insurance

5 essential facts about health insurance

The ER should be avoided, if possible
The ER should be avoided, if possible © V. J. Matthew/Shutterstock.com

Hospital emergency departments were designed to treat true emergencies, such as persistent chest pain and traumatic injuries. But overuse of the ER has driven up both prices and wait times.

"Many of the conditions for which patients often go to the ER, such as sprained ankles, colds and other conditions that are not life-threatening, are better handled at an urgent care facility or by their own physicians," says Marty Rosen, co-founder of Health Advocate, a health insurance assistance firm.

Avoiding the emergency room can save money and time.

"With most insurance plans, the copay cost is significantly higher at an ER than getting the same treatment at urgent care," Rosen says. "If you're on a high-deductible plan with a $3,000 deductible, you may pay that entire amount out of pocket for treating a sprained ankle at a trauma center ER. At an urgent care, you might spend a few hundred."

Patients at most urgent care clinics are treated within one hour, versus average wait times of up to six hours at ERs, Rosen adds.

To determine whether an ER visit is in order, consult your primary care provider or a nurse hotline if one is included in your insurance plan.

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