Avoiding Unnecessary Emergency Medical Costs
Holding down medical costs starts with understanding your insurance plan.
If you’re an employer, ask your insurer for documentation on what your plan will and won’t cover if you or your employees need immediate care.
For example, get clarity on your ER copay and coinsurance and on what the plan will cover if you’re not admitted to the hospital.
Your insurer can also tell you which area hospitals accept your insurance. You can then ask the billing department at your hospital of choice whether the ER doctors participate in your insurance plan.
And because most insurers cover medically necessary ambulance services, know how your plan defines that—typically, it means the patient is unconscious, bleeding heavily, or in severe pain.
While the emergency room can help care for any medical situation, it costs an average of three times more than a visit to an urgent care center.
You can help them do just that by making sure they understand the differences between an emergency room and an urgent care facility.
While an emergency room can handle any medical situation, the average cost of an ER visit is approximately $2,300, according to industry data.
In comparison, the average cost of visiting an urgent-care center is $176.
In addition, in a non-life threatening situation, you can usually be treated at an urgent care center effectively and far more quickly than in an ER; typical wait times are significantly shorter in urgent care facilities.
Urgent care centers are usually staffed by at least one emergency medical physician, as well as physician assistants and advanced practice resident nurses. Many facilities have x-rays and labs onsite.
While hospital ERs are open 24/7, many urgent care centers are open late and on weekends and holidays.
Deciding Where to Go
Here's a brief guide your employees can use when deciding between an emergency room and an urgent care facility:
Visit an emergency room if you experience:
- Allergic reactions to food or animal or bug bites
- Broken bones, particularly large bones
- Chest pain
- Constant vomiting
- Continuous bleeding
- Severe shortness of breath
- Deep wounds
- Weakness or pain in a leg or arm
- Head injuries
Visit an urgent care center if you experience:
- Flu or a severe cold
- Coughs and sore throat
- High fevers
- Earaches and potential eye infections
- Vomiting, diarrhea, stomach pain
- Cuts and severe scrapes
- Minor broken bones such as fingers or toes
- Minor injuries and burns
Getting the right care when needed always should be your priority. But with so many urgent care centers and walk-in clinics now available, making an informed choice can save employees thousands of dollars and help stem the continuing rise in healthcare costs that affect all of us.
If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company's next renewal. It’s free as part of your participation in CBIA Health Connections!