Going to the emergency room isn’t typically on anyone’s list of fun things to do. If you’re like most people, the idea of it is nerve-racking for many reasons. Emergency room visits can be expensive, time-consuming, and stressful. At Vera Health, we understand you want a health insurance plan that covers ER visits, so the short-term health insurance plans we offer provide benefits for emergency room care to help alleviate some of the worries an ER visit can cause. Health emergencies happen from time to time, so why not protect your wallet from costly, unexpected ER bills?
When Should I Go to the Emergency Room?
If you need medical attention right away, the emergency room can be your best option for accessing health care as quickly as possible. A trip to the ER can also prevent serious health complications from getting worse. Some reasons to go to the emergency room may include:
- Bleeding that won’t stop
- Broken bones, major
- Chest pain
- Coughing or vomiting blood
- Difficulty breathing, shortness of breath
- Fainting, sudden dizziness, or weakness
- Head injury with passing out or confusion
- Poisoning or drug overdose
- Severe burn
- Sudden confusion or disorientation
- Sudden changes in your ability to see, talk, or move
- Sudden or severe pain
- Suicidal feelings
- Unusual belly pain or pressure
- Vomiting or diarrhea that won’t stop
Here’s an example of a situation when someone would need to consider going to the emergency room.
Imagine the following scenario. You’re in your favorite hot yoga class working on your fitness. However, you forgot to drink enough water over the past couple of days. You usually try your best to stay hydrated, but your freelancing job has been extra demanding lately, and sipping water slipped your mind. You needed a break to relieve some work stress, so you closed your laptop and headed to the yoga studio. You start class. You’re sweating and loving life, but you’ve been so focused on work that you forgot to drink enough water before your steamy hot yoga session. During your 15th downward dog, you have chest pain, dizziness, and difficulty breathing.
You wave your yoga instructor over and tell them what’s going on. You don’t think you can drive, so your yoga teacher calls an ambulance and sends you to the nearest emergency room. She asks you if you have health insurance to help pay for the ambulance ride. You’re able to muster, “yeah, I have short-term health insurance for these types of things.” In the emergency room, you’re diagnosed with dehydration and indigestion and given intravenous (IV) fluids to restore your body back to health. Your medical provider explains the importance of hydration to you and gives you a chart with the recommended amounts of water to drink per day.
Once you get the hydration you need, you’re told to go home and get some rest. Since you have health insurance, the billing department explains that your insurance will be billed for the visit, and you’ll receive any additional statements in the mail. Then, your best friend picks you up and takes you home. You lay on your couch and feel grateful for your rejuvenated health and your affordable short-term health insurance plan that helps you when you need it most.
Urgent Care vs. Emergency Room: What’s the Difference?
Emergency rooms and urgent care centers may sound similar, but they are quite different. Urgent care centers were created to give people access to health care when they:
- Need medical assistance outside of their primary care physicians’ regular hours
- Have a medical issue that isn’t serious enough to go to an emergency room
- Want a convenient health care option that doesn’t require appointments
- Need an affordable alternative to the emergency room for non-life-threatening health issues
A great rule of thumb to follow if you’re determining when to go to an urgent care facility or an emergency room is to decide whether you’re experiencing a life-threatening emergency. If you’re not, you could receive the same medical care that you would from an emergency room for a fraction of the cost from an urgent care center. It could also be more cost-effective to use your short-term health insurance benefits through Vera for doctor’s office visits or Telemedicine to treat conditions that aren’t emergencies.
Some common reasons to go to an urgent care center include:
- Allergic reactions
- Animal or bug bites
- Broken bones, minor (fingers and toes)
- Cold and flu
- Cuts that may need stitches
- Earaches and ear infections
- Eye infection (Pinkeye)
- Rash or other skin irritations
- Sore throat
- Sprains and strains
- Urinary tract infection (UTI)
Also, keep in mind that a short-term health insurance plan through Vera provides benefits for urgent care visits as well as emergency room care. So, if you’re experiencing one of the ailments above, you could visit an urgent care clinic for a $50 access fee. Then, the remainder of your bill would apply to your coinsurance (the amount that you’re responsible to pay for a covered health care service). To put health care fees in perspective, here are some examples of average costs for illnesses treated at emergency rooms and urgent care facilities:
- Emergency room: $345
- Urgent care: $97
- Emergency room: $595
- Urgent care: $127
- Emergency room: $400
- Urgent care: $110
- Pink Eye
- Emergency room: $370
- Urgent care: $102
- Strep Throat
- Emergency room: $531
- Urgent care: $111
- Urinary Tract Infection
- Emergency room: $665
- Urgent care: $112
As you can see, going to an urgent care center for common health issues can be much more affordable than emergency room treatment. However, these examples are not life-threatening conditions. If you’re experiencing a more serious health issue, then consider going to an emergency room to get the appropriate care for your needs.
How Much Is an Emergency Room Visit?
Emergency room costs can depend on several factors, like the kind of treatment(s) you receive and the type of health insurance you have. According to Consumer Health Ratings, the average cost of emergency room visits in 2019 was around $1700. Also, studies show that emergency room costs have steadily increased since 2013 and are likely to continue climbing. That’s a lot of money!
High emergency room costs are one significant reason to get health insurance and safeguard your finances. In fact, did you know that medical debt is the number one cause of bankruptcy in the U.S.? Thankfully, short-term health insurance exists to give you some financial protection from unexpected medical costs. It may not cover all of your medical expenses, but short-term health insurance can prevent you from paying every medical fee out-of-pocket. So, what do emergency room benefits through Vera include? Let’s find out.
Emergency Room Benefits Through Vera Health
According to the Centers for Disease Control and Prevention (CDC), Americans made over 145 million trips to the emergency room in 2017. Since ER trips are so frequent, Vera offers short-term health plans with benefits for emergency room needs. Plan benefits provided through Vera vary by state, but all emergency room visits apply to your deductible (the amount you pay before your health insurance kicks in) and coinsurance with an additional $250 access fee. In some states, the access fee is waived if you’re admitted to the emergency room.
So, think back to the hot yoga scenario we discussed earlier. Say you have a short-term health plan through Vera with a $1,000 deductible and coinsurance of 80/20. Once you reach your $1,000 deductible, your plan pays for 80% of a covered medical cost, and you’re responsible for the remaining 20%. Therefore, if your emergency room visit for dehydration costs $800 and you’ve met your deductible, your short-term health plan would cover $640, or 80% of your ER bill. Then, you would pay the remaining $160, or 20% of your ER bill. So, in this example, you would pay $160 versus $800. Make sense?
So, does short-term health insurance cover ER visits? You bet. Emergencies happen, and using short term medical for an emergency room visit can provide some financial peace of mind for life’s crises. Plus, Vera offers short-term health plans every day of the year with no open enrollment period. Pretty sweet, right? To learn more about our flexible coverage options and low monthly premiums, call 888-499-1187 to chat with a friendly Vera Health expert today! You can also visit us online at any time to discover how you can get insured on your own terms. We hope to hear from you soon!
Short Term Medical coverage is not required to comply with federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of pre-existing conditions or health benefits (such as hospitalization, emergency service, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.