If you're at the emergency room (ER), you are probably there because you're dealing with a serious medical problem.
While you are there, you will have to answer questions about your medical history and your health insurance. You might have to make important decisions about tests and procedures, too. Being prepared may help you avoid huge medical bills.
Here are five tips to get better and more affordable care during a medical emergency.
1. Don't Assume the ER Is the Right Place for You
You might avoid a long wait and save a lot of money by going to an urgent care center instead of the ER. These centers can handle many illnesses and injuries that used to be treated only at an ER, such as:
- Burns
- Minor broken bones
- Cuts that require stitches
Save the ER for life-threatening conditions like seizures, serious head injuries, and severe pain, such as pain that could point to a heart attack or stroke, or concerning abdominal issues (ex: appendicitis).
A few tips: Many urgent care centers take insurance coverage. Ask if your plan is accepted. If you are taking your child to an ER or urgent care clinic, try to use a pediatric center or one where there are pediatricians on staff.
2. Be Ready to Answer Questions About Your Health
Whether at an urgent care center or the ER, the doctor treating you will need good information to give you the best care. If possible, be ready to provide your medical history when you arrive at the ER, including:
- A list of all daily/regular or new medications or antibiotics or supplements you're taking, have been recently prescribed, or recently completed
- Any allergies you have, especially to medications
- A list of previous stays at the hospital (especially ICU admissions)and diagnoses you have received
- Information on any past surgeries
- A list of past or chronic illnesses
- Health problems that run in your family
- Vaccines you've received
- Any specialists (including their names) you may be seeing
It's a good idea to store all this information on your cell phone using a medical records app. Or if you prefer, write down your medical information and keep it in a place where you can grab it quickly. That way, you won't have to try to remember all of it when you're sick or hurt.
3. Know Your ER Rights
The Affordable Care Act requires insurance companies to cover care you receive in the ER if you have an emergency medical condition. You don't need to get approval ahead of time, and it doesn't matter whether the hospital or facility is in or outside of your insurance network.
But the key words are "emergency medical condition." That means your symptoms are bad enough for you to think your health will be in danger if you don't get care right away. If you have time, try to check with your usual doctor first.
4. Could My Doctor Do This Test Later?
You may need a lot of tests or imaging while you are in the ER to figure out what's causing your health problem. This is especially true when you have a medical emergency. But tests and imaging done in a hospital can cost a lot more than they would if done elsewhere.
If you are able, ask your ER doctor if there's any risk in putting off tests and scans until you can see your primary care doctor, who might decide you don't need them. If you do need the tests but it's not an emergency, they'll likely cost less in a doctor's office than they will at the ER.
5. Check ER Bills Carefully
You should be charged in-network rates for most of the care you get at the ER. During your stay, you might be treated by someone outside your network. This could be the ER doctor, a technician, or a specialist. . In the past, these out-of-network providers could bill you for whatever fee was not covered by your plan (called “balance billing”). The No Surprises Act, which took effect in 2022, protects you from being billed out-of-network fees related to your emergency care. This protection applies whether you have insurance through an employer, a Marketplace, or from the individual market.
Check all your ER bills and insurance reports carefully.
