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One-in-Six ER Visits Leads to Surprise Medical Bill, Study Reveals

About one out of every six emergency room visits leads to an individual receiving a surprise medical bill for out-of-network coverage, according to a study released yesterday by the Kaiser Family Foundation. As well, 67% of individuals are worried about being able to afford paying a surprise medical bill, according to the study.

This news comes as many states are looking at different ways to handle the issue of surprise medical bills, which occur when an individual visits a healthcare facility that is not part of his or her insurance network, or is treated by a healthcare practitioner at an in-network facility who is not part of the individual’s insurance network. In many cases, especially in emergencies, individuals may not have the opportunity to check whether a facility or a doctor is part of their insurance coverage, leading to huge bills when they leave the hospital. Those bills are often sent to collections if they are unpaid, and agencies are then forced to try and collect on debts that individuals were completely not prepared to handle.

Nearly 40% of non-elderly individuals have received an unexpected medical bill in the past 12 months, according to the survey. Within that group, half said the amount they were expected to pay less than $500, while 13% said that the amount they owed was more than $2,000.

The number of healthcare visits that result in a surprise bill vary widely by state. Thirty-eight percent of emergency room visits in Texas result in a surprise bill, compared with just 3% in Minnesota. Nine states had rates that are about 20%, while 11 states had rates that were under 10%.

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