Going to the emergency room can be a nerve-wracking and confusing process. Most people are not concerned with thinking about their financial decisions when they are hurting, but about the medical help they need. But when the situation dies down and a surprise medical bill arrives in the mail, it can add even more stress to your plate, this time, financial stress. Despite over 90% of Americans having some form of health insurance, medical debt is a persistent issue for Americans. 1 in 10 adults owe medical debt and millions owe more than $10,000 in expenses. While no one wants to think about a trip to the ER, some advance planning can help you save a lot of money.
10 Tips to Reduce Your ER Bill:
- Consider the Urgency
- Prepare a Plan
- Ensure Coverage
- Have an Emergency Fund
- Compare pricing
- Avoid ambulances (when possible)
- Organize your Info
- Question tests and medications
- Request an itemized receipt
- Negotiate charges
- Consider the Urgency of the Situation
Knowing when to go to the ER can be a difficult decision. In cases where you are unsure of the urgency of your medical situation, it can be helpful to use resources like Telehealth or urgent care centers for non-life-threatening issues. Going to the ER for non-emergent issues can result in a high price tag, as ER visits are typically more expensive than seeking care at other healthcare facilities, especially if your insurance does not cover the full cost. This can lead to substantial out-of-pocket expenses. Besides the financial component, there are other downsides, including long wait times, increased risk of exposure, and limited follow-up capabilities. One of the best ways to save money on healthcare is to find the right facility for your needs, and not to use resources like the ER unless they are necessary.
- Prepare an Emergency Plan
If you are planning for potential future emergencies before they happen, you are staying ahead of the game. A great first step in preparing your ER plan is to start by collecting your vital information, such as your name, birthdate, and contact details, alongside your insurance card or policy info. Next, it can be helpful to take some time to understand your insurance, including your deductible and policy coverage. When preparing for emergencies, it is important to locate healthcare providers or facilities within your insurance network and keep your primary care doctor’s contact information handy. Additionally, it may be beneficial to keep a copy of essential information in an accessible location, such as your vehicle’s glove compartment, making it readily accessible in an emergency situation in the future. By taking these steps, you are ensuring you are ready to handle any stressful medical situation, which can give you confidence and control and help you save money at the ER.
- Make sure you are covered
Researching which hospitals and emergency centers accept your insurance and are considered “In-Network” is a crucial step. The last thing you want to do is double-check your insurance in an emergency, but going outside of it can cost thousands of dollars. In the United States, the average ER visit costs around $2,200 in out-of-pocket costs, and this is for people with insurance. It is very common to find a lack of price transparency in hospitals for common procedures, so doing your homework upfront can save you thousands of dollars. Although hospitals do offer “cash-pay” discounts to patients, check what insurance will cover and know where to go when or if an emergency arises.
- Have an Emergency Fund
One thing many financial experts are insistent upon is having a fund allocated for emergencies. Many people talk about this fund covering life events like losing a job or car repairs, but it can also be used for trips to the ER. According to a recent study done by SecureSave “a shocking 67% of Americans don’t have enough money saved to cover that same hypothetical unexpected $400 expense.” This means when an unexpected trip to the ER wrecks your spending plan for that month, people are forced to go into credit card debt and other kinds of debt that are generally best avoided if possible. Having an emergency fund can allow you to have peace of mind as you obtain the healthcare that is vital to your well-being. To learn how much you should have in your emergency fund, consult your money mentor in a 1:1 meeting.
- Compare healthcare pricing using your benefits
Many companies offer healthcare concierge benefits that help you determine where to go for certain services to get the best price. In an interview with the founder of REDU Health, Rich Stephenson shared a story about how he was looking for a new TV and was able to easily find a price comparison on Google. He asked a simple but important question, “Why can’t we do the same for our healthcare?” The lack of price clarity in the healthcare industry has created a particularly challenging environment for patients to get affordable healthcare. Companies like REDU Health gather mountains of data on healthcare prices through a variety of methods and present it to their users in a simple way so they can compare the pricing of medical tests, procedures, and visits. Ask your HR representative if they provide a resource like this.
- Avoid ambulances when possible
If you thought you felt unwell when you called the ambulance, just wait until you get your bill! In the past several years, ambulance rides have increased in price, according to a study conducted by Fair Health, prices have risen for Advanced Life Support (ALS) by almost 23%, and for Basic Life Support (BLS) it has risen almost 18% in 2020. This brings the average cost up to $1,277 for an ALS ride and BLS to $940. Unfortunately, many insurances do not cover the ambulance ride, so many people are stuck paying out of pocket for this service. If it can be avoided at all, it is best to find alternative transport to the hospital and leave the ambulance for only the most serious of situations. Ambulances are truly intended to provide lifesaving medical care on the way to the hospital, and it is wise to avoid them unless necessary.
- Organize your information
This may sound like a simple thing to do, but having your medical history recorded and your most recent tests readily available can be a great way to save money at the ER. This will allow your medical provider to provide the most efficient care for you, avoid unnecessary procedures, and ensure that you get the best possible care – for your health and your wallet. Also, by providing a clear medical history and insurance information, you can minimize the risk of balance billing or out-of-network charges, which can result in unexpected and costly medical bills. Balance billing occurs when your insurance company deems the medical costs charged by the hospital or provider to be too high and bills you for the difference in what they consider to be a typical charge and what the hospital charged you for your care. Some states have passed regulations against excessive balance billing, so be sure to explore if your state is one of those.
- Be cautious about unnecessary tests or non-vital drugs
Did you know that hospitals can mark up materials like gauze by 400%? One blog recently chronicled a shocking case that happened to a patient, “Following a patient’s diagnosis of lung cancer, he was charged $308.00 for four boxes of sterile gauze pads each containing twenty-four 4-inch by 4-inch dressings, which can be bought over the counter at Walgreen’s for $3.99 a box. These were tacked onto his $348,000.00 bill.” One study recently found that a common pill like Tylenol is typically charged at $15 for a singular pill at the ER, with patients typically taking an average of $345 worth of pills during an overnight stay. Rich pointed out that his team had studied X-rays and found a large cash-pay price range, from $193-$1054 depending on procedures and facilities. He warned that if your doctor recommends an extra test that can be performed conveniently down the hall, they may not have your financial health in mind while recommending it, and it might be better to do more price research before automatically agreeing. In a shocking recent study, “97 percent of ER doctors nationwide said they’ve ordered imaging tests they know are unnecessary.” This is partially due to malpractice prevention but can also be explained by patient demand. As a patient or advocate, it is much better to ask questions upfront to determine the necessity of certain tests than be stuck paying for the ones you don’t need.
- Request an itemized bill
When dealing with medical bills, it’s vital to request an itemized receipt. As Pat Palmer, CEO of Beacon HCI, points out, hospital bills often contain errors. In fact, about 8 out of 10 bills they see contain mistakes. So, don’t just pay up blindly. Take a close look at your bill. You might find charges for medications you didn’t even take or treatments that lasted longer than they should have. For example, a medical billing expert recently saw that the parents of a 6-year-old girl were charged for a pregnancy test. Mistakes like this are all too common and can add to an unnecessary financial burden. Once you spot these discrepancies, don’t be afraid to negotiate.
- Negotiate Charges
What most people don’t realize is that the amount on the bill is just a starting point. After checking your itemized bill, reach out to the hospital’s billing department to discuss your concerns and explore options for cost reduction. Often, hospitals are willing to work with you to find a mutually acceptable solution, which may include discounts, payment plans, or financial assistance programs. It is important to remember that you can also request the cash pay price after receiving your bill to compare what the coverage would be outside of their insurance. It is common to be able to negotiate for a significant discount, usually between 35 to 50 percent off the original charges. Being polite and persistent in your negotiations can lead to substantial savings, making your medical expenses more manageable and preventing financial strain.
Incurring medical costs is unavoidable, especially if you are prioritizing your health. You can mitigate the impact on your wallet by implementing these tips and making informed decisions. It’s a strategy that ensures you get the care you need while lessening financial stress. To learn more about how you can save money with your healthcare and manage your emergency fund, meet with your Money Mentor today.
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice. It is not a substitute for professional medical guidance, diagnosis, or treatment. Always seek the advice and consultation of your healthcare professional or qualified medical practitioner for any health-related concerns or questions.