So they’ve changed the benefits at work, and of course the copay costs are going up. Mostly, it’s just five more for a regular doctor’s visit, ten more for a specialist, etc.
But get this, a visit to an emergency room is going up from $150 to FOUR HUNDRED DOLLARS.
I don’t go to the emergency room very often. I did a few months ago when it turned out my body decided to become allergic to ibuprofen just to piss me off apparently. For $150, I didn’t mind very much. It was worth it to make sure the sudden swelling in my face didn’t cut off my airway.
But now, knowing that going to the emergency room is going to cost me FOUR BIG BENJAMINS on top of a couple of hundred for the ambulance, I know I am going to be reluctant to call 911 for an extended asthma attack or that weird pain in the middle of the night that might be gas but maybe isn’t. Six hundred to me is approaching half my goddamn paycheck. I will gladly gamble with my life to avoid that kind of skinning.
And I was hugely pissed off when my landlord jacked up my rent by a hundred.
What the fuck HR? This is the best deal you could get us? An 166 percent price hike for emergency services? Is this increase fucking normal???
For those of you thinking of chastising me for saying I would gamble with my life for six hundred dollars, you don’t know what a sudden $600 debt would do to my plans to keep from sleeping in the streets. Talk about gambling with my life.
At least in my medical group, E.R. is reserved for truly immediately life-threatening crises. Anything less is handled by “urgent care”, when you need to see a doctor (or at least an intake nurse) sometime today. Basically if I didn’t arrive there by ambulance, I probably don’t need the E.R..
Medical care is god-awful expensive, especially full ER/ hospital/ I.C. facilities. The premium jump is harsh but most likely reflects their true increase in costs; they probably should have had a smaller increase sooner rather than wait so long.
Health insurance costs, generally, have been skyrocketing for years.
There’s also the factor that a lot of people tend to go to the ER for issues that aren’t truly emergencies (please note that I’m not necessarily saying that this is true for the OP). Health insurers often send communications to their members about “know where to go,” in order to encourage them to understand what’s an ER-appropriate health issue, and what would be better-suited to an urgent care visit, or a visit with your GP or a telehealth visit.
I strongly suspect that the rise in the ER visit cost with your insurance is a direct product of this, and an intentional “stick” to get employees to not use the ER unless it’s an actual emergency.
“Make America Great Again”? For starters, let’s make health care affordable for every American. Sick people deny themselves professional care because of money. People ration their prescriptions or eschew them all together because of money. A hospital room is economically equivalent to a suite overlooking the Riviera. I could go on and on, but I’ll just wind myself up for nothing.
Health care costs are going up for pretty much everyone. My company has avoided any price hikes in premiums in 2026, technically, but we’re lowering the amount employees can save on their premiums via their participation in the wellness program. The practical impact is that most employees are going to be paying a bit more in premiums next year.
Is such a price hike normal? Eh, no, not quite, but it happens on occasion. A few year back, pre-covid, I was going through open enrollment with a group of employees and there was an audible gasp when I revealed the increased premiums for our point of service plan. At least in our case, the premiums went up but the plan didn’t change otherwise.
The thing is, we’re not living in normal times. A lot of people are either screwed over or are going to be screwed over soon. The GOP is hellbent on fucking us all.
While they have better hours than a typical doctors office, they are not 24x7. Have an issue at the wrong time of day, or the wrong issue (possible fracture) & one has no choice but to go to an ER.
Because many poor people have little or no health coverage at all, and so go to an Emergency Room which are required by law to take anyone regardless of ability to pay. So the ER waiting room is filled with indigent mothers with toddlers suffering rashes and ear infections. And as mentioned, full-facility medical care is expensive even if it’s not being utilized efficiently.
Absolutely so; FWIW, in the U.S., a broken bone that’s displaced or an “open wound” fracture would be an injury in which an ER visit (rather than an urgent-care center) would be generally recommended anyway.
Also FWIW, most health insurance plans now cover “telehealth,” and work with a third-party telemedicine provider like Teladoc, which is generally available 24/7. Telehealth is certainly not appropriate for a lot of serious issues, like broken bones, shortness of breath, etc., for which the ER would pretty much always be the recommended course of action, but if it’s 1 a.m., and you suddenly discover you have flu-like symptoms, sudden onset of nausea or diarrhea, your kid has developed pinkeye, etc., it can be a better option than waiting in the ER for hours to be seen, and they can often prescribe medications.
While this is absolutely also true, my point was mostly that many people who do have health insurance also go to the ER for health issues which don’t actually warrant the ER, when other options like urgent care, teleheath, or a visit with your GP would be sufficient, and less expensive for the insurer, and the patient. And that seems, IMO, to likely be a big factor as to why the OP’s health insurance has jacked up their co-pays for ER visits.
I don’t know who the OP works for, how big a company it is, or who their health insurer is, but it’s absolutely possible that the insurer has looked at claims filed by people covered by the OP’s company’s plan, and seen a lot of ER visits for non-emergency issues, and instituted that change to the OP’s employer’s plan due to that.
(Disclosure: my main client, for the past decade, has been a regional U.S. health insurance company, and this is an ongoing issue for them.)
I recently had a 3-month wait for a new patient visit for a new GP/family/‘regular’ doctor. Not that everyone changes doctors regularly & I did not need any services during that time period but I wouldn’t have called my not-quite-yet doc if I did have an issue then.
I think we have some telehealth services but I’ve never used them & would need to figure out how / who to call before being able to contact them.
Yup; my client offers a telehealth service called Doctor on Demand to their members, and yes, members need to set up an account with Doctor on Demand before they can use it. It’s another hoop to jump through, it’s annoying, and you undoubtedly aren’t the only one who doesn’t look into it until they suddenly need to use it.
I had spinal fusion August 1st (3 levels of vertebrae). It was delayed two weeks while the neurosurgeon fought to get the insurance company to agree to pay for inpatient. There’s a very real risk of spinal fluid leakage (up to 16%, depending on age and other factors which I had), and often no warning signs until it’s too late. As it was, I was in for 5 or 6 days.
The tax subsidies for people who buy ACA (individual) health insurance were expanded and enhanced in 2021; those expanded subsidies are currently slated to go away at the end of this year. Sign-ups for ACA plans have increased dramatically over the past three years, and the subsidies (which reduce the monthly premium for many people) are a big reason why.
Congress is well-aware of this ticking time bomb, but it doesn’t look like they have felt any particular urgency in addressing it. In the meantime, health insurers have assumed that a lot of low-to-moderate income people won’t be able to afford their insurance next year, and a lot of healthy people who are on those policies will cancel them; as a result, they have submitted rates for 2026 which include substantial increases. The median increase is +18%, but in a lot of states, it’s much higher; I know that in the state where my client competes, the three major insurers which offer ACA Marketplace plans have submitted increases which range from +19% to +28%.
Many policies it is; which is utter BS! - Having chest pain? Go to the ER, says everyone
If that turns out to be a heart attack & you’re admitted, no cost for that ER visit; however, if it turns out to be angina or indigestion & they send you home; you get stuck with the bill. Costs should not be based on the results of tests the average individual cannot perform if you’re following medical advice.
I’ve had lots of success with virtual doc, and the 24/7 nurse line for my dialysis clinic.
Patient Portals are benefit most clinics and surgery centers have. Avail yourself of these services before calling 911 or rushing to the ER.
Now if you slip down holding a butcher knife and somehow it stuck in your chest, call 911. If you can. I doubt you’ll care what it costs at the time.
If your life is in true danger of being extinguished, say a auto accident, you probably won’t be able to make the choice. If there’s a pulse you’re going in the ambulance.
Yes, there will be times when you’re just unsure…That’s when to use virtual doc or if possible go to Urgent care.
I’ve spent many more hours than I care to remember trying to decide if what the issue is needs care at this moment. I tend to be slow to go. Drives my family insane. It’s my perpetual optimism telling me, it’ll be ok to wait. I cite examples when pushed. I really get the fam upset when I get to that point.
These are hard times. I don’t see it getting better anytime soon.
This was the case for me for the three times I went to the ER over the last two and a half years. All three times I was admitted to the hospital, so I guess it was justified.