Voices of healthcare consumers
Another Hoboken mom and I recently collaborated on our experiences getting our toddlers stitched up, to the tune of $1,690 at the ER vs. $279 at PromptMD. I thought it might be helpful to post our actual emails so readers can get a sense of the personal situations of the people behind the numbers. I developed my ER vs. PromptMD case study as if neither J nor I had health insurance because there is too much variation in copays and coverage. $1,690 is what those healthcare providers actually bill, the amount they get paid depends on their arrangements with health insurers.
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From: J
Subject: ER visit
Date: Wednesday, August 26, 2009, 12:42 PM
Kathy,
My insurance covered all but 10% of the hospital visit so I paid $95. Then 2 visits to pediatrician with copays of $15 each and another 10% on top which was only another $20 so total looked like $145. I was “lucky” that my son’s accident happened at daycare and the ambulance was called to attend to him first which I didn’t have to pay for (not sure how much that would have been). You can claim the Prompt MD visit with your regular insurance, they should have given you forms. When I have done this for my husbands recent visits I have received a significant portion back.
Despite the fact my son needed stitches, I did wait a while at the ER because we had to wait for the pediatrician who was busy upstairs in the childrens ward. I think I would probably do Prompt MD next time too, my husband raves about their service and I am tired of going to the ER (although haven’t been since the new one opened). My son has had his fair share of “incidents” in his short life 
J
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From: Kathy Zucker
Sent:Wednesday, August 26, 2009 1:31:31 PM
Subject:Re: ER visit
Thanks for the info, it sounds like you have much better insurance than we do. We used to have UnitedHealth (loved them) but my husband’s employer switched to Anthem Blue Cross this year to save money and they are horrible. We have the most expensive plan they offer, but we still have a $600 deductible (so we didn’t get anything back from my husband’s recent PromptMD visit for an infection) plus they only cover 70% after that.
It sounds like the total cost of your son’s stitches was about $950 for the ER plus the ambulance and the two ped visits. Yikes, that’s close to $2k in bills. When you compare that to the $279 PromptMD is charging, no wonder our healthcare system is going bankrupt.
Do you mind if I post your email (and mine) on my blog? I like to provide data whenever possible about ways to save money and time, and this is a biggie.
Kathy
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From: J
Subject: ER visit
Date: Wednesday, August 26, 2009, 2:00PM
That is fine with me Kathy. My son’s accident was in Nov last year and we had another big yr of medical expenses so had already met our $500 deductible and $2,000 out of pocket max by then. We are lucky with insurance through my job but am considering staying home next yr when #2 arrives and then we will be up for a lot more expense through my husbands job - yikes! My son just had his tonsils/adenoids out last week so think we are over the deductible/out of pockets again this year. Hoping #2 is a LOT healthier than #1.
