Average hospital stay cost per day with insurance

"The average insured overnight hospital stay costs about $11,700. But, this price tag varies significantly by type of insurance coverage (and if you have insurance coverage at all).

While this data shows that uninsured patients have a lower average hospital stay cost, it’s important to remember that insurance companies often set an out-of-pocket maximum. While your bill may be high, you’ll only be required to pay the amount your provider has set as your maximum.

In addition, most insurance companies will often negotiate your hospital costs, helping you get a discounted price compared to what you were originally charged."

The Bummer! game is a great way to give students an opportunity to make decisions based around insurance and see the outcomes!

Health insurance provides important financial protection in case you have a serious accident or sickness.

People without health coverage are exposed to these costs. This can sometimes lead people without coverage into deep debt or even into bankruptcy.

It’s easy to underestimate how much medical care can cost:

• Fixing a broken leg can cost up to $7,500

• The average cost of a 3-day hospital stay is around $30,000

• Comprehensive cancer care can cost hundreds of thousands of dollars

Having health coverage can help protect you from high, unexpected costs like these.

How a Marketplace health insurance plan protects you

When you have coverage, your plan protects you from high medical expenses 3 ways:

• Reduced costs after you meet your deductible Once your spending for covered services reaches your plan’s

  deductible

  The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

  , the plan covers part of your medical expenses. Marketplace plans cover between 60% and 90% of your covered expenses after you’ve met your deductible.
  • Example: If your plan has a $1,000 deductible, you pay the first $1,000 in covered services. After that, your plan pays between 60% and 90% of your covered expenses, depending of what kind of plan you have. You pay between 10% and 40% of the costs as

    coinsurance

    The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

    or

    copayments

    A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

    .

• Out-of-pocket maximum This is the total amount you'll have to pay no matter how much covered care you get in a plan year.

  • Example: If your plan has a $3,000 out-of-pocket maximum, once you pay $3,000 in deductibles, coinsurance, and copayments the plan pays for any covered care for the rest of the year. This provides important peace of mind and protection from very high medical costs.

• No yearly or lifetime limits Health plans in the Marketplace can't put dollar limits on how much they’ll spend each year or over your lifetime to cover

  essential health benefits

  A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services.

  Speak Up — Trauco said it’s helpful to become your own patient advocate. “If you are truly in need, write about it and talk about it,’’ Trauco said. “Contact your local newspapers and TV stations to get the word out. Good Samaritans are still among us and a medical expert may offer assistance to a patient at no cost. Tell your story because someone else is also living a parallel trauma.’’

  With the COVID-19 pandemic in its third year, the cost of healthcare and health insurance is on many people’s minds. Although health insurance is meant to protect us financially when we are sick or injured, the cost of a major medical expense like a hospital stay is still often unknown before the bill arrives in the mail.

  Here are a few infographics that show the average cost of hospital stay by type of insurance, including the costs associated for people without coverage. This article also looks at the cost of various medical procedures.

  Download the full infographic summary

  Disclaimer: The info represented in these infographics does not necessarily reflect the views of PeopleKeep, its staff, or its affiliate partners.

  

  How much does an average overnight hospital stay cost?

  The average insured overnight hospital stay costs about $11,700. But, this price tag varies significantly by type of insurance coverage (and if you have insurance coverage at all).

  Let’s break it down:

  

  How insurance helps

  While this data shows that uninsured patients have a lower average hospital stay cost, it’s important to remember that insurance companies often set an out-of-pocket maximum. While your bill may be high, you’ll only be required to pay the amount your provider has set as your maximum.

  In addition, most insurance companies will often negotiate your hospital costs, helping you get a discounted price compared to what you were originally charged.

  Take a look at what you might pay for each hospital bill without insurance:

  

  Even with insurance, hospitalization costs can be staggering. Sometimes, patients who received treatment at a hospital that’s out-of-network for their insurance company would get surprise medical bills. These surprise bills incurred additional healthcare costs for patients. In 2022, the No Surprises Act took effect, helping to eliminate or reduce many surprise bills across the country.

  Estimating your hospital bill costs

  Whether or not you have insurance isn’t the only thing influencing your hospital bill. Take a look at a few common factors that can play a part in how much you pay out of pocket:

  

  A smart way to get medical bills covered

  With the costs of hospital visits and overnight stays on the rise, it can be daunting to think about the price you’ll pay if you’re ever sick or in an accident. That’s where health reimbursement arrangements (HRAs) and health stipends can come in handy.

  HRAs

  If you’re an employer, an HRA allows you to reimburse your employees for their individual health insurance premiums and qualifying medical expenses with tax-free money. To learn more about how HRAs can help offset your employees’ medical bills, see the infographic below:

  
  If an employee has a medical bill from their hospital stay that qualifies for reimbursement, an HRA allows you to reimburse them up to their monthly allowance.

  See which medical expenses you can get reimbursed through your employer with an HRA

  

   

  Sources: American Hospital Association, 2021 | MD Save, 2021 | National Nurses United, 2020 | Healthcare Cost and Utilization Project, 2020, 2018 | Health Care Cost Institute, 2017

  If you own a small business with fewer than 50 full-time equivalent employees (FTEs), a qualified small employer HRA (QSEHRA), might work best for you.

  An individual coverage HRA (ICHRA) is an excellent option for businesses of all sizes that want more flexibility with their benefit, including the ability to create employee classes.

  HRAs aren’t just available for those with individual health insurance coverage. If you already offer a group health insurance plan, such as a high deductible health plan (HDHP), you can use a group coverage HRA (GCHRA) to supplement your policy. This ancillary benefit is also known as an integrated HRA.

  Not sure what HRA is best for you? Take our HRA quiz!

  Health stipends

  Another option for your organization’s health benefit is a health stipend. This taxable employee stipend allows you to reimburse your employees for their medical expenses up to a customizable monthly allowance. Health stipends work like an HRA but with fewer regulations.

  While an HRA is often a better choice for organizations looking to offer a health benefit to their employees, health stipends have their advantages. If your employees receive advance premium tax credits, they can use their benefits without affecting APTC eligibility. You can also offer stipends to more types of employees, such as international workers or independent contractors.

  See the difference between health stipends and HRAs with our comparison chart

  Conclusion

  The average cost of healthcare and health insurance continues to rise each year. This is especially burdensome for the uninsured.

  With personalized health benefits such as HRAs or health stipends, you can help your employees afford their medical expenses, including costs associated with hospitalization.

  If you’re looking to provide your employees with a health benefit, PeopleKeep can help. Our HRA and employee stipend administration software helps organizations like yours to easily set up their benefit in minutes.

  Schedule a call with a personalized benefits advisor today to see how a health benefit can fit your organization’s benefits package

  This blog article was originally published on November 21, 2013. It was last updated on April 26, 2022.