Yahoo Finance An ER Visit Taught Me the Value of Health Insurance
I never thought that at 20 years old, I would have to go to the emergency room but that is exactly what happened. Luckily, I had signed up for health insurance just a few months prior to my unexpected trip. However, I didn’t do it because I thought I needed it. I only did it to avoid the huge fee of not being insured.
Unfortunately, no one ever taught me how health insurance works. It was something I had to learn on my own, and something that this ER visit opened my eyes to — both how it works and its value.
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Below are four things I learned after my first ER visit that you might not know yourself.
1. Understand Deductibles
When I went to the ER, I honestly thought most of my bill would be covered. I had no idea that I’d get numerous bills worth thousands of dollars over the next few months that weren’t covered by my insurance. This was because I had a high deductible.
A deductible is the part of the total cost of care that you are responsible for paying before your insurance starts covering anything. So, for instance, if you have a $1,000 deductible, and your total bill is $1,500, you are responsible for paying that first $1,000. Once you’ve paid that, your insurance will cover the rest — the remaining $500, in this example. Once the deductible is met, you might be responsible for a copayment or coinsurance cost, but that’s it.
To make things worse, at the time I was working full-time as a teacher’s assistant for a special-needs classroom, making only $800 a month. It was a salary position, which meant I got paid during the summer months, even though I wasn’t working — but still, it was meager pay for someone who received an ER bill for $5,000.
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2. Go to Urgent Care for Not-So-Serious Emergencies
Debt.org found that approximately $18 billion could be saved per year if patients with non-urgent medical problems utilized primary or preventative health services in lieu of the ER. Perhaps this is common sense, but when you’re terrified and in pain, you often don’t think clearly. I went with the ER because I thought it was my best bet, and wound up with a huge bill that could have been significantly smaller had I gone to an urgent care clinic instead.
The average visit to urgent care costs approximately $150 per patient, according to Debt.org. Conversely, ER visits keep getting pricier. A 2016 report conducted by the Health Care Cost Institute found that between 2012 and 2016, the price of an outpatient ER visit increased by 31 percent to $1,917.
Despite this sizable price difference, urgent cares can handle most things that ERs do, with two exceptions: they don’t keep detailed medical histories and they often don’t have the equipment to handle life-threatening conditions. So, if you’re looking to save money and your situation isn’t critical, you might want to try urgent care first.
3. Dispute the Medical Bill
The Emergency Medical and Treatment Labor Act (EMTLA) enacted in 1986 makes it illegal for any hospital to deny a patient emergency medical care just because they lack the means to pay. The good (and bad) news is, they’ll treat you whether or not you can foot the bill.
When I started getting all of my medical bills in the mail, I had a full-blown panic attack. I felt dumb for not understanding my policy and wished I had avoided going to the ER altogether. But eventually, I learned that I could dispute the charges.
I began the process by sending in all of my paystubs. Those clearly showed I was a sophomore in college and only making $800 a month with a full-time job. After a review period, the hospital cleared the medical bills completely.
Obviously, this route won’t work for everyone, but if you don’t have the means to pay, showing evidence of that might help your case.
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4. Healthcare Ministries
After having regular health insurance, I decided to change things up. When I started working for myself, I enrolled in a healthcare ministry instead. These are faith-based organizations in which monthly costs are usually significantly lower than traditional insurance.
Health ministries aren’t for everyone. You have to agree to the organization’s faith-related terms of service (e.g., you must attest that you believe in God), they’re under no legal requirement to cover your care and you can’t contribute to a health savings account (HSA).
This transition was incredibly beneficial for me though. I ended up having to go to a gastroenterologist a few times, and with regular insurance, I would have paid hundreds if not thousands of dollars for my treatment. With the healthcare ministry, I paid less than $200 for multiple visits.
Learning about insurance and choosing the right program can be difficult at first, but it’s definitely worth taking the time to figure out. You might think because you’re young and healthy that it’s not something you need to worry about, but that’s simply not the case. Take it from me, being knowledgeable about it is crucial for when you inevitably need to use it.
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This article originally appeared on GOBankingRates.com: An ER Visit Taught Me the Value of Health Insurance
