How Much Does a Trip To The Emergency Room Cost?
With some planned and unplanned expenses, we’ve been racking up the medical bills for the past couple of months. While my husband has health insurance provided by his employer, my daughter and I have a high deductible health savings account eligible plan. While I still think this is the best plan for our needs, it really can be a hit if you do have to go to the doctor, even worse if you need to go to the emergency room. I know Chris at Stumble Forward and Greg at Club Thrifty have had similar issues recently. What is wrong with the picture when your kid needs to go to the emergency room and your first thought is, “Wow, this is going to be expensive!?!”
Sick Kid
Let me say that my daughter’s kindergarten year has awesome as far as illnesses. We’ve had a few coughs and sniffles, but she hadn’t missed a day of school until early March when she woke up with vomiting and diarrhea. She’s such a giving child that she passed that along to her Mommy. Luckily stomach bugs tend to pass quickly, and we seemed to be back in action after a couple of days.
I recovered well, but she seemed to develop a cough and runny nose. I thought it was probably unrelated, and there was no fever, so I sent her back to school. She did OK for the rest of the week. I got a call the following week from school that she was pretty sick with a fever, cough, and pink eye (the bane of all school nurses!). No worries on the pink eye, but since she had been sort of sick for a couple of weeks and it seemed to be getting worse, I called her pediatrician’s office. As usual, they had no openings for acute visits. Seriously, nothing makes me more upset than a doctor’s office that won’t see sick people, but I do try to understand that you can only take so many appointments.
Our next stop was urgent care. At this point, the little punk looked really rough with a snotty nose, terrible cough, and big red eye, but they gave her a popsicle while we waited that made it all better. I have to say that I was really impressed with the urgent care doctor. She told me it was probably the flu, likely unrelated to the stomach bug, but could also be a some sort of bronchitis. She asked if I wanted a lab test to rule out the flu so that she could give antibiotics. She said the test would cost about $100 if my insurance didn’t cover it. I’ve never had a medical doctor ask about cost before ordering or prescribing something. I agreed to the test because I really wanted to see what was wrong. Sure enough, it was the flu (what happened to our flu shot?). We were sent home with instructions of Tylenol, fluids, and rest. This was Thursday.
Emergency Room?
By Saturday, the little giver had passed the flu along to Mommy. Mom was definitely off her game with a fever and body aches, but even well Kim would have seen that my daughter’s cough was getting worse. We tried everything; honey, hot drinks, cold drinks, vap-o-rub, standing in the shower. Nothing helped. By 3PM, the cough was constant to the point that she was throwing up about 4 times an hour. The fact that she also was bawling her eyes out, asking me to make the cough stop probably didn’t help. At that point, in my fevered haze, I decided we were going to the ER. Even if they had to sedate her, I had to MAKE THE %#!*ING COUGH STOP!.
One hidden benefit of a small town is that the emergency room is never very full, so we got right in. They gave her an oral steroid and a nebulizer treatment right away. The cough was gone within about 30 minutes of arrival. Hallelujah! The doctor was concerned that she might have pneumonia, and if you could have seen how sick she was, it wasn’t an impossibility. They did a chest x-ray, which was negative. At that point, the doctor told us she did have bronchitis, along with the flu, and gave us a prescription for antibiotics and cough medicine that would make her sleep. (thank you doc!)
While I was incredibly relieved that we didn’t actually cough up a lung, I was worried about the bill. Even though we are more prepared for emergencies now than we have ever been, old thoughts from days when we whipped out the credit card popped up. Honestly, at this point, we have quite a bit socked away in our HSA account. We were saving it for braces, but we can replenish before those are necessary. So how much was a visit to Urgent Care and then the ER?
Retail Costs:
Urgent Care and Labs $217
ER Visit $1115
Drugs (steroid) $28
Radiology (chest X-ray) $152
Radiologist (to read chest X-ray) $54
Respiratory (nebulizer) $92
Take home prescriptions $76.06 ($45 was for the eye drop that I didn’t have a sample of, darn!)
Total cost to be sick: $1734.06
Now, even though we have a high deductible and everything applies to that, I don’t have to pay this cost out of pocket. Because the providers we used accept assignment, our insurance company sets a cap on how much they will pay for a service. Because of that, we get a discounted rate, which lowers the cost to $1308.51, almost a 25% discount. Whether you agree or not, those are the rules.
Since we will pay with HSA money, this will also save about another $327 in taxes. If you have to pay any out of pocket costs for health care services or medicines, I strongly suggest looking into this type plan.
What if You Don’t Have Insurance?
If you don’t have insurance, you could be looking at full price. I know for a fact that our hospital offers a 30% discount if you pay all at once with a cash or a check. They also set up payment plans, but you lose the discount and get a penalty if you miss a payment. Not all hospitals will work with patients, so you could be forced to use credit or get sent to collections if you can’t pay. This amount is not likely to bankrupt anyone, but what if my daughter had been admitted for pneumonia or something worse? I think going without health insurance is just too much of a risk.
Finally, it really makes me mad when I have to admit that I thought about costs and money before taking my sick kid to the emergency room. Honestly, I would have probably done the same thing, even if I knew it would have been $5000 or $10,000, but how many people have to weigh getting needed health care with how much money they have in the bank? I don’t have an answer, but I’m repeatedly reminded about the crazy cost of health care in the US, and right now, I’d rather my tax dollars go toward some sort of solution rather than funding things that do me no good.
Do you think about costs before going to the doctor? Feel free to fire off your thoughts about insurance or health care.
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My father has a CT scan schedule for Monday, and they’re of course very expensive. So I was sitting down thinking about how technology costs are driving down: TVs, laptops, smartphones, etc. Yet the cost of healthcare keeps rising. Why isn’t the technological side of healthcare becoming less expensive??
Kim, I think you totally did the right thing this time around. But we do think about costs before we hit the ER, and I think it works well for us to do so b/c it causes us to stop and make sure that we’re really in an urgent situation instead of just acting out of fear or whatever. We have a high deductible too, so I know what you mean about the cost factor.
You really have to stop and think before you go. I can’t imagine how it would be with a bigger family.
We have a pretty high deductible at $5K, but we don’t really think twice about going to the DR. My wife’s insurance is pretty good and the discount rate is around 50% so our out of pocket isn’t terrible. Couple that with the fact her employer put $2K into an HRA so we don’t pay a dime until after $2k in costs it is pretty sweet.
That being said he crushed our deductible last year (and max out of pocket of $8K) because our little guy spent 10 days in the NICU and we have crushed our deductible this year since our little guy had to get tubes and does a breathing treatment once a day and another one if he gets a cough. The good news for us, is everything else that will probably pop up this year is free.
So sorry to hear about your little one. That’s horrible to see someone so small have to go through medical issues. I hope he grows out of needing the breathing treatments. I guess this year, I would go in for any ingrown toenail, mole removal, or other test you’ve been putting off!
Wow, what an experience all of that was. I am shocked at the prices one would have to pay without insurance coverage. We don’t think of any costs in Canada because we don’t pay Health Care at least up front maybe in our taxes but not like the way you have to. If we want to see our family doctor for anything we just call. If it is after hours we belong to a special team of doctors where one is on call or we can go to a walk-in clinic. My company pays I believe 90% of all our medications. Sorry to hear you were both so ill… Do you get to pay those expenses with a monthly plan or do you pay right at the hospital or do they bill you later? How does the payment process work?
The hospital bills the insurance company who then approves the claim if it was billed properly. If the provider is in network, which is the case in my situation, they will determine what rate the hospital can charge since I haven’t met my deductible. The hospital then bills me. I know our hospital will work out a payment plan if you can’t pay it all up front, but some places do make you pay the balance in full. If you don’t have the funds, that’s when you get in trouble, and people turn to credit cards or even payday or other type loans. Luckily, we keep at least $2K in a our health savings account to cover things like this, so we’ll pay it off when we get the final bill. Should be any day now. I’ve already gotten the insurance company statements with how much we will owe, but the actual hospital has to bill us. Confusing to a Canuck, eh?
Wow, sorry to hear about your daughter. I hope that everything is okay.
We don’t have any children so probably visit the doctor once a year if a condition gets bad. Cost isn’t something that we think about, although we do have a high deductible health care plan $3,000 I believe. But the good thing is that my wife’s company picks up the first 50% of the deductible, so we’re really only on the hook when it surpasses the $1,500 mark.
$1500 sounds like a pretty good deductible level if you ask me.
We’ve had an HSA plan for several years now and love it. I think these type of plans really work for families that are relatively healthy. We’ve been able to save a lot in our HSA simply because we don’t go to the doctor often. And as you save more, you can continue to increase your deductible if you want, thus reducing your monthly premium.
I have been really happy with our HSA. It’s certainly the lesser of the evils.