I get many calls from customers carefully reading fine print on policies asking about special deductibles for emergency rooms and limitations for emergency room coverage for persons not admitted into the hospital. To those customers, I would firstly say: Good job!! Reading the fine print is a very good idea and understanding it even better. So I do not mind these calls in the least. It shows a very savvy consumer and I am more than happy to assist them in understanding these insurance terms and definitions.
The issue is quite simply this: Emergency room costs in the US are ridiculously high. A quick stay in one can cost over $1,000 without needing much in the way of medical care. It is because of this that insurers want to protect themselves from these costs (understandable, but it does tend to make some customers a bit nervous which is likewise understandable). Here’s the deal: if you are not in peril for your life, DON’T go to the emergency room. There are many somewhat new medical facilities called “Urgent Care Centers” all over the US. This should be your first go-to in case of sudden medical issue (not life threatening) during hours that a doctor’s office is not open or you cannot get a timely appointment.
So, when my kid has a bad ear ache and I know it won’t wait until Monday morning, this is where I go.