencies are best attended to in an emergency room.