Without Car Insurance, You Could Be Paying Big for Your Hospital Stay

Without Car Insurance, You Could Be Paying Big for Your Hospital StayHospital visits can quickly accumulate staggering bills, leaving individuals grappling with financial strain in the aftermath of a car accident. The high costs associated with medical treatments, procedures, and even ambulance services underscore the importance of having reliable car insurance. A comprehensive car insurance policy can act as a financial safety net, helping to cover medical expenses resulting from accidents. From emergency room fees to necessary surgeries, having the right car insurance coverage can alleviate the burden of substantial healthcare costs, providing you with peace of mind and financial security during challenging times.

What affects my hospital bill?

If, after a car accident, you need to go to the hospital (which is advised even if you do not believe that you have an injury), you will likely end up being billed by the hospital for whatever services you end up receiving from them. Factors that may affect the bill you receive from the hospital, as per Texas Health Resources, include:

  • Whether the hospital has a standard charge per service or a negotiated package rate with each payor
  • Your insurance and other coverage limits (benefit plan design, deductibles, coinsurance, copayment, maximum out of pocket, provider network participation, etc.)
  • Specific covered benefits, eligibility, and medical necessity criteria
  • Coding, billing and reimbursement rules governed by complex insurance, managed Medicare, and managed Medicaid policies
  • If a field is indicated by “N/A”, the individual line from the list of standard charges, or a package rate, does not have a negotiated rate with the payor or is subject to the contract and claim processing guidelines based on the claim
  • Outlier and additional day payments are not included in the standard charges as those are evaluated at the claim level, not at the individual line level
  • Your specific health condition
  • Changes from initial request for service/procedure
  • Time spent in procedure, surgery, operating room and recovery
  • Your length of stay
  • Specific equipment, supplies, drugs, and/or implants used for your care
  • Unexpected additional tests, procedures or issues identified by the physician/surgeon during your care, or changes to procedures you receive

What can I expect to pay out-of-pocket?

Depending on what type of health or car insurance you have (or whether you have insurance at all), out-of-pocket prices may vary. To find the figures represented below, we used San Antonio’s Regional Hospital Out-Of-Pocket Estimator. There is a vast selection of different types of procedures and therapies and services on selection, but we chose the treatments you might expect to receive if you were in a car accident.

It should be kept in mind that this notice is given when using the estimator: “The estimate cannot be relied on as the final set cost for services you may receive as actual expenses can and will vary from patient to patient depending upon your physician’s treatment choices and your particular health care needs.”

So while these prices may not be exactly what you might see on your own hospital bill, it gives a good idea of what to expect.

  • Basic head injury. In the majority of car accidents, you may expect to have some injury to your head, whether it be a minor concussion or a traumatic brain injury, head injuries are a common injury seen from vehicle accidents.
    • In order to determine whether or not you have a brain injury, and to determine the type and severity of the brain injury, a CT scan is often required.
    • The estimator valued a CT scan alone would cost: $7,526.00
      • This does not include any type of treatment or therapy you might need once your head injury is diagnosed.
  • Broken arm. This is another common injury, and one you might expect after a car accident. The specific option we chose was “Closed treatment of broken forearm bone on small finger side at elbow with manipulation.” No invasive surgery. The results were shocking:
    • The estimator valued the treatment cost for the broken arm would cost in total: $51,611.55
  • Fractured hip. This is a more severe type of injury seen in car accidents, and often requires surgery. For the estimator, we chose “Hip replacement with principal diagnosis of hip fracture without major complications.”
    • The estimator valued the treatment of the hip replacement to cost in total: $92,636.40

The totals in some of these hospital visits included high prices of recovery rooms, and room and board:

  • Hip replacement. Semi-private room & board for four nights: $14,369.17
  • Broken arm. Recovery room: $5,293.00

Outside of the San Antonio’s Regional Hospital Out-Of-Pocket Estimator, we found other sources reporting similar prices for staying at the hospital. ValuePenguin stated “the average per-day hospital cost is $2,883, according to health policy research site KFF. Although that figure is already high, the average stay is 4.5 days, according to Definitive Healthcare — meaning Americans rack up $12,974 in bills during an average stay.” In Texas, the average hospital stay of four nights is about $13,109. So that estimator above may not be far off.

Forbes reports that “the average ambulance ride ranges from $940 to $1,277 depending on the level of care needed.” So you’re already accumulating bills before you even get to the hospital.

The cost of healing

Let’s say you’re back from your hospital visit, but now you have to take off time at work to heal. How long will that take and how much money will you lose? Now, if you work at a desk job, you may be able to return to work sooner than if you work at a construction site.

Taking our earlier example of a hip replacement, Johns Hopkins says this: “If you have a desk job with minimal activity, you can return to work in about two weeks. If your job requires heavy lifting or is otherwise tough on the hips, it is recommended to take off about six weeks to recover.”

According to DataCommons, the median individual income in San Antonio is about $26,586. That’s about $2,215 a month, and about $1,107 every two weeks. Depending on your rate of recovery and any complications you may come across, you may be having to miss out on a significant amount of income on top of having a huge hospital bill to pay.

How insurance can save you

Making sure you have the right insurance coverage is crucial after a serious car accident in Texas. While everyone needs the basic insurance required by the state, there are additional options that can provide more protection. Personal Injury Protection (PIP) is a helpful coverage that allows you to make claims regardless of who is at fault, providing at least $2,500 for medical bills and lost wages. It’s a good idea to consider getting more PIP coverage because it’s reasonably priced.

Uninsured/underinsured coverage (UM/UIM) is another important option. It protects you if you’re injured by a driver with inadequate or no insurance. You can buy UM/UIM coverage in amounts up to your liability coverage, giving you financial support when dealing with the aftermath of a serious accident. For those with financed cars, gap insurance is recommended. It covers the difference between what the insurance pays for a totaled car and what you still owe. These extra coverages go beyond the basics and provide valuable protection and financial security in unexpected situations.

Many Texas drivers opt for the minimum limits coverage, known as a “30/60” policy. Essentially, this policy offers a maximum of $30,000 in bodily injury coverage per person, with a cap of $60,000 in total coverage for bodily injuries in situations involving more than one injured person. Taking this into consideration with the prices we’ve listed on what you are likely to pay without insurance, having insurance can save you a lot of financial pain should you ever find yourself in a car accident.

None of us plan to get into car accidents. We hardly even consider it a possibility. But for far too many people, it is a harsh reality. The best way to ensure that you are not put in the unfair position of having to pay thousands upon thousands of dollars for diagnoses, treatments, hospital stays, medication, and physical therapy, is to make sure that you have good car insurance. The legal team at Pat Maloney: Accident & Injury Attorney are here to help you understand your options concerning your car insurance. To schedule a free consultation with an experienced San Antonio car insurance attorney at Pat Maloney: Accident & Injury Attorney, call us or use our contact form.