Americans visit the emergency room over 130 million times per year, according to recent data from the CDC✓
✓ Trusted source
Centers for Disease Control and Prevention
CDC is an agency of the United States federal government tasked with protecting public health and safety through the control and prevention of disease, injury, and disability.. When you or a loved one are facing a medical crisis, you are not thinking about the money. But when the hospital bill arrives, emergency room costs can be a big shock.
⚠️ Insurance may not protect you. Many insurance plans have high deductibles and high out-of-pocket maximums. You could be on the hook for thousands of dollars for a single trip to the ER.
What goes into emergency room costs? Why does ER care cost so much, even when you arrive with health insurance? And how can you mitigate those costs in future visits? Here’s what you need to know to understand the costs, understand your options, and plan for these unexpected costs.
What am I Paying For When I Visit the Emergency Room?
According to a recent United Health Group study, the cost of an average non-emergency ER visit is $2,000. If you have insurance, you’ll be paying a co-pay of around $150 for the visit itself. That doesn’t include other fees that might get added on, like the lab work and prescriptions that might be required after an ER visit, or the services of an out-of-network doctor.
To understand emergency room costs, we have to break them down into their component parts.
🚑 The Ambulance Ride
If you have a true emergency, you will probably arrive at the emergency room in an ambulance. When emergencies happen and you are incapacitated, the ambulance will get care to you as you are transported to the medical facility. That en route care can literally be a matter of life and death, so it’s good to have it. It can also be expensive, so it’s good to have a handle on what goes into that transportation and care cost.
A recent study from the University of Michigan found that, even with insurance, the average ground ambulance transportation left the patient on the hook for an average of $450. An air ambulance can cost well over $20,000!
That’s before you even set foot in the ER.
🏥 Emergency Room Costs
The cost of your ER visit will vary with the cause of your visit. Here’s a rundown of average costs of some typical reasons for a visit:
- If you come to the ER as a result of a car accident or some other very serious injury, one cost you will likely encounter is the trauma fee. This is the cost of having the trauma unit get you stabilized. You certainly WANT to have trauma care when it is needed, but it will cost you. In an interview for Fresh Air, reporter Sara Kliff says: “This is the fee that trauma centers charge for essentially assembling a trauma team to meet you when you’re coming in and those folks out in the field, maybe the EMTs, for example, have determined that you meet certain trauma criteria.”
- Another common reason for an ER visit is a broken bone. Setting a broken leg can cost as much as $7,500.
- Lab work and diagnostics can add hundreds of dollars to your bill, depending on what is called for.
- Doctors’ fees for sub-trauma level care can add hundreds of dollars an hour to your ER bill. These fees can start at around $100 for basic care and well over $1,000 for the first hour of critical care.
- In-network/out of network fees. One thing to realize about doctor fees – just because you go to an in-network hospital doesn’t mean you will necessarily be seen by an in-network doctor.
The more complex your emergency, the higher the cost will be.
💼 Costs of Doing Business
Beyond the care you receive during an ER visit, there are operating costs of an ER that you are also paying for. Sarah Kliff describes the “facility fee” as “the cost of keeping the doors open 24/7 in the ER“. This charge can vary a lot from one ER to another, usually ranging from $50 to around $400.
👇 The Bottom Line on ER Costs
Even with insurance, the cost of an ER visit will likely be more than the visit co-pay itself. You will be responsible for the fees incurred up to your deductible, then the co-insurance (often 20% of the bill). Without insurance, you will need to advocate for yourself and find resources to either reduce the bill or make a payment plan that works for you.
Is Urgent Care a Better Option?
So what about all those Urgent Care facilities that are cropping up in strip malls across the country? Are those a better option?
Urgent care facilities are set up to handle non-life-threatening situations. If you’ve been in an accident and have a major injury, get to the ER. If you are experiencing chest pains or other heart-related symptoms, get to the ER.
But if you are experiencing minor cuts, a UTI, back pain, or minor burns, you might save money and time by going to an urgent care facility.
👉 In short, if life and limb are in danger, get to the emergency room.
What if I’m Uninsured?
If you are facing a serious and/or life-threatening medical emergency, you will receive care. Emergency rooms cannot refuse to treat a patient. That care will not be free. If you don’t have insurance, those costs could be far above your means. You’ll have to ask about the hospital’s charity policy, work out a payment plan, and contact Medicaid to see if you qualify.
Compared with a copay of $150 plus some lab fees, you would be looking at an average bill at an average of around $2,000. And if you have more serious issues or get transported via helicopter ambulance, the cost could be in the tens of thousands of dollars.
7 Ways to Manage (or Avoid) the Cost of Emergency Care
Medical emergencies are by nature hard to predict, but there are things you can do to mitigate their financial impact.
- See a primary care physician. Primary care physicians can provide care for non-life-threatening conditions at lower costs than an ER.
- Use Urgent Care. If it’s not a life-threatening emergency, an Urgent Care facility might be a better option if the facility can treat your illness or problem.
- Try Telemedicine. Online telemedicine providers like GoodRx provide affordable consultations that can help you decide whether you need an ER visit or not.
- Use a Free Clinic. Check the National Association of Free and Charitable Clinics for options in your area.
- Consider using a Health Savings Account (HSA). It will reduce your taxable income and give you a cushion for medical costs.
- Cut your costs. There are lots of ways to get help with medical bills, including using government resources like Medicare, Medicaid, and CHIP. You can also find help with groups like the Patient Advocacy Foundation (PAF). If you are uninsured, PAF has resources to help you understand your rights in that situation. If you feel that a bill is inappropriate a patient advocate can help you negotiate.
- Prepare. It’s hard to think straight during a medical crisis, so plan beforehand. Find out what urgent care facilities are in your area and what cases they accept. Locate primary care doctors in your area. Learn about ER costs at hospitals in your area. Find out which hospitals have relationships with your insurer. If you have a plan in place you won’t have to think about money when trouble strikes.
In a true emergency, there may be little you can do to control costs. If you’re unconscious and someone calls an ambulance, all that matters is getting care. Those incidents are rare, though, and many ER visits are avoidable or manageable.
Prioritize Your Health
All financial planning is about planning for the future, which includes the unexpected. An ER visit definitely qualifies as the unexpected. First and foremost, you’ve got to take care of yourself. Without your health, a lot of other financial problems can begin to pile up.
The priority is getting the care you need. You also have to take care of your finances. Understanding the emergency room costs can help you manage your health and those costs more effectively.
🏥 Interested to learn more about the underlying reasons for the high cost of healthcare in the US? Start here: Why Is Healthcare So Expensive?