A Breakdown of What You Can Expect to Pay When Staying Overnight in the Hospital

Medical Costs…can’t live with ‘em, can’t live without ‘em.  Healthcare is a topic on everyone’s mind and while the opinions sway back and forth about universal healthcare, Medicaid, social security, and prescription drugs, the fact remains that healthcare is expensive.  In a consumer market where hospitals can, and do, seem to charge whatever they’d like for procedures, it’s tough to get a clear breakdown of costs.  Without the option to shop around (emergencies), patients are left with a bill feeling a bit helpless in the matter.  The following is a breakdown of what you can expect to pay when staying overnight in the hospital.

Where the Costs Come From

First, medical supply pricing has no bounds.  For example, in the supermarket, if you were shopping at a store that sold boxes of cereal for $50, you would make a consumer decision to purchase your cereal somewhere else!  This simple example of free-market simply does not apply to emergency care and health care services.  You don’t get to decide how much the material in your knee surgery costs; you don’ have much, if any, consumer power.  Suppliers know this and are able to rack up a few thousand dollars pretty quick on an overnight or extended hospital stay.

Coding:

Where the costs actually come from is a computer with a coder using some universal codes to tell a billing machine what the heck the hospital has been doing to your body the last day or so.  These codes trigger the services that you will eventually be billed for.

Other costs include:

1. Transportation to Hospital (ambulance, taxi)
2. Nursing care
3. Meals
4. x-rays  (national average around $450)
5. Lab tests
6. physical services and physical therapy after treatment (not on hospital bill but something to consider)
7. Medications

Inpatient vs. Outpatient:

Inpatient care takes place at the hospital as a planned event.  Insurance providers will sometimes have a large deductible, and then cover all additional costs of the care and not treat each day as a new treatment and therefore, a new deductible.  Outpatient care takes place outside of a hospital and often doesn’t require hospitalization. It should be noted that insurance companies view these two types of care quite differently with different deductible and eligibility requirements.

How Much for Appendicitis and a Hot Meal?

This isn’t a balance sheet:  the numbers on either side sometimes don’t add up.  In a study by the Archives of Internal Medicine, the median charge for acute appendicitis admissions at 289 medical centers and hospitals throughout California ranged from $1,529 to almost $183,000!  There is no set price for surgery and don’t be surprised by a $39 box of Kleenex.  So what can you expect to pay?  Maybe the answer is:  the unexpected.  While insurance will cover a lot of the costs (more on that below), nobody on a big health insurance plan can seem to articulate the parameters.

Insurance Coverage:

In Network?  If you have the luxury to choose the hospital with which you will be admitted, it’s important to ask if it is in your insurance network.  Further, during your stay, make sure the services offered are covered each and every time a new service is being provided.

 As shown above, the costs vary widely between hospitals.  Some insurance companies allot $1,000 for one stay in the hospital during a coverage year.  While the $1,000 dollars certainly would no do much to cover the national average overnight stay of 15,734 (Comparative Price Report).

Co-Pay:

If insured, the co-pay is a small price to pay for the thousands of dollars saved.  Get savvy with your understanding of your insurance plan to know which you’ll be paying a $50 co-pay and when you’ll be paying a $50,000 tab.

Deductibles:

Assuming you have insurance (which is certainly a good idea) then an overnight stay, or any stay, is going to cost you some or all of your deductible for that service.  Here is a list of common premiums and deductibles.  Deductibles and insurance premiums have an inverse relationship:  the more you pay for a premium, the less you have in deductible.  The less you pay for a premium, the more you pay for a deductible.

Lost Income:

Not that an overnight hospital stay isn’t costly enough, the loss of income from not being able to work is often forgot about.  Unless your employer offers sick time (which even then is limited), an overnight stay at the hospital means no hourly wage.  Here is some information on collecting workers compensation and disability.

Discharged:

When you’re discharged from the overnight stay(s), you should request an itemized breakdown of the services and charges you can expect to be billed.  This might be tricky and it might try to be grouped like a shady business-expensed lunch.  Demand it itemized so you can clearly breakdown what your insurance company will pick up the tab for and what you’re going to be responsible for.  Overall, the question “how much is this going to cost me” can be complicated, but with some due diligence:  finding out which procedures are covered and which are not, itemizing our medical bills, and understanding in-network and out of network costs, you can be a savvy overnight guest in any hospital in the country.