Health Insurance: 3 Tips for Emergency Room Visits

Finding a good, affordable health insurance plan that covers your needs is often a stressful experience, and it may even seem impossible for some. Even after the changes brought by the Affordable Care Act (ACA), nearly 16% of people in the US state that they’ve skipped trips to the doctor’s office due to high costs. Last year, it was also found that 8.5% of people in the US didn’t have a health plan at all, marking the first time this number has increased since implementing the Affordable Care Act.

The increase in people without health insurance can be partly explained by a decline in Medicare coverage. There’s also the fact that most states no longer have a tax penalty for lacking health coverage, so those who rarely get sick may simply choose to go without it. This is a risky decision, however, since the consequences of lacking an insurance policy when you need it can be financially crippling. Visits to the emergency room, in particular, can be costly even for those with insurance thanks to out of pocket costs like ambulance rides. Here are some important tips for getting affordable and high-quality emergency care.

Understand Your Rights

Under the ACA, emergency room care is considered one of the ten essential health benefits that any type of plan must cover. As long as you have an insurance plan, you should have no doubt that you’re covered for ER visits. You also need to understand that emergency room visits are for exactly that—true health emergencies. These are generally defined as injuries or illnesses that can endanger your life if not immediately treated. If you receive health care from the emergency room for minor injuries, your medical costs will be significantly higher.

If there’s no way to avoid the emergency room, you still need to know that you don’t have to have everything done there. If they want to do blood tests, for example, or perform other tests that don’t constitute medical emergencies, you can have these done at your primary care office at a later time. Making sure you get only the care you need can save you a great deal of money.

Consider a Catastrophic Plan

A catastrophic health plan is a type of high-deductible health plan that protects you in a worst-case scenario of unexpected injury or illness. These plans offer low monthly premiums in exchange for the high deductible, which means you’ll pay higher out of pocket costs compared to low deductible plans before your health coverage kicks in. High-deductible health plans save you from paying all the costs for an emergency situation and can be a good idea for those who rarely need health care and can’t afford the monthly premiums of other plans or who don’t get health care from their jobs.

Catastrophic health insurance plans are generally meant for those under 30, but there are hardship exemptions that can make those over 30 eligible. A hardship may include homelessness, bankruptcy, or an event causing significant property damage.

Try Urgent Care

If you’re concerned about the costs of the emergency room, even with health insurance, there are alternative sources of quality care. The costs of going to urgent care are generally between $100-$150 vs the thousands of dollars you can spend in the emergency room. Urgent care centers handle millions of visits from patients each year, and they provide services on a first-come-first-serve basis. This makes urgent care clinics great for those with mild to moderate injuries or illnesses who would otherwise have to wait for hours to be seen in the emergency room, which prioritizes patients based on the severity of their needs. Urgent care can also be the best option for when you need medical care outside of hours for your primary care physician.