My Very First Emergency Room Visit

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This week was filled with wonderful firsts. I had:

  • my first time cowering for an hour in the fetal position,
  • my first emergency room visit,
  • my first morphine shot,
  • my first CT scan,
  • …and my very first kidney stone!!

Ironically, I was just talking to a friend about how they planned to quit their corporate job and wander around the world for a while, working odd jobs like ski resort seasonal worker, bartender, or barista. Being the ever-practical geek, I pointed out that she should be sure to buy some health insurance or use COBRA. “I’ll just be real careful”, was the dreaded reply. Careful only gets you so far… (And I’m still waiting on my stone to pass!)

I haven’t gotten the hospital bill yet, but I’m sure it would be thousands of dollars without insurance. I’ll have to do the math and see if my decision to stay on my wife’s employer plan for $200 a month instead of going for the high-deductible HSA plan for $100-$150 per month was a good idea mathematically.

According to this PBS article Young Adults Fastest-Growing Group of Uninsured, the out-of-pocket costs can be pretty crazy:

Average day in hospital: $7,157
Burst appendix: $48,151
Fractured ankle, and a tib-fib fracture: $101,790

Geez, now I really want to see my bill.

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  1. It seems to me without insurance there is sort of a double-whammy because the insurance providers (especially HMOs) have negotiated fees. If you pay out of pocket you are not only paying for expensive procedures but also paying “full price”.

  2. SavingEverything says

    Most health insurance providers allow you to view the medical bills that they receive, which includes the actual charges, the charge that insurance companies and medical facilities agree to accept, and actual payments of both you and provider, etc. Actually, you may want to see if it may be of better benefit for you if you went “individual” for medical coverage through one of the health insurance plans that are supposedly regulated or ok-d through your state. Oregon, for example, has Blue Selection Plus Plan (70%coinsur) with 1k deductible at ~103/month, or their Premier Plan at 80%coinsu at ~113/month (of course, premium increases based on age and lower deductible.) Hmm, so maybe you should be glad you have what you have with your wife (unless you’re paying 200, plus her monthly contributions from paycheck.)?

  3. Moneyfriend says

    Most health insurance providers allow you to view the medical bills that they receive, which includes the actual charges, the charge that insurance companies and medical facilities agree to accept, and actual payments of both you and provider, etc. Actually, you may want to see if it may be of better benefit for you if you went “individual” for medical coverage through one of the health insurance plans that are supposedly regulated or ok-d through your state. Oregon, for example, has Blue Selection Plus Plan (70%coinsur) with 1k deductible at ~103/month, or their Premier Plan at 80%coinsu at ~113/month (of course, premium increases based on age and lower deductible.) Hmm, so maybe you should be glad you have what you have with your wife (unless you’re paying 200, plus her monthly contributions from paycheck.)?

  4. Steve Austin says

    Hospital bills are frightening things to me, and I’ve fortunately never even had to pay one myself. I’m not working and therefore not covered by any employer’s plan. I opted to not play with COBRA when I left my employer last year, and instead decided to self-insure for any/everything under $5k/yr, everything above that will be covered by my high-deductible policy with Mid-West Insurance of Tennessee (some national plan, costs me ~$62/mon — I’m a strapping mid-late 30s single male, so I guess that’s why my insurance is so cheap).

    Re: kidney stones, my brother and father have both had them, so to stave off familial proclivity to the stones, I just drink pail fulls of water every day. ๐Ÿ˜‰

  5. Hey there,

    Any thoughts about cheap (but safe) options for health insurance? My wife and I just got married, both at 23. We’re grad students and are looking for an alternative to the school sponsored plan ($1900 per year for the both of us). It could very well be the case that we stick with this plan

    Hope you are feeling better and that the stone passes smoothly!!

  6. My “I’ll just be real careful doesn’t work in the real world” epiphany came on just such a midnight visit to the ER for a kdney stone moment as yours (if you’ve never had one, you just can’t imagine the pain!)…except I didn’t have insurance at the time. The total bill ended up being about $4,500 (which they cut in half because I paid it in full). Signed up for health insurance at work the very next day.

    As Steve Austin (can the bionic man even get kidney stones?) says….drink lots and lots of water.

  7. Wow Jonathan, bad news! – my father in law just had a kidney stone – not fun. I just posted an spot on choosing insurance a couple of days ago (although mine was more focused on car insurance since I hit a deer). Unfortunately, on average, the insurance companies win in the end. Doesn’t make choosing insurance very motivating – until something happens.

  8. A few things to know if you should incur large medical expenses (which you probably won’t with the kidney stone). For example, if your wife has a stroke (freak kind of thing at 35 but you get what you get) you will have large medical expenses.

    1) Your insurance company will turn evil on you at some point. You have to tape record your calls with them. You’ll especially need the conversation on tape where they “turn to the dark side” because they will be most unreasonable during that one. You’ll want it on tape in case you need to fight.

    2) You won’t give due consideration to point 1) because at first your insurance company with be friendly and helpful. Trust me. They will turn eventually, probably when the cost of your expenses passes some magic number.

    3) Don’t pay any bill until it has been correctly discounted by your insurance company and applied to your deductible or paid. When the insurance paperwork is in order, then you pay your part.

    4) You can usually hold a hospital off indefinitely as long as you are working to make progress on your insurance company to have you bill paid correctly. As long as they have not been paid, it is in their interest to help you resolve the bill with insurance, and their aid can be very very helpful.

    5) A bill that is really messed up will eventually go to collections. The magic phrase is, “I am writing to dispute this bill.” The key word is dispute, and you do it right away as soon as you get the first notice. You do not pay something just because it comes from a collector.

    You must Google for the Fair Debt Collection Practices Act and read it. The collectors use this language and so should you; hence the word dispute. These are the rules that bind them.

    6) If a collector calls, you want that conversation on tape. They are more evil than insurance. That’s their job. Evil people have to earn a living too.

    7) If you absolutely must pay a bill yourself, you should get a discount. I know the local billing people at our hospital can’t resolve a bill for less than about 60% of its amount. But several times (at the end of the year when they wanted to close the books) they have offered me a 25% discount if I would give up and pay the bill. I would start off seeking a 40% discount and see what you can deal for.

    I’m sure there are things I’ve left out, but it’s a start. Obviously this could be a whole article (at least).

  9. I also had one earlier this year. They say (the doctors), and I have to think and agree it must feel like having labor pains. I do have insurance and the bill was near $9000 with insurance (discounts) the original bill we over $18500. I have an HSA with a $1500 deductible and then all is paid at 100%. I had one night in the hospital, a laser outpatient procedure and 2 office visits and some pain pills. I should not forget those pain pills. YOU must have some type of insurance. They should “Travel the World” but have some coverage or your financial life/future could be ruined. Good luck on your stone, hope it passes with any procedure.

  10. SavingDiva says

    This sort of thing makes me very happy that I have a reasonable job with great benefits…

  11. My wife just had a hysterectomy. I love how hospitals bill. Cost of two days stay and the operating room costs – $25,000. Not to mention the surgeon’s fee, the anaesthesiologist, the urologist, the radiologist. But the hospital bill when discounted to the negotiated price was a MERE $4400. Our costs because of our deductibles (mind you our medical insurance is not the high deductible type) is still going to be a couple of thousand for the hospital and all the doctors.

    BTW, my limited understanding of the cause of kidney stones is too much protein in your diet.

  12. I said it before, but the high deductible was worth it mathematically for me. The amount of my new premium + deductible for the entire year is exactly the same as my premium for the year used to be – the plus side is that with the high deductible I am saving aside that difference and if I don’t need the health insurance, I saved $1850 that year. If I use the deductible, I break perfectly even (and I get 100% coverage now instead of 80% on most things, so I’ll do better all around).

    It’s definitely worth running the numbers on a high deductible plan…

  13. Albrecht says

    I had the same happen to me 1.5 years ago.

    If your wife’s insurance is any good you will not have to pay a cent.
    The craziest bills were from 911 services – if I knew then that they would be such a hussle to convince that my insurance
    does cover them, I’d have simply called my wife to pick me up at work where I was alone and trembling instead of dialing
    the 3 magic digits. Taxpayer subsidized? – Hardly only! I told them that I’m having a pain in my lower back and need only
    EMT van. Still, like a pack of hungry wolves, rushed they to me, firefighters and police, being directed to consider each stupid call
    like a cash flow generator. ๐Ÿ™‚

    Another thing I wish my brother told me before the passing of the stone happened – is his secret recipe for chasing the stone
    away quicker (since no painkillers worked). Here it is: drink lots of bear and then sit in the hottub for a while. Good luck!

  14. Anonymous T says

    One thing I learned after my wife had 2 c-sections– don’t be in a hurry to pay off those hospital bills. You’ll usually get a first one that does not take into account the insurance payments, and it’ll be a big surprise. Don’t pay that one. It usually is OK to wait a while (call the hospital billing dept if you are not sure) and ensure that all insurance payments are pending prior to your balance being known.

    I also found it very helpful to check my insurer’s website which has the claims very quickly so you can watch the bills as they play out.

    And be sure to check all the bills for accuracy. They often get messed up and bill for things you didn’t receive.

  15. I had no health insurance for four months after grad school. I had no job and no money. That was a whole different world. A sore throat made me panic. Luckily, I didn’t get in a car accident or pass a kidney stone.

    That four months was my taste of what it must feel like to not be able to afford basic healthcare. It’s a shame that millions of working class people in this country live every day with that kind of dread, the only real word for it.

  16. Bummer – hope you feel better soon.

    I’ve been lurking for a while but had to comment on this – I’ve always kept some kind of health insurance even during that stage of life (when I was young & healthy and not getting it from my employer) when a lot of people forego it. But it was a few years ago when I was hit by a car and broke my leg, requiring an ER visit, 2 surgeries, and months of physical therapy, that it hit home just how important an investment that was.


  17. Tell your friend that if she wants to do the wandering bum thing to move to Canada or England, and she’ll be a lot better off if she gets hurt. ๐Ÿ˜‰

  18. I went to the ER two months ago for a sinus infection and all I wanted was an antibiotic. It was Sunday so I couldn’t go to a regular doctor. I spent about 45 minutes in the ER and they charged me just over $800. I had no tests or exams, just a doctor asked my symptoms and gave me a prescription.

    Luckily I have good insurance so they paid over $500 of the cost, but it sickens me to know that I could have just waited a day and gone to a doctor for the $10 office visit.

    Live and learn!

  19. Insurance is terrible. Especially for the young. I use to always listen to people complaining about the costs, but I was a relative healthy, young man. I had no idea about the various deductibles and and out of network costs and specialist fees for not getting pre-approved for treatment. They can really nail you with that.

    About a year and a half ago, I was 26, and began having blood pressure problems. My resting BP was 220/140. Not good under any circumstances, but for resting that was just terrible. I thought I had good health insurance with the company I was with, but I was wrong. I ended up with more than 10K in medical bills. Not 10K total, but 10K I was responsible for. No surgury, no invasive tests, just things like a cardiac stress test and MRIs. It has taken almost 18 months of killing myself to pay them back. My only saving grace was that medical information is protected and even though some of it went to collections, none of it hit my credit report.

    Bottom line, good health insurance is indespensible. A serious accident or surgury without adequate insurance can literally RUIN YOUR LIFE. Take the ankle fracture. If you didn’t have insurance, you are now 100K in debt, with out any kind of offsetting asset like a house or education. In many cases a serious accident prevents you from earning regular income as well, which can cause other bills to start piling up.

    I liken it to a computer, in my opinion. You can download “pirated” copies of almost anything, but never mess with trying a pirated OS. Too much depends on it.

  20. I agree with you on the health insurance/COBRA point. I’ve been unemployed at various points, before and after living overseas–just prior to grad school, etc. During those times, I always made it a point to either pay for COBRA or get health insurance. I also backpacked around the world and even then I bought travel insurance to cover any type severe medical emergency. Luckily I never had to use it but I don’t consider that money wasted. Knowing that my emergency room bills will be covered or that I can be flown out of the country if I broke a leg (which did happen to a friend of mine) was completely worth it.

  21. Yikes! That doesn’t sound like fun!

    I’m only 20 years old and was against insurance but my pesky mother insisted I signed up with my employer, Circuit City. It’s $57 every two weeks but definitely something I’m thankful for after two repeat visits to the hospital last year for dehydration, including on visit for them accidentally poisoning me with a liquid form of aspirin that I’m allergic too. Total cost was around $6,000 — for me after insurance paid, just under $600.

  22. Sorry, I’ve heard how painful kidney stones can be – hope you are feeling better now — but I definitely think you made the right decision regarding the $200 vs. $150 high deductible plan. That’s just a $600/yr difference — you are going to save astronomically on this one experience alone (although I’m sure you’d rather have skipped it!).

    I have a supposedly good plan through my husbands’ work (APWU ins.) The biweekly payment isn’t much ($50), but we have deductibles and co-payments and even after that somehow we are responsible for 10% of all bills. They were raving about this plan (his work) – but it hasn’t worked out to be that great, IMO, so far. I feel like I’ve been paying out-of-pocket for every doctors appointment so far. Only if we continue going to the doctor now will we make use of the actual plan. And who wants to keep going to the doctor? Next year I think I’ll choose a plan that has no deductible, but most likely it will have to be an HMO. I have no problem with HMOs except for referrals. I absolutely despise them — that’s why I took this plan. But at least with the HMOs, they covered every single thing (except the co-payment). Then they have these “open” plans — half HMO with no referrals — but you pay a ridiculous amount biweekly for that privilege. It’s often more than double what we pay now.

    I never really considered a high deductible plan — because it gives me an insecure feeling – but maybe I’m wrong — it seems whichever plan I pick — there’s something wrong with it.

  23. I’ve been lurking here for a while but had to comment on this. I had my first stone in January. It was the most painful thing I have ever experienced. It was also a bit painful paying those bills. I do have insurance through my work but there is a $2500 deductible. The good part is I met my deductible for the year on January 4th. ๐Ÿ™‚

  24. Wow, I knew healthcare was getting expensive, but not this fast. In 2003, I had an appendix “issue” (I’ll spare you the gory details); not technically a rupture, but I did end up in the hospital for a week, and at home for another week. I would have to check, but I believe the total bill was around $14K. That number stuck in my head because of a little something called co-insurance. You might want to check your policy a little closer. It can be a bit of a surprise when you think you are only on the hook for the deductible. Still better to have it than not…

  25. mimi, you basically have to decide what you want health insurance for. High deductible plans are really meant for people who use health insurance as a fallback if something happens that’s outside of their budget. I don’t expect my insurance to pay for routine doctors visits (although I’d file it under the insurance just to pay on the deductible).

    It’s just like my car insurance – I don’t expect to have to need it, so my deductible is fairly high. Sure, stuff happens, and then I’m faced with a bit more out of pocket expenses, but if I never need to use it I am better off in the long run. If I expect to crash monthly, well, that’s why they offer $50 deductibles. ๐Ÿ™‚

    If you’re going to the doctor often enough, then there’s no point in getting a high deductible plan – unless the coverage still works out to be better. Like for you with the 10% out of pocket expenses – I don’t have to worry about that, which is a big relief. I’d rather a known fixed amount than some percentage of an unknown amount – it’s a lot easier to plan for. I put the deductible into savings each month (an HSA, which means tax deferred and extra retirement money, too!), so if I ever have to pay the deductible, it’s available for me.

    There are so many factors that go into the perfect health plan for any given individual…

  26. Hope you’re feeling better, Jonathan. Start chugging that water!

    I’m one of those uninsured young adults — recently left my job to attend graduate school, but the COBRA wasn’t worth it to me. I rarely go to the doctor (besides the dentist and optometrist). But those numbers for a fractured ankle or burst appendix look really scary. Does anyone know of any really low deductible plans geared toward someone like me? I saw the Tonik plan, but it’s not offered in my state.

  27. good luck, im 25, and have had 2 stones

    for my case, with my insurance, i paid around 500 bucks a visit (CT, morphine, etc)

    by the way, if you’re sick of waiting and you really want to get it out, if i had a kidney stone again, i would drink several beers to help pass it,

    (one doc told me this, saying his advice was ‘under the table’, and not to quote him, its what he did and passed it in one day when he had a stone)

  28. I’m assuming that tib-fib number assumes you’ll need a pin to set it. If it’s a simple hairline fracture it shouldn’t cost near that much.

    For the record, i was one of those uninsured young adults for awhile. I only have health insurance now because my medical school requires it. Before I worked as a medical assistant and I had no health insurance. Ironic, in a way, that a member of the field couldn’t even afford to have insurance.

  29. Sorry to hear about your stone. Eeek, feel better soon. Don’t worry, this too shall pass.

  30. My advice is to save all of your EOBs (Explanation of Benefits) once your charges start trickling through insurance, whether they come on paper or are PDFs on your carrier’s website. If your hospital and providers are “par” (participating/contracted) with your insurance company, then they are obligated to accept what the EOB says, and can’t bill you for a penny more. Also, save your receipts for any co-pays or other payments you make.

    You’d be surprised how many different people your claim has to pass through on its way to the carrier and back, and it is not uncommon for mistakes to happen. Patients get billed all the time for charges that they may not actually be responsible for, and so it’s really important to hold on to your paperwork so you can prove your case in the event of a billing error.

  31. Thanks for the well wishes everyone. I think I’ve worn out an entire new Brita filter in three days, with all the water I’ve been drinking. I’m glad to see I’m not the only young person getting kidney stones – I thought it was only those old fogies ๐Ÿ˜‰

    Oi, I really hope there aren’t complications with the medical bill. Sounds like a real headache. I’m just curious how much all this stuff costs, since there is no transparency and it probably costs differently for each health insurance provider. I do hope they leave the “retail” price on there.

  32. I too have been to the ER for a kidney stone. Don’t you love how they leave you curled up on the floor, moaning in pain for over an hour when nobody else really seems very sick? My advice: save a few of the good pain meds so you can take them right away if you get another stone (I hope you don’t, but there’s a good chance you will – sorry)

    And definitely chug the water right now since it hasn’t passed yet…

  33. Well Jonathan, I’m sorry you’re in pain… but man, what perfect material for a blog post ๐Ÿ™‚

    I checked those numbers you gave me and *WOW* am I ever happy to be Canadian. You see we have this public healthcare thing. It’s kind of socialist and it’s kind of a money black hole. But the people in crisis aren’t complaining about the service.

    However, not having to run the hospital at a profit makes a big difference, you see, my aunt works for the health centre and the average cost of a one-day stay (in Canada) is $2400-3000.

    Of course, we suffer the burden of “increased taxes”, but I made a comment on a previous post of yours that these numbers are about the same. Our taxes = Your taxes + healthcare costs.

    Either way, just some food for thought.

  34. i thought these stones were from too many minerals in your systems, aka taking vitamins with 1000% of your daily mineral recommendation. that’s why i stopped taking vites. i dont even want to think about having a stone. i cant believe how many people just on here have had them

  35. good luck to you. stay rested more.

  36. Chris in Boston says

    Sorry to hear of your kidney stone issues.

    A lot of people mistakenly believe that the painful part is when you pass it from the bladder through your urethra.

    In actuality, the most severe pain is when its passing from your kidney into the ureter tube and while its en route through the ureter to the bladder. Once it reaches your bladder, the stone itself should pass with no pain.

    It is important that you collect the stone so that the doctire can analyze the type of stone it is. I was fortunately able to identify the root cause for me was too much grapefruit in my diet.

    Water helps flush it. But also Cranberry juice is very good for cleaning out the kidneys.

    Gotta love morphine though! ๐Ÿ™‚

  37. I understand that there is a great documentary coming out on June 29 (US theaters) that addresses this very sad issue we have in the most powerful empire in the world…Health Care. The already controversial and award winning documentary is “SICKO” by M. Moore. I understand it makes our moral stand in the world look pretty bad.

  38. I can’t wait for Michael Moore’s Sicko documentary!

    Any cheap health care insurance for poor graduate student?

  39. I’ve always feared kidney stones due to the reports of the torturous pain. I’m afraid I now fear it even more.

    A useful reference:

    Drinking water may help in prevention, but you still can be unlucky. From the webpage:

    “Kidney stones may also be an inherited disease, as they often occur in family members over several generations.”

  40. argh. hope you’re feeling much better now.. I totally would be in a fetal position for six hours.

  41. Nice post. It took me a while to convince my boyfriend he needed to find insurance when he took a few months off from school and no longer qualified under his parents’ plan. Even though he didn’t end up needing the high deductible plan he bought, it’s still worth having for situations like yours.

    Unfortunately, the suggestion that Jonathon’s friend wander around Canada wouldn’t help her. A friend of mine went to a Canadian university for his Ph.D. Since he wasn’t a citizen, he didn’t get the health care coverage, but he did have to pay the taxes.

  42. Jermaine says

    Quitting my job two months ago and several doctor visits over the past month made me realize how important insurance is and how much of a scam it is. About a month ago I had a real bad stomach ache over a 2-day period and the only thing the doctor could find wrong was elevated bilirubin levels. A couple of follow up tests and an ultrasound of my abdomen revealed that all is OK. I thought about letting my insurance lapse, but decided to keep it through COBRA for $500/month. I wanted to switch to a cheaper plan with a higher deductible, but since my previous employer is not in open enrollment I was not allowed to do so. Also since it takes 30-60 days for COBRA to kick in I was paying out of pocket for doctor visits and the self-pay rates are A LOT cheaper than what is normally charged.

  43. SavingEverything says

    I’m must add some crazy numbers that’s still scary even with individual health insurance. In MA, where all residents are now required to get a health plan, have plans that range from ~$184-379 to even as high as $543 / month, depending on health insurance company, coverage, deductible, copays and coinsurances. In NY, plans are ~$230-271 / month. In NJ, a friend of mine says individual is like between $440-1000 / month. And all these rates are for one individual. COBRA from your ex-employer may be the same or a little less than these monthly premiums. Having student health insurance from school may be also less. Having health insurance with your employer is of course the best! But, it’s really a gamble if you choose not too get health insurance, imho. (and, if you have any type of prolonged disease or something that you maintain with normal Rx’s, not having insurance would be more of a risk on your assets!) So, i guess the moral…. insurance is important, because it’s your health and your assets and life!

  44. You may consider using

  45. Where should look for insurance if my employer doesn’t offer it. I was referred to Atlantis Health Plan of NY. They have HMO plan for $300 per month. Has anyone used them?

  46. Great Blog. Just though I’d chip in, I visited the ER couple years ago when I was still in College for some weird stomach pains. I got some CT scans, blood cultures, etc. done. I was able to view the claims that the hospital made against my insurance and wow was I surprised:

    CONTRAST MEDIA 276.00 0.00
    VENIPUNCTURE 17.00 0.00
    PATHOLOGY PANEL TEST 157.00 0.00
    PATHOLOGY TEST 90.00 0.00
    ATH TEST/BLOOD COUNT 110.00 0.00
    ADVANCED IMAGING – CT 3,075.00 0.00
    ADVANCED IMAGING – CT 3,078.00 0.00
    OUTPATIENT CARE 810.00 15.00

    That second number is the ‘patient responsibility’ so luckily I only had to pay $15.00 out of pocket. So that was a total of $7647 and 5-6 hours in the ER with the final diagnosis being “a really bad stomach flu” and a prescription for some Acetaminophen (Tylenol). I can’t even imagine how much of a hassle it would’ve been without the proper insurance.

    Hope everything works out and that you get better. Rest up!

  47. When i was getting my MBA i had a high deductible student plan for my wife and I. Broke my clavicle in snowboarding accident and the doctor bills came to $980 total (with a clavicle you just basically put it in a sling and wait for it to heal – i didn’t even use a painkiller besides ibuprofin). My deductible was $1000, so i never did use that insurance, but i wouldn’t want to be caught without it.

    I’m covered by BlueCross/BlueShield from my wife’s job now, with a great dental and vision plan, but will have to choose from the Federal Gov’t plans (i work for the Dept of Commerce) when my wife quits her job and starts law school in a few months. Considering Kaiser Permanente because it has the cheapest rates but you have to go to their facilities. The gov’t pays 75% of the premium, so $150 for both of us for a month for the standard plan (the same as the premium but higher deductibles across the board). Anyone have any experience with Kaiser?

  48. I found a “young adult” plan from blue cross blue shield. Take a peek:

    You still don’t want to get sick, since $2500 might be a lot in one’s early twenties.

  49. Hello Jonathan

    Sorry for your troubles mate. However, It’d be great to see a follow up that helps people of various age groups better prepare for a situation like this. Especially us unemployed / self-employed blokes.

    HSA + High-Deductable plans are a joke in my case, even though I’m in my early 20’s. I guess its time to research some cost effective alternatives. Hope everything works out well for you. Cheers.

  50. Jay:

    You absolutely used your insurance with your broken clavicle. While still under your deductible, you benefited from the contracted rate that your insurance company negotiated with the hospital/physician. It probably saved you 50%!

  51. Just to let you know I have Aenta’s high deductible plan and you cannot just simply compare what they would have charge a person without insurance. They still get discounts because there’s still in-network plans.

    I was really sick and went to the doctors office and had to be put on an IV, they pumped me with shots and I thought the bill was going to be outrageous since I have am using the HSA plan. Come to find out the bill would have cost a person without insurance something like 300 dollars, but since Aetna has a plan with them it only cost me 113 dollars, which came out of my HSA account. I got two prescriptions and both I went with generic at walmart and both combined didn’t cost me more than 10 dollars.

    Basically my employer contributes 125 dollars a month into my HSA and one month of contribution paid for this one time of being sick. When I had 3 people looking over my body, hooking me up to an IV, putting shots in my butt. I truly thought I was going to get a big bill and I guess if I had no insurance I would have, but using Aetna’s in-network plan really saved me a lot of money.

    I haven’t contributed a penny to my HSA account myself and I’m already up to 3,000 dollars. It’s earning around 4.25%. I can’t say enough good things about the HSA plan for those young that don’t get sick often.

  52. I?ve not had any emergency room visits but I definitely learned a lesson from EAF?s comments

  53. i actually just found out i had kidney stones last month for the first time as well. but guess what? i was travelling abroad when it happened! it was a scary experience because i was in a 3rd world country (peru!) but all in all, the experience was ok and the whole process only cost me 100-200 dollars (compared to if I had the same experience in the US it would have been thousands) interesting isn’t it? i ended up not even bothering contacting my insurance since the amount was so small. so lesson learned, if you have a medical emergency and no insurance, go to a 3rd world country. ha ha. jk.

  54. Dang man, hope you’re doing better!

  55. I took my husband to the ER last week. We received our bill. It was for 5,000. They charged him 1,600 for just walking in, then charge him 500. for a CBC and 1,800 for a ABD Acute W/Chest. He had no other major test. My husband is between insurances because he left his old job. He is currently looking seeking insurance. He came in sick at his stomach. I guess we should be thankful that they seen him. The woman in the news today could not be seen by anyone, not even the janitor. Her husband even call 911 to get help to take her to another hospital. She died because she could not get any help. I wonder if she had insurance or not, if this was the reason? America will help people in other countries before we will help our own. They will even bring people in from other countries to give them free health services.

  56. Teresa-

    hmmm… everyone in the United States, no matter if they have insurance or not, or no matter if they are a citizen, has the right to a medical screening exam on arrival to the Emergency Department, per the Emergency Medical Treatment and Active Labor Act (EMTALA).

    If your story is true, you should probably vote for health care reform, as our system is definitely broken.

  57. Mike Lee says

    As an ER doc, here’s my advice to everyone:

    Always call your regular doctor first before rushing to the Emergency room. Many times, they may be able to help you over the phone, and slide you into their appointment schedule for the next day to see you. If they feel the symptoms you describe is an emergency, they will tell you to go to the emergency room. The added bonus is that they usually call ahead of time to the ER you are going to to give us a heads up which will help expedite your service/admission if you need it. Secondly, he will give us additional information from your file that you may not have.

    It it can wait, then wait and see your regular doctor in the morning instead (eg cough, cold, congestion, fever, sinus infection, etc) It’s called an emergency room for a reason. ER docs HATE seeing primary care types of complaints because it’s something that a primary care doctor takes care of. You waste the ER’s resources (room, doctor/nurses time) when they can be seeing someone with a real emergency. Also, it will always be more expensive to go to an emergency room, than to your own doctor first.

    But of course, if you have an emergency, we always welcome your visit, and in fact look forward to it because it’s what we’re trained to do and what we enjoy doing.

    In any case, feel better Jon!

  58. Yes, I have always praticed going to the ER as a last resort. Because, I know that it is cost more than a regular Doctor’s visit. But come on, 5000, without any major test and with no admittance. The reason they kept him all night was because it was Memorial Day weekend and they were short of staff.

  59. Mike Lee says

    The reason why it’s $5000 is because all the tests are done on the premises, and immediately (versus waiting a week for the test results from your doctor). You’re essentially paying for rush service.

    Also, even though patients feel like they are being over charged, they don’t realize that ER docs actually go through a differential diagnoses of what you might have, and have to make a calculated decision from one’s test results, exam, and history of whether one has a life threatening illness. If we are wrong, one could potentially be discharged and die at home. It’s that extra level of complexity of thought process that most people don’t consider, and that’s what you’re paying for. Why do you think ER physician’s malpractice premium is around 100k versus an internist/family doctor’s premium of 10-15k? We see the sicker patients and take bigger risks.

    Finally, the $5000 is not what the ER doctor is charging you, it’s the cost of each test, cost of each consultant doctor that sees you in the emergency room, cost of each CT scan, cost for the radiologist to read your CT scan. You’re paying several different doctors to interpret complex tests, sometimes in the middle of the night. If you hired 5 lawyers to research a case for you overnight, you’d probably be facing even higher charges, but probably wouldn’t see it as being overcharged…so why is paying for a doctor(s)’ services considered a ripoff to so many people?

  60. The worst kidney stone attack I ever had struck me while I was the ER doctor on duty, the only one in the county. It was interesting how reluctant the rest of the hospital’s medical staff was to take my place when there was no other alternative. My opinion of physicians in general really went down after that experience, and I am one of them.
    I got IV morphine for that, it helped slightly. The thing that helped the most was getting off my feet, being relieved of caring for others, & self-hypnosis. This was before drugs like Toradol were used for kidney stone pain, in my opinion, those drugs (i.e., NSAID’s) work much better than morphine on nearly all my patients. My last episode of kidney stone was last summer, and started a few hours after I completed a day’s hike in hot dry desert conditions with not quite enough water ingested. When the pain started, I started drinking a pint of water every 30 minutes & drove across town to a store that was still open & bought Aleve. 200 mg of that & 1000 mg of Tylenol gave me a lot of pain relief. Within 18 hours I was much better, within 24 I was painfree. I passed the stone painlessly 3 weeks later. I did not seek medical attention, although I have done that several times before. I would not have recognized the stone had I not passed others. The stone was very small, more like a little dirt particle, & seemed negligible. I was visiting my sister 1600 miles from home & put off returning home until I was sure I had passed the stone. It is really no fun to have a kidney stone while you are traveling!
    —- Many patients pass stones without knowing it, usually quite a while after the pain is gone. It is important to get one of your stones analyzed for chemical composition. Usually the best prevention is to maintain adequate hydration at all times. For average sized men in otherwise good health, this means about a gallon of water a day, plus many extra trips to the bathroom. Other kinds of stone patients would have different hydration requirements. Generally the only way you can be sure you are getting enough water is to take a little more than enough, hence the need for extra bathroom visits. I know this can be a hassle, but it’s nothing compared to a kidney stone. People tend to train themselves to become dehydrated so they can decrease their frequency of urination, it seems a consequence of an over-regimented society.
    —- People’s ability to sense when they’re dehydrated is vastly overrated. My personal/professional opinion is that most people are dehydrated to some extent most of the time, so that if they have one episode of diarrhea or vomiting they almost faint. That’s one reason so many ER patients get IV’s in them.
    —- I start every day drinking a pint of room-temperature water, all at once, and end every day drinking a cup of the same. The rest of the day I try to ingest the remainder of my gallon. One way to insure you take enough water is to fill your own personal gallon jug of water every morning, and make sure you have emptied it by the time you go to bed. It’s silly to count cups of water when you need to count quarts & gallons. I use room-temperature water because it is painful to drink that much ice water quickly, and I want to get the chore of so much water drinking out of the way. If your water tastes bad at room temperature, get a better kind of water. Most city tap water is quite foul at room temperature from all the chlorine they use. Pure water at room temperature should taste good all by itself. I buy reverse-osmosis (RO) purified water from machines that dispense it by the gallon, they’re available at most large grocery stores. Pure water will keep indefinitely in clean containers. I buy my RO water 7 gallons at a time in a large jug I bought at WM, and refill it faithfully once a week. No one else drinks from my jug.
    Kidney stones run in my family. When I researched my family history I found a gggrandfather who died in 1873 of “gravel,” as kidney stones were called at the time. Most likely it was not a single kidney stone that killed him. He either had kidney failure as a result of multiple obstructions, or severe kidney infection from a stone blocking a ureter. The vast majority of kidney stone patients just suffer from intermittent painful episodes, and most pass their stones themselves. Nowadays stones can be removed, when necessary, more easily and with more safety than ever before.
    I agree with Mike Lee on calling your doctor before going to the ER, in general. But you need to think ahead of time about what conditions mean “Call 911, NOW” Sometimes the ER is the best “first resort.” When I was in practice, two situations bothered me a lot. One was people with conditions that weren’t at all severe, often conditions that would go away even if nothing were done, who would “rush” to the ER and endanger lives in doing so. The other was people with life threatening conditions who would put off, delay, procrastinate visiting the ER until they were on death’s door, and sometimes well past it. I think every able bodied person should have already taken a course in First Aid & CPR, but that’s just my opinion.
    I have already read the case of the woman who died in the ER of the waiting room that Teresa referred to. The media reporting was totally inadequate. As best I could tell by reading between the lines, that particular hospital had already been sanctioned by the federal government for previous EMTALA violations.
    Just be aware that now that you’ve had one stone, you are more likely to have another, they tend to hit out of the blue. I have had enough of them in my lifetime for me to know they tend to hurt when I’ve been working up a sweat doing something active, and at the same time fall behind on my fluids.

  61. Average day in hospital: $7,157 That’s extortionate!!!!! How can any organisation justify that amount.

  62. I just got my bill from the hospital for
    for a 3.9 mm kidney stone. It`s $11,084.00. That doesn`t necessarily include other costs. Still have the damn stone 5 weeks later-too!

  63. Ouch!

  64. I was there for a few hours, not admitted. Two bags of I.V. fluids 2 shots of pain meds. Told it will pass and given a `script for viocodin.

  65. Blue Cross agent says

    Sorry to hear about your hospital visit. Hopefully your health insurance can coverage you and that you feel better.

  66. I had the pleasure of having a kidney stone last year that actually required three surgeries (I believe at least one of these was unnecessary). The total cost was $34,000.

    Good news: I have insurance.
    Bad news: the kidney stone ER visit occurred on New Years Eve, meaning that I missed NYE with my fiancee and had to max out my out-of-pocket for two years (2006 for the ER visit, 2007 for the surgeries). In total, I paid $3,500. Not fun for a 23-year-old (at the time).

    And worst of all, I have another kidney stone that I have to take care of this year (I should have done it last year when my out-of-pocket was maxed out but I kept getting too busy).

  67. OK, I just got hopefully the last bill for my visit to ER with a kidney stone. 4 hours at ER, IV, morphine, CAT scan and 10 minutes of doctor’s time comes to $8,500. That is $35 a minute! And the best thing is that they sent me home with the stone still inside! There is something wrong with medical billing in this country.

  68. I had my plumber fix a leak in my house, he charged me $50 for 1 minute’s work. I complained that I made less than that, and that I was a doctor. He replied, “Yeah, I made less than that when I was a doctor, too.”

  69. All right, I was in the ER for 90 minutes, IV, morphine, CAT scan and (generously!) 10 minutes of doctor’s time – my bill was approximately $10,000 for the ER and $1,000 for the doctors time – $11,000 in 90 minutes – also left with nothing more than an asprin and the stone still inside me – we’re now talking $122 a minute (mostly waiting time) or something like $1,000 a minute of actually talking to someone!

    I think we’re talking even more than a plumber makes right now – God what a screwed up Health Care system this country has!!

  70. “my bill was approximately $10,000 for the ER and $1,000 for the doctors time…I think we’re talking even more than a plumber makes right now”
    No, you just wrote that your doctor’s bill was 9% of your total bill. Even if your doctor charged you NOTHING, your bill still would have been $10,000.
    This would be like my plumber charging me $50 for his time and $450 for the copper fitting he installed — actually, with the price of copper skyrocketing, this may yet happen!
    Fortunately I’m able to doctor myself & do a bit of my own (real) plumbing. Cleaned out my clogged kitchen drain yesterday using an old plumber’s snake I had laying around & other tools I have accumulated over decades, cost was $0, a lot of sweat at the time & sore muscles this morning. My last kidney stone I didn’t take to the ER, treated it with a lot (I mean a LOT) of fluids and generic naproxyn and acetaminophen from Wal Mart, cost about $6 for the meds, can’t give an estimate for the cost of the water, though. I don’t advise aspirin for kidney stones, because aspirin promotes bleeding in many people, stones usually cause some bleeding in the urinary tract, surgery is rarely necessary to remove the stones, and you really don’t want to have a bleeding problem after surgery. My last stone passed 3 weeks later with little difficulty. As always, your mileage may vary.

  71. Extortion is right! We brought my two-year old daughter to the ER because she had swallowed some of my Grandmother’s pills (thanks grandma!) We waited for an hour in the waiting room, they checked her vitals and brought us into another room.

    After around 1/2 hour waiting there, they drew her blood. Around three hours later, they told us all was ok- that we had passed the window of harm anyway (if she had swallowed the specific medication that we were concerned about, she would have had violent seizures and probably would have died before even the blood draw) and discharged us.
    We probably won’t qualify to have the bill paid for by Medicaid because the hospital sent us the bill three months late, which is past the Medicaid’s window of opportunity. BTW, the bill came to over $1000… for a blood draw and checking vitals! This may not sound like much to some, but we can’t afford that…

    At one time, we were offered health insurance by my husband’s employer. It would have come to $700/month for our family of four who has no pre-existing medical conditions. That’s $8400 per year- which is way beyond what we’d pay even including the ER visits if we paid for everything out of pocket. And this health insurance was offered by a hospital. I simply don’t understand how so many Americans can justify writing such a large monthly check to such a criminal industry.

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