how much a doctor visit cost without insurance

How Much Does a Doctor Visit Cost With and Without Insurance?

Without insurance, medical care can get pricy fast. Where you live, what doctor you’re going to, and what tests you need will all figure into your doctor’s visit bill. In this article, we’ll break down those costs and give you some tips for saving money.

What Goes into the Cost of a Doctor’s Visit?

Geography is one of the biggest factors in the price of a doctor’s visit. Most medical facilities pass some of their overhead expenses onto their patients. If you live somewhere with a higher cost of living, like California or New York City, you’ll likely pay more for doctors’ visits. The practice has to pay more for utilities and rent, and those costs show up in your bill. For example, Mayo Clinic’s Patient Estimates tool quotes $846 for a 60-minute office visit in Jacksonville, Florida, but $605 for the same visit in Wisconsin.

Like the cost of living, supplies and equipment will also end up on your tab. Say you need a strep test, blood draw, or Pap smear. The supplies needed for the test plus the cost of the lab fees will all figure into the price.

Bills for the same exams and procedures can also vary depending on what kind of facility you’re going to. Smaller practices and public health centers are often a lot cheaper than university or private hospital systems. This is due in part to their buildings being smaller and their overhead fees being lower.

Price of Out-of-Pocket Doctors’ Visits

The cost of a doctor’s office visit also depends on what kind of doctor and the procedure you need to have done. For example, an in-office general wellness checkup will be cheaper than a specialist procedure. If you have an emergency, an urgent care center will be much more affordable than the emergency room.

Primary Care Physician — Physical Exam

Physicals usually include blood pressure readings, cholesterol measurements, and vaccines. Prostate exams for men and Pap smears and breast exams for women are also often included. Pediatric physicals focus on the growth milestones for your child’s age. Doctors check height, weight, sleep patterns, diet, and the vaccines required by public schools.

The range for a yearly physical can be anywhere from $100 to $250 or more without insurance. A CVS Minutecare Clinic may charge just $59 for a sports physical, but not all organizations will accept this as proof of physical health.

Primary Care Physician — Procedures

On top of the base cost for physical exams, you may have extra charges for any specific tests or procedures you need. According to the Cardiometabolic Health blog, the most common procedures in primary care medicine include bloodwork, electrocardiograms, and vaccines/injections.

Bloodwork is one of the biggest cost wild cards. Certain tests can run you from as little as $10 to as much as $10,000 . Large national labs like Labcorp offer pricing on their website, so you know what to expect going in. For example, Labcorp’s General Health Blood Test , which includes a metabolic panel, complete blood count (CBC), and urinalysis, costs $78.

Electrocardiograms or EKGs check your heart health and can find cardi ac issues. This quick procedure involves monitoring your heartbeat through electrodes placed on your skin. While it’s a painless and accurate way to detect heart conditions, the costs can add up without insurance. Expect to pay as little as $410 or as much as $1700 for this procedure, depending on local prices.

Vaccines are often required before sending your kids to school. The CDC publishes a vaccination price list annually to give you an idea of what to expect. For example, they quote $19-$132 for DTaP, $21 for Hepatitis A, and $13-$65 for Hepatitis B. The COVID-19 vaccine, however, is free of cost, regardless of insurance status.

Urgent Care Visit

If you have an emergency but are stable, urgent care is much cheaper than the emergency room. According to Scripps , most urgent care centers and walk-in clinics can at least treat dehydration, cuts or simple fractures, fever, flu, strep, and UTIs. Note that if you have chest pain, a serious injury, seizures, a stroke, or pregnancy complications, you should go straight to the ER .

For a base exam at an urgent care facility, expect to pay between $100-$150 . That price will go up depending on what else you need. For example, Advanced Urgent Care in Denver quotes $80 for an X-Ray, $50 for an EKG, $135 for stitches, and $5 for a urinalysis. In comparison, expect to pay $1,000-$1,300 for the same procedures in the emergency room.

How to Lower Your Out-of-Pocket Medical Costs

Healthcare expenses may seem overwhelming without insurance. Luckily, there are many resources available to help you cover the costs.

Free & Low-Cost Immunization and Wellness Clinics

For standard vaccines and checkups, look for local free or low-cost clinics. Check out The National Association of Free and Charitable Clinics’ search tool to find a location near you. Your city’s public health department should also offer free or low-cost vaccines and basic medical care services.

Certain large vaccine manufacturers also offer vaccine programs. For example, Merck’s patient assistance program offers 37 vaccines and medicines free to eligible patients. The program includes albuterol inhalers and vaccines for Hepatitis A, Hepatitis B, MMR, and HPV.

Cash Negotiations

Most health systems offer lower rates for patients paying cash. Some even have free programs for low-income families. For example, Heritage UPC in North Carolina has a yearly membership for low-cost preventative care. In Northern California, the Sutter Health medical system offers full coverage for patients earning 400% or less of the Federal Poverty Income Guideline .

As of January 1, 2021, all hospitals in the United States now have to follow the Hospital Price Transparency Rule . That means they have to list procedure prices clearly on their website. You can also call medical billing before your appointment to discuss cash pay options.

Federal Medical Payment Support

If all else fails, there are federal programs to help you cover the cost of medical bills.

Organizations like The United Way and United for Alice offer grants for ALICE (asset-limited, income-constrained, employed) patients. These are people living above the poverty level, making them ineligible for other government programs but below the basic cost-of-living threshold.

Medicaid is available for children, pregnant women, and adults under a certain income threshold. If your income is too high to qualify for Medicaid but you can’t afford private insurance for your children, you may be eligible for the Children’s Health Insurance Program (CHIP) to cover your children’s medical care.

Use Compare.com for the Best Doctors’ Visit Prices

Navigating bills for a doctor’s visit can feel overwhelming, but Compare.com is here to help. With our price comparison tool, you can search all clinic and doctors’ office prices in your area. Compare makes sure you’re prepared for the cost of your checkup long before you schedule your appointment.

Nick Versaw leads Compare.com's editorial department, where he and his team specialize in crafting helpful, easy-to-understand content about car insurance and other related topics. With nearly a decade of experience writing and editing insurance and personal finance articles, his work has helped readers discover substantial savings on necessary expenses, including insurance, transportation, health care, and more.

As an award-winning writer, Nick has seen his work published in countless renowned publications, such as the Washington Post, Los Angeles Times, and U.S. News & World Report. He graduated with Latin honors from Virginia Commonwealth University, where he earned his Bachelor's Degree in Digital Journalism.

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No Insurance? How to See a Doctor Without Insurance

Shop around, ask about cash discounts and consider community health centers and free clinics.

This article is based on reporting that features expert sources.

8 Tips for Getting Medical Care Without Insurance

Millions of people in the U.S. live without health insurance, a circumstance that can cause people to weigh the need to see a doctor against the cost. Unfortunately, many people will put off or do without medical care because they can't afford it, a decision that could jeopardize their health.

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While the Affordable Care Act has boosted the number of Americans with insurance, millions remain uninsured. In 2018, 27.5 million people – more than 8% of the U.S. population – were uninsured, according to the U.S. Census Bureau. Private health insurance covered 67% of Americans. Those without health coverage face the dilemma: Where can I go for medical care without insurance?

The Coverage Gap

In addition to the people who are uninsured, millions are underinsured, according to a survey by the Commonwealth Fund. Among people with health insurance, 29% were underinsured in 2018, compared to 23% in 2014, according to the fund's Biennial Health Insurance Survey: "People who are 'underinsured' have high health plan deductibles and out-of-pocket medical expenses relative to their income and are more likely to struggle paying medical bills or to skip care because of cost."

The survey found that 41% of underinsured adults reported they delayed needed medical care because of cost. By contrast, 23% of people with adequate insurance coverage said they delayed such treatment. Also, 47% of underinsured adults reported medical bill and debt problems.

Tips for Finding Affordable Medical Care

If you're uninsured or underinsured, here are eight strategies for finding affordable medical care:

• Research your eligibility for insurance.
• Shop around.
• Agree to a price in writing.
• Ask about a cash discount.
• Keep good records.
• Be prepared.
• Consider community health clinics.
• Think about urgent care centers.

1. Research your eligibility for insurance.

Depending on your situation, you might be eligible to buy individual health insurance coverage from the ACA marketplace or in the individual market, or you might qualify for Medicaid, Medicare or the Children's Health Insurance Program for your kids, says Kim Buckey, vice president of client services at DirectPath, a company that provides personalized health benefits education and enrollment services to large employers.

2. Shop around.

Prices for health care appointments and procedures vary dramatically, with differences of up to 2,000%, says Bill Kampine, co-founder and senior vice president, analytics and innovation, for Healthcare Bluebook. The company's client base includes municipal and large self-insured employers. It also offers a free online tool that individuals can use to comparison shop for health care services by region.

3. Agree to a price in writing.

4. Ask about a cash discount.

5. Keep good records.

6. Be prepared.

7. Consider community health centers and free clinics.

There are a number of health care providers that provide services at little or no cost to those who are eligible, says April Temple, an associate professor of health sciences at James Madison University in Harrisonburg, Virginia.

8. Also, think about urgent care centers.

Nationwide, there's been a meteoric rise in the use of urgent care centers in recent years. These facilities provide a higher level of care than what's available at some pharmacy retail clinics, but aren't equipped to provide emergent care for things like heart attacks and strokes. Urgent care centers can treat a wide array of maladies, including upper respiratory infections, bronchitis, diverticulitis; high blood pressure, food poisoning, sprains, minor fractures and lacerations. An urgent care visit typically costs around $150, according to Debt.org.

12 Common Medical Emergencies

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our  editorial guidelines .

Buckey is vice president of client services at DirectPath, a company that provides personalized health benefits education and enrollment services to large employers.

Kampine is co-founder and senior vice president, analytics and innovation, for Healthcare Bluebook. The company’s client base includes municipal and large self-insured employers. It also offers a free online tool that individuals can use to comparison shop for health care services by region.

Temple is an associate professor of health sciences at James Madison University in Harrisonburg, Virginia.

Tags: health insurance , Affordable Care Act , Medicaid , patient advice

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Cost Of A Doctor Visit Without Insurance

By: Smiljanic Stasha

Last modified: Sep 29, 2022

The cost of a doctor visit without insurance  can depend on many factors, such as the state, facility, treatment, etc. However, this article will give you an average cost of what you should expect when seeing a doctor without an insurance policy. 

How Much Is a Doctor's Visit Without Insurance?

Typically, your insurance coverage determines the cost of a doctor 's visit. So, how much is a doctor’s visit without insurance ? A doctor 's appointment costs between $300 and $600 if you don't have insurance, but this number might vary depending on lab tests, the facility, and the procedures performed during the visit .   

The Average Cost for a Doctor Visit by Speciality

The cost of a doctor 's visit is determined by whether or not you have health insurance and what your policy covers. The price will differ depending on several factors, including the kind of doctor you're going to. Additionally, the course of treatment will affect the price. For example, if laboratory testing is required. Therefore, the overall cost depends on what services you will get.

However, people should not avoid going to the doctor because of the cost, as their health should be a priority. If they put off receiving immediate help, it could cost them even more in the long run, both in terms of their health and money.  

Fortunately, you can still see a doctor and receive medical treatment such as preventive care, acute care, urgent care , or emergency care, even if you don't have health insurance. The tricky part is locating services that are within your budget. Community health clinics, walk-in clinics, and direct care providers are good places to start. 

Related: How Much Does a Psychiatrist Cost Without Insurance?

Services That You Will Receive

When you consider billable items like blood tests, x-rays, and ambulance rides, the costs of medical treatment quickly add up.

Diagnostics test costs vary widely depending on your location and region. According to the Healthcare Booklet, a blood count lab test can cost anywhere between $20 and $120, a chest x-ray can cost between $50 and $250, and a prenatal ultrasound can be between $90 and $500.

Related: How Much Does CT Scan Cost Without Insurance?

Related: How Much Does an MRI Cost Without Insurance?

Related: How Much Is an Ultrasound Without Insurance?

Can the Expense Be Reduced?

So, can you reduce a doctor’s visit cost without insurance? Fortunately, there are a couple of things you can do to reduce your costs. 

First, you should mention you are uninsured so the center can offer you the care that fits your budget. Secondly, you can also ask for a payment plan and strategically pay them off each month. Lastly, try to use prescription savings cards and look for drug samples or a generic version of your medicine. Overall, this should reduce the out-of-pocket price of your treatment. 

What Affects the Cost of a Doctor's Visit?  

Patients can now find out how much their health care services will cost through a handful of indicators. This is crucial information to have on hand because the expenses are usually lower than those of an urgent care facility or an emergency room. 

According to the Healthcare Bluebook, an ACL knee surgery in Grand Rapids can cost anywhere between $6,498 and $23,098. In Detroit, a gall bladder removal can range from $3,683 to $16,509.

Therefore, most of the time, in the US, the location where you get the health care dictates the cost of the care itself. So make sure you inquire about the costs of the place before going to stay within your budget. 

When seeing a doctor or another healthcare provider , almost all private insurance policies require the insured person to pay some money before the treatment. A primary care physician's visit usually costs $15 to $25 in copays. However, a specialist's copay will usually range from $30 to $50.

In some situations, the cost might be connected to the facility you visit . However, the cost should be mainly connected to the care you get or your insurance policy.

By facilities, we mean places like urgent care , emergency room, and doctor's office. If you go to a facility that is not included in your policy you might end up spending money out of your pocket.

Corruption Cost Over $500 Billion Every Year

We have to mention corruption, a global issue that impacts health systems globally. It can take various forms, but it always diverts resources away from patients, resulting in inferior treatment quality.

Corruption is estimated to cost the worldwide public health system around $500 billion every year. This is significantly more than is required to provide universal health coverage. Donors should support long-term, strategic approaches to health sector integrity grounded in a thorough understanding of the sector's dynamics and the roles of many actors.

Globally, 1.6% of annual deaths of children under five and more than 140,000 deaths can be explained in part by corruption. Corruption is a complex and multifaceted challenge that must be fought.

In Conclusion

Overall, it's hard to predict the exact cost of a doctor’s visit without insurance , but this article gives you a rough idea of what to expect. The cost depends on many factors and situations, but, as previously mentioned, you can take a couple of steps to reduce the cost. 

Additionally, try to have a health insurance policy if you don’t already. During these unpredictable times, it's always better to be safe and covered. 

Where to See a Doctor if You Do Not Have Insurance?

You can visit a doctor without insurance, but the costs will vary depending on your situation. Additionally, keep in mind that not all providers charge the same rates, so researching before visiting your local urgent care is recommended. However, always choose what’s best, not the cheapest.

Can Providers Refuse Treatment?

A doctor may refuse treatment to a patient in certain circumstances. However, they cannot refuse treatment when someone needs urgent care. For example, doctors in emergency rooms have a legal obligation to treat everybody who walks through the door.

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Cost of doctor visit by state

The following estimated costs are based on cash prices that providers have historically charged on average for doctor visit and will vary depending on where the service is done. The prices do not include the anesthesia, imaging, and other doctor visit fees that normally accompany doctor visit.

Need help to cover that price?

See how Sidecar Health insurance can help cover your medical needs.

What happens at a doctor's visit?

People go to the doctor for routine physical exams as well as acute care when they get sick or injured. Visits to the doctor are important for preventing disease and managing any health problems. During your doctor’s visit, the physician checks your blood pressure, temperature, and heart rate. 

Your doctor may listen to your heart, check your ears, nose, and mouth, and perform a physical exam. They may also ask you about your medical history and the medications you take. Your doctor may want you to have blood drawn for laboratory testing during your doctor’s visit.

How long should a doctor’s visit last?

It’s common for your entire visit to the doctor to take a long time. From start to finish, your appointment may take well over an hour . Many patients sit in the waiting room before being called back for examination.

How long you’ll wait depends on your specific doctor’s office and how busy they are. Once you’re in the exam room, the visit with your doctor will go quickly. On average, patients spend about 20 minutes in the exam room with their doctor.

Why are doctor visits so expensive?

Doctor's visits are expensive for several reasons, including their offices’ administrative responsibilities and the cost of medical services. Your doctor’s office has to work with different insurance companies and pay administrative staff trained in medical billing. Your doctor charges for their services, lab work, or imaging they run and may charge facility fees as well.

How much does a doctor visit cost without insurance?

Without insurance, your doctor’s visit can cost hundreds of dollars. On average, people in the U.S. pay just under $400 for their annual physical exam at a doctor’s office if they don’t have insurance. These costs include the provider fee for seeing the doctor and costs for any blood work or imaging that’s needed.

What are the signs of a bad doctor?

Know the warning signs of a bad doctor so you can avoid problems and get better medical care. One sign is if your doctor doesn’t listen to you or take your concerns into account during your visit. Another is if your doctor rushes through your appointment, not giving you the time needed to deal with your concerns.

A third warning sign is if your doctor doesn’t explain why certain tests or treatments are needed in a way you can understand.

What should you not tell your doctor?

Your doctor doesn’t need to know every detail about your life to provide proper care. But they do need you to be truthful about your health. You should never lie about the symptoms you’re experiencing or the medications you’re taking. If you aren’t taking medications as prescribed, your doctor needs to know. You don’t need to tell them health details they already know or give them any of your financial information.

Costs vary by specialty

The cost of a doctor visit could vary depending on the specialty. To see the cash prices for a specialist visit, type is a specialty.

* Savings estimate based on a study of more than 1 billion claims comparing self-pay (or cash pay) prices of a frequency-weighted market basket of procedures to insurer-negotiated rates for the same. Claims were collected between July 2017 and July 2019. R.Lawrence Van Horn, Arthur Laffer, Robert L.Metcalf. 2019. The Transformative Potential for Price Transparency in Healthcare: Benefits for Consumers and Providers. Health Management Policy and Innovation, Volume 4, Issue 3.

Sidecar Health offers and administers a variety of plans including ACA compliant and excepted benefit plans. Coverage and plan options may vary or may not be available in all states.

Your actual costs may be higher or lower than these cost estimates. Check with your provider and health plan details to confirm the costs that you may be charged for a service or procedure.You are responsible for costs that are not covered and for getting any pre-authorizations or referrals required by your health plan. Neither payments nor benefits are guaranteed. Provider data, including price data, provided in part by Turquoise Health.

The site is not a substitute for medical or healthcare advice and does not serve as a recommendation for a particular provider or type of medical or healthcare.

Find Urgent Care today

Find and book appointments for:.

• Urgent Care
• Pediatric Urgent Care
• COVID Testing
• COVID Vaccine

How Much Does Urgent Care Cost Without Insurance?

• For individuals without health insurance, the average trip to urgent care can cost anywhere from $150 to $200.
• Factors impacting urgent care costs include location and services provided.
• Free or discounted healthcare options exist, but urgent care is not entirely free without insurance.

How Much Is Urgent Care Without Insurance?

Finding affordable urgent care, uninsured self-pay costs at urgent care, how much is urgent care without insurance in california, how much is a physical at urgent care without insurance, how much is std testing at urgent care without insurance, is urgent care free without insurance, going to urgent care without insurance, when should i go to urgent care, when should i go to the emergency room instead of urgent care, how can i reduce my out-of-pocket cost of urgent care, solv can help you find an urgent care clinic near you.

• Frequently Asked Questions

When you have a pressing medical issue, your first priority is getting to see a doctor, quickly. Getting an appointment with your primary care provider can be difficult on short notice—especially if you need to be seen during “off-hours” on the weekend, in the evening, or even on a holiday. The great news is you don’t have to have an appointment to see a medical provider at urgent care centers .

Urgent care clinics offer high-quality medical care and extended hours, as well as pricing that is usually more affordable than a visit to the emergency room.

If you don't have health insurance, healthcare costs may be a huge concern. Based on data collected for Solv ClearPriceTM (for individuals without health insurance) the national average for a base visit to an urgent care can cost about $150.

Depending on the specific services you need and the severity of your injury or illness (as well as the location of the clinic), that price could increase to $350+ in total. That’s still cheaper than an emergency room visit, which can cost upward of $2,600 on average, according to United Health.

Factors That Impact the Cost of Urgent Care

The actual cost of an urgent care visit can be difficult to pinpoint because each clinic charges different prices based on the services you need and the fluctuating national averages of healthcare services. Here are a few of the main factors that may affect your urgent care costs , based on internal Solv research.

Urgent care location

The location of your preferred urgent care clinic has an impact on your cost of treatment. According to data from Solv ClearPriceTM, the service prices at urgent care clinics vary from city to city and from rural locations to urban locations.

Services provided

The range of services that any urgent care provides to you will depend on your condition and the severity of your condition. These services have a big impact on the overall cost of your visit. Things like x-rays , laboratory tests, stitches , and bandaging all come at a cost.

According to the Mayo Clinic, some urgent care locations use a pre-defined level of care to calculate the cost of your visit. There are typically three to four different levels of care. Standard care visits for minor problems like earaches and sore throats are on the lower end of the cost spectrum—usually considered level 1 or level 2. But if you break a bone, require stitches, or have a more severe medical issue, that would be considered a level 3 or 4 visit.

Urgent Care Cost vs. Emergency Room Cost

Compared to emergency rooms, urgent care is often much more affordable for minor illnesses and injuries. According to Debt.org, an emergency room visit can run you around 10 times more expensive than a visit to an urgent care clinic.

If you don't have insurance, finding affordable urgent care is important. Below are some tips from Solv for finding the most cost-efficient urgent care clinics.

• Research low-cost clinics in your area - Look for clinics in your area that advertise low costs or fees based on a sliding scale.
• Consider telemedicine - Some urgent care clinics offer virtual urgent care visits for a lower cost than in-person visits.
• Ask about payment plans - Some urgent care clinics offer payment plans to help patients manage the cost of their care.
• Compare prices - Call different urgent care clinics in your area and ask about their prices. You may be able to find a clinic that offers a lower price for the same services.

Even if you do not have insurance, you can still receive medical care at an urgent care clinic. However, you will need to pay for services you receive on your own—this is known as “self-pay”. As we mentioned above, the cost of these services will depend on the urgent care you visit and the type of care you need.

Benefits and Drawbacks of a Self-Pay Option

The self-pay option at urgent care can be beneficial because you can get medical care without the hassle of dealing with deductibles, copays, or other insurance-related fees. Additionally, there may be some urgent care clinics that offer discounts for self-pay patients .

However, a drawback of the self-pay option is that the cost of medical care can be expensive. With a base cost of around $150, according to SolvClearPriceTM, and additional costs for tests and treatments, the bill can quickly add up.

Uninsured Self-Pay Costs vs. Insured Co-Pay Costs

If you have insurance, the cost of urgent care visits will depend on your coverage. You may have to pay a copay for each visit, and if you have not met your deductible, you may need to pay the full cost of the visit until you do.

In comparison, the self-pay option can be more expensive than insurance—but not in every case. If you have health insurance, you can review your plan documents or call a representative to find out what your co-pay and deductibles are.

If you’re in California and thinking about going to urgent care, you can expect prices that are near national averages, according to Burbank Urgent Care. However, you should remember that the cost of your visit will vary depending on the type of care you need and where you go for treatment.

A physical exam may also be known as a “routine check-up”. According to the Mayo Clinic, it is useful to help evaluate your overall health and help prevent you from developing a chronic health condition (like diabetes or heart disease).

Physical exams involve a series of tests and assessments to check for potential health problems, such as high blood pressure, high blood sugar, or signs of cancer. A physical exam can also help to identify any risk factors that may contribute to the development of certain health conditions (like obesity or family history).

According to Forbes, the cost of getting a physical exam at urgent care is around $138 on average. It's important to note that additional tests or treatments may be necessary based on the results of your physical exam, which can increase the overall cost of your visit.

If you’re due for your annual physical and your primary care physician is booked out for a while, going to urgent care can be a good option for you.

STD testing is an important part of maintaining good health. The CDC recommends that sexually active people get tested at least once a year for common STDs. Urgent care clinics are a fast and cost-effective way to get STD testing. A huge benefit to getting tested at urgent care is that you can get treatment right away if you test positive.

The average cost of STD testing at urgent care can vary depending on the type of tests you get and the location of the clinic. The cost may be higher if you need additional tests or treatments.

Healthcare costs are a concern for many people, especially if you’re uninsured. While urgent care is generally more affordable than an emergency room visit, it's not free. However, there may be some free or discounted healthcare services available to you, if you meet certain criteria. These include things like planned parenthood, public health, or student health centers if you are enrolled in a school, college, or university.

Free Healthcare Options

Some communities offer free or discounted healthcare services, for some things. These services are usually paid for through government grants or run by volunteers, according to the National Association of Free and Charitable Clinics (NAFC).

The range of services provided by these centers varies, depending on their location and the scope of practice of those who work there. Those who are eligible to receive care will also vary, depending on each clinic or health center. In general, the NAFC notes that you may need to meet certain income or residency requirements. However, there are some health centers that will provide services to anyone.

Free Health Services vs. Urgent Care

While free health services may be a good option for some patients, it's not a substitute for establishing care with a primary care physician and not a substitute for getting emergency care if you need it, advises the NAFC.

If you don't have insurance, getting medical care can be expensive and stressful. However, urgent care clinics can offer affordable payment plan options for those who need immediate medical attention.

When you visit an urgent care center without insurance, there are a few things you should keep in mind. First, it is important to bring all the necessary documents with you that you may need. These include:

• Your identification
• Your mailing or billing address
• Contact information for your next of kin
• Your medical history and a list of any medications you take
• A form of payment

If you’re wondering how much you may have to pay after your visit, give the urgent care a call before you go and ask about their fees and what their payment options are.

Urgent care clinics are designed for people with a medical concern that is urgent but not necessarily an emergency. According to Solv’s Chief Medical Officer, Dr. Rob Rohatsch, these non-emergency conditions can include:

• Cuts, minor burns , and rashes
• Fever, cough , and sore throat
• Ear infection
• Insect or animal bites
• Mild asthma
• Immunizations
• Falls, sprains, and broken bones

Additionally, some urgent care clinics offer limited lab tests, including:

• Blood tests
• Pregnancy tests
• Drug screening
• Strep and flu tests

Although urgent care is not a replacement for seeing your primary care physician, it can be an excellent choice if you are unable to wait for an appointment with your PCP.

If you are experiencing symptoms of a potentially life-threatening condition, you should go immediately to an emergency room for care, the Mayo Clinic. These include symptoms of conditions like:

• Heart attacks
• Severe asthma attacks
• Traumatic injuries
• Severe allergic reactions
• Severe respiratory illness

In some cases, if you go to an urgent care clinic and the healthcare professionals there determine that you need more specialized care, they will refer you or transfer you to a nearby emergency room.

You are the best advocate for your healthcare and your finances—so before you head to urgent care, it is perfectly acceptable to contact the clinic and ask questions to get a better idea of how much the visit will cost. Calling ahead can also help you determine if you need to go to urgent care or if your medical condition can be addressed in a telemedicine appointment.

Some questions you may want to consider are:

• How much is the office visit fee?
• What additional expenses will I be charged?
• Do you think I will need tests and, if so, what is the cost?
• Do you think I will need an X-ray and, if so, what is the price?

You can get a better idea of what you’ll be charged for an urgent care visit using Solv’s ClearPriceTM online tool. This tool can help you save money on healthcare even if you have health insurance because it gives you an idea of the average “self-pay” rates at a clinic.

If you’re looking for an urgent care clinic, our lab finder can help you find an urgent care clinic near you.

Solv’s telehealth services providers can also help you assess your injury or illness to determine if you need to go to an urgent care clinic and then get you connected with referrals and follow-up appointments.

Frequently asked questions

Do i need an appointment to visit an urgent care center, how much does an urgent care visit cost without insurance, how does the cost of an urgent care visit compare to an emergency room visit, what factors can affect the cost of an urgent care visit, how can i find affordable urgent care if i don't have insurance, what are the benefits and drawbacks of the self-pay option at urgent care, what are some conditions that can be treated at an urgent care clinic, when should i go to the emergency room instead of urgent care.

Michael is an experienced healthcare marketer, husband and father of three. He has worked alongside healthcare leaders at Johns Hopkins, Cleveland Clinic, St. Luke's, Baylor Scott and White, HCA, and many more, and currently leads strategic growth at Solv.

Dr. Rob Rohatsch leverages his vast experience in ambulatory medicine, on-demand healthcare, and consumerism to spearhead strategic initiatives. With expertise in operations, revenue cycle management, and clinical practices, he also contributes his knowledge to the academic world, having served in the US Air Force and earned an MD from Jefferson Medical College. Presently, he is part of the faculty at the University of Tennessee's Haslam School of Business, teaching in the Executive MBA Program, and holds positions on various boards, including chairing The TJ Lobraico Foundation.

Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

• What Are My Care Options and Their Costs? (July 23, 2023) https://www.uhc.com/member-resources/where-to-go-for-medical-care/care-options-and-costs
• Emergency Rooms vs. Urgent Care Centers. (July 23, 2023) https://www.debt.org/medical/emergency-room-urgent-care-costs/
• How Much Does An Urgent Care Visit Cost In 2023? (July 23, 2023) https://www.forbes.com/advisor/health-insurance/urgent-care-cost/
• Strep Throat. (July 23, 2023) https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338
• Physical Exam. (July 23, 2023) https://my.clevelandclinic.org/health/diagnostics/17366-physical-examination
• STDs. (July 23, 2023) https://www.cdc.gov/std/prevention/screeningreccs.htm
• NAFC. (July 23, 2023) https://nafcclinics.org/get-involved/volunteer/
• Competitive Pricing at Burbank Urgent Care. (August 2, 2023) https://www.burbankurgentcare.com/prices
• telemedicine
• healthcare costs
• urgent care

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Heath Care Pricing Transparency and Consumer Rights: Asking about costs

• Health insurance cost estimator
• Shoppable services
• Good faith estimate
• Standard charges
• Asking about costs
• Checking bill accuracy
• Disputing a charge
• Negotiating and paying the bill
• Beyond the appeal

Be proactive with conversations about costs.  Bring up the topic with your doctor and let them know if you prefer to research prices before scheduling services or filling prescriptions.

Discussing costs during a visit

TIPS FOR SCHEDULING CARE...

• The government has passed laws allowing some preventative care services at no charge.  Check your insurance policy coverage and additional details at CDC.gov .  You can schedule a preventative care or "wellness" visit, but be sure to mention it to your doctor as well, because some types of conversations go outside the preventative care boundaries, and you could be charged for the visit.
• Tell the doctor you would like to get a  good faith estimate
• See if it is included in the provider's  shoppable services
• Check your  health insurance cost estimator  website to compare prices with other providers
• Search for the billing codes in the provider's machine-readable  standard charges file
• Read this patient guide to surprise medical billing protections you can use now (source: PIRG)

WHILE WITH YOUR DOCTOR...

• If the doctor starts to write a prescription, use your phone to check the price for that drug on your pharmacy benefits website or app (for example, Express Scripts).  Also check GoodRX for competing prices.  If the drug seems expensive, you can ask the doctor if there are less costly alternatives that would work just as well for your condition.  GoodRX allows searching by health condition.
• Some doctor visits use time-based billing (priced by the number of minutes).  In other settings, charges are based on the complexity of medical decision making.  If possible, you could raise this topic while with your doctor so that when the bill comes, you'll know what level of medical decision making to expect on your bill.

Additional resources

• Patient guide to surprise medical billing protections Tip: ask "Are you part of my plan's network," not "Do you take my insurance?" The latter could get you billed at out-of-network rates. Source: PIRG.
• Be aware of facility fees Doctor offices, urgent cares, imaging centers and other such centers owned by hospitals may add an unexpected hospital "facility fee" to the bill. This article tells more about it.

• << Previous: Standard charges
• Next: Checking bill accuracy >>
• Last Updated: May 21, 2024 4:31 PM
• URL: https://libraryguides.missouri.edu/price-transparency

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How Much Does A Dermatologist Visit Cost Without Insurance?

• April 27, 2023

Regular visits to the dermatologist are essential as they can help identify problems, such as skin cancer, early. If, like most people, you rarely visit the dermatologist, you might be wondering how much a dermatologist visit costs without insurance.

Well, the cost of seeing a dermatologist without insurance varies depending on various factors, such as the type of treatment you need and the location of your provider. Generally speaking, an initial consultation will cost about $221. 

In this article, we’ll discuss the cost of visiting a dermatologist without insurance, when to see a dermatologist, and some helpful tips for saving on cost.

What Does A Dermatologist Visit Cost Without Insurance?

Studies show that about 31.6 million Americans are uninsured. Do you fall under this category? Then you might be wondering how much your upcoming visit to the dermatologist will cost.

On average , people who pay out-of-pocket spend about $221 for every visit . This excludes other direct and indirect costs associated with the visit.

Let’s take a look at the additional costs of visiting a dermatologist.

Procedure Costs

Aside from the initial consultation fees, you might have to pay for other procedures. Your dermatologist might order some procedures such as cryosurgery to treat various non-cancerous and cancerous growths. 

The cost of the procedures varies based on factors such as the methods and durations they take.

Here are some common dermatologist procedures and how much they cost without insurance:

• Cryotherapy to remove abnormal tissue: up to $425
• KOH Test for diagnosing a fungal infection: up to$9.89
• Mohs micrographic surgery treatment for skin cancer: up to$5000

Prescription Costs

Once your dermatologist completes a check-up, they might prescribe medication, such as creams, ointments, and antibiotics. Prescription costs will vary depending on the type and dosage of drugs prescribed to you. 

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Aside from type and dosage, other factors also affect the cost of prescription drugs such as inflation and drug patents and exclusivity. This means that if your dermatologist prescribes a drug that’s patented, it might cost you more. The reason being that companies that make generic drugs cannot make a patented drug.

Let’s look at the price range of common prescriptions without insurance:

• Benzoyl Peroxide: up to $28
• Minocycline Er 55 mg: up to $1002
• Clindamycin: up to $400

Factors That Affect The Cost Of Dermatology Appointments

Other indirect factors, such as your insurance plan, can also affect the overall cost of your appointment. Here are a few factors that can influence pricing:

Frequency Of Visits

Healthy individuals might only need to see a dermatologist once or twice a year. You might visit a dermatologist more often if you have the following: 

• A stubborn rash
• Eczema 
• Recurring skin infections
• Severe acne
• Skin cancer

Regular visits mean you’ll have to pay multiple fees per year, which can be expensive if you don’t have insurance coverage.

The area a dermatologist practices in contributes to how much they charge for a visit. For example, dermatologists in rural areas usually charge less than those practicing in major cities as major cities require higher rent and wages. Also, a location with several dermatologists might have more competitive prices.

According to a report by the American Association of Medical Colleges , there’s a growing nationwide shortage of medicine sub-specialists, including dermatologists. By 2034, the shortage is expected to be about 13,000 doctors. 

This means that people will have to wait long durations to get an appointment, and those in rural areas may have to spend more on fuel to travel to the nearest dermatologist.

Specialties

Dermatologists who specialize in rare skin conditions charge more for their services. Specialist and subspecialist dermatology are less competitive than general dermatology, which means these specialists usually charge higher fees than general dermatologists.

When To See A Dermatologist

Your skin is the number one guard against infection and bacteria. Therefore, any time is the best time to see a dermatologist for preventative care and overall skin health. But, if you notice inflammation or something unusual on your skin, get it checked out immediately. 

When you go in for an exam, the dermatologist might diagnose your skin condition by just looking at it. Alternatively, they may conduct a full skin examination and use a dermatoscope or a handheld lens to further examine your scalp, nails, and skin. 

Here’s when you should see a dermatologist:

Skin Tags And Moles

Skin tags and moles can get in the way of you having clear skin, but they are usually nothing to worry about. 

Often, they don’t require medical care. However, if you notice a change in the shape, color, and size of your moles or skin tags, it’s best to see a dermatologist immediately. 

Such changes could be symptoms of skin cancer – and with cancer, the earlier you begin treatment, the better.

Stubborn Rashes Or Itchy Hives

Stubborn rashes or itchy hives on your legs, hands, or any other part of your body can signify an infection or an allergic reaction. A dermatological check -up can help determine the right course of treatment.

Skin Or Nail Infections

Do you get skin infections regularly? These infections can be caused by bacteria, fungi, or other microorganisms living on your skin. 

If you notice warts, fungal infections, or something else on your nails, visiting a dermatologist can help determine the issue and how to treat it. 

If you find more hair in your hair brush, pillow, or shower than usual, you might need preventative care for hair loss before it worsens. Let a dermatologist assess what’s going on, determine the cause of your hair loss, and prescribe a treatment plan, such as laser therapy.

Stubborn Acne

If you have stubborn or severe acne, it is best to see a dermatologist to determine the best course of treatment. 

Trying at-home remedies might worsen the acne or lead to lots of scarring. This is because at-home remedies don’t guarantee safety and fail to address the root cause of the acne. Your dermatologist might prescribe oral antibiotics or topical creams that could help clear up your skin.

Age Spots And Wrinkles

If you’d like to keep your skin supple, consider seeing a dermatologist as soon as you notice age spots or wrinkling. 

Dermatologists can recommend therapies, creams, and serums that will help reduce the appearance of wrinkles, sun damage, and sagging skin while boosting collagen production. These include chemical skin peels, light therapy, and laser skin resurfacing.

Tips for Saving Costs When Choosing a Dermatologist 

Would you like to save on costs when choosing a dermatologist? Healthcare costs can add up quickly, even when you have insurance. Luckily, there are many ways that you can save some money when seeing a dermatologist.

The following tips could help you keep the cost of a dermatologist visit as low as possible:

• Research prices and services before scheduling an appointment. Doctors don’t charge the same fees for their services, meaning you can find one whose prices are within or close to your budget. Ensure you compare various pricing models to find the best one for your needs. 
• Take advantage of free screenings or discounts . Many clinics offer free or discounted screenings for their services. Ask your doctor if they offer any discounts and take advantage of them.
• Use telemedicine platforms. Consider video and phone visits with a dermatologist if you don’t need to get examined in person. Telemedicine platforms are usually much more affordable than traditional in-person visits and can help you save on travel costs.  
• Payment plan settlement. Go for a dermatologist who accepts sliding scale fee payment plans, medical credit programs, or installments. With such plans, you can pay for your visit over some time rather than at once, which may be more manageable for your budget.
• Find financial assistance. Check out health programs in your area that provide financial assistance for those who need medical care but cannot afford it, such as free clinics.

The best way to save on dermatological costs is by having insurance coverage. Insurance gives you access to discounts on treatment and medication costs. 

If you’re looking for the best insurance plan to meet your personal needs, let Enhance Health help you. We provide advice and help people throughout the insurance application process. Get in touch with us today to enjoy the best healthcare coverage.

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He went to get medication for ADHD. MercyOne charged him nearly $1,500 in facility fees.

Colby Grabill only recently started to grasp the link between his untreated ADHD and depression, and was referred by his physician to a MercyOne psychiatrist last year to get medication to help.

He said he went to three appointments from July to October at the hospital’s behavioral health center in Des Moines ― the first for about a half hour, the others lasting about 10 to 15 minutes.

When the 35-year-old father of six finally got bills for those visits, he said, he thought surely there’d been a mistake. Cigna Healthcare paid all but $20 of the $150 doctor bill for each visit, but Grabill was told he was personally responsible for paying $488.78 in hospital facility fees to MercyOne for each visit. For all three visits, the amount due was $1,466.34.

More: Biden is targeting the ‘junk fees’ you’re always paying. But it may not save you money.

“At first, I was in a little bit of a panic, but I just thought it was an error. Something must have gotten screwed up,” he said. “By the time I realized this was legitimate, I was just flabbergasted. I couldn’t believe they could charge me that much.”

The sticker shock that caused Grabill and his wife to contest the bill with MercyOne is being felt across the country.

Hospital facility fees increase dramatically for variety of care

While federal regulations have long allowed hospitals to charge patients a facility fee to offset the cost of providing care, those fees have been increasing dramatically and have expanded from emergency rooms to outpatient clinics, online telehealth visits, surgery centers and off-campus doctor’s offices owned by hospitals and their health systems, health care research has shown.

From 2004 to 2021, facility fee charges increased by 531%, according to an analysis of industry data from the  Peterson-KFF Health System Tracker , an online information hub that monitors and assesses the performance of the U.S. health system. That was four times faster than increases to professional fees for emergency department evaluations and management services, which rose 132% during the same span.

Hospitals have said facility fees are needed to provide round-the-clock care to patients, regardless of their ability to pay, and that they pay a high price to provide that care.

The American Hospital Association says overall median hospital operating margins were negative through 2022 and into the beginning of 2023, and Medicare pays only about 84 cents on the dollar for the cost of care provided to beneficiaries.

But facility fees also have become a big reason why consumers are finding it increasingly difficult to pay their medical bills. The fees can far exceed those for the care itself and often aren’t covered by insurance. Especially vulnerable are those who need to meet high deductibles before insurance starts to cover some of the bill.

Grabill said he signed a form all patients are required to sign before his visits saying he would pay for his medical care. But he wasn’t told ahead of time about the facility fees ― or that other providers not under the hospital's ownership could render the same service without those fees.

Specifics on facility fees not readily available from Iowa's largest providers

A federal rule that went into effect in January 2021 requires all hospitals operating in the United States to provide clear, accessible pricing information online about the items and services they provide. The goal was to make it easier for consumers to shop and compare the cost of care before going forward.

More: Hidden hospital prices harm patients: Can this new pricing tool make a difference?

But getting hospitals to comply with that rule, which is poorly enforced, has been an issue across the country, numerous media outlets have reported.

MercyOne, UnityPoint Health and the University of Iowa Hospitals & Clinics, Iowa’s largest medical providers, declined to provide Watchdog with a list of their facility fees or to say where those fees aren’t charged. They also did not respond to a question about whether they post anywhere online how much facility fees will be at hospital-owned providers.

Watchdog checked websites for all three and found that while fees for some individual services are disclosed, facility fees are not.

Neither Eve Lederhouse, listed online as MercyOne's communications director, nor Todd Mizener, its public relations manager, responded to several calls and emails related to the facility fees.

MercyOne’s website refers people to its insurance and Medicare handbooks to learn what’s covered and what’s not. It has an online price estimator , but the link doesn’t work for Des Moines.

UIHC tells people they will be charged facility fees for rooms, equipment, tests and labs , but it doesn’t say how much those fees are. Instead, it tells consumers online to review their health plans or call their insurers.

Kevin Kirkpatrick, spokesman for UnityPoint Health, sent Watchdog a statement saying the company provides services and tools that make it easier for patients to understand their costs, pay their bills, learn about coverage options or get financial assistance when needed.

But nothing on its webpages details the amounts of facility fees, and those fees ― included in the price of procedures ― aren’t included in its self-service cost estimator tool.

The Iowa Hospital Association has a service online called Hospital Charges Compare , but that provides only data based on average charges for procedures and services. It’s based on what’s coded for claims processing.

When asked about facility fees, Craig Borchard, the association's vice president of communications, said that "if 'facility fees' means charges for an inpatient or procedure room, you’d have to get that from the hospitals."

Advocacy group: Voters want clear information on medical charges

Voters are in favor of requiring transparency in medical billing, eliminating facility fees and mandating uniform prices for service, regardless of where a patient seeks care, according to the Washington, D.C.-based national research and affordable health care advocacy organization United States of Care.

A 2023 poll for the group found 74 % of voters  supported banning facility fees everywhere for outpatient, same-day services, and  81% wanted medical providers to disclose their facility fees upfront to patients, before they are treated. The poll was conducted by Morning Consult and had a reported margin of error of plus or minus 2 percentage points.

In December, the U.S. House of Representatives passed the bipartisan  Lower Costs, More Transparency Act , which would require that hospitals, insurance companies, and other health care facilities publicly list the prices they charge patients. The bill also includes a reform that would require the same price for drug administration under Medicare at an outpatient setting. The policy, known as “site neutral payment,” has been opposed by organizations like the American Hospital Association.

Committees in the Senate, meanwhile, also have discussed banning facility fees and instituting site-neutral payment reform.

“There’s a constellation of activity happening, and pretty remarkable progress,” said Lisa Hunter, senior director for policy and external affairs at United States of Care.

In an interview with watchdog, Hunter said hospitals have been buying up independent doctor practices and outpatient services at a rapid pace because Medicare for years has allowed upcharges for services at hospitals’ off-campus facilities.

United States of Care's research found that when a hospital acquires an independent physician’s practice, the prices patients pay increase on average 14%.

“There’s other research on this with cancer patients or those who receive IV drugs” at outpatient clinics, Hunter said. “They are hit with 20% more of an out-of-pocket cost. The differential in what is being charged is outrageous.”

In the meantime, several states have passed measures aimed at controlling facility fees.

“Some states are banning facility fees for things like preventive services, or some have for telehealth,” Hunter said. “Some states are wading in a little more delicately because the data around this is very uneven and highly variable depending on where you are.”

In recent years, no one in the Iowa Legislature has taken any steps to limit or eliminate facility fees, or to make them more transparent to health care consumers, she said.

Grabill said he and his wife are still waiting to see what MercyOne will ultimately do about the facility fees the health system tried to charge him. He said his bills have been resubmitted to the hospital for review.

Officials from Iowa's Department of Insurance said they would acquaint Grabill with another new federal law, the No Surprises Act , which prevents insurance companies from forcing consumers to pay too much for unexpected bills in some circumstances.

The act, which went into effect in 2022, protects patients from surprise bills for covered emergency out-of-network services, including air ambulance services (but not ground ambulance services) and for covered non-emergency services at an in-network facility. It also protects patients from surprise bills from a facility, such as a hospital or freestanding emergency room, or a provider, such as a doctor, for in-network coinsurance, copays, or deductibles for emergency services, even if the facility or provider is out-of-network.

Grabill said he would have shopped around had he known three simple visits were going to cost him so much.

"I can't believe they are just dumping these huge costs on people," he said. "I don't know how people are tolerating this. ... I'm still not OK with paying it."

How to fight facility fees

Before you see a new provider, ask your insurer if it covers facility fees. If so, ask what portion of those fees will be covered and how much you will be responsible for paying.

When your doctor refers you to a new provider or specialist, ask whether the provider is hospital-owned or works for the same hospital health system.

More: Worried about what you'll pay for hospital care? These tips may help you get a better deal

When you make an appointment, ask whether you will be charged a facility fee. If there is one, ask if there is another location where you can go where a facility fee isn't charged. Some doctors may practice at a location that doesn't charge one.

It's difficult to fight facility fees because they are legal in most places. But you can always talk to the health care provider about waiving or lowering the fee. You can also appeal to your insurer to cover more of the cost.  

For more about the No Surprises Act, go to iid.iowa.gov and search for No Surprises Act.

Lee Rood's Reader's Watchdog column helps Iowans get answers and accountability from public officials, the justice system, businesses and nonprofits. Reach her at  [email protected] , at 515-284-8549, on Twitter at  @leerood  or on Facebook at  Facebook.com/readerswatchdog .

Low cost MRI for $399 available without a doctor's order and without insurance

By taylormed mri | posted - may 14, 2024 at 3:00 p.m., (taylormed mri).

Estimated read time: 3-4 minutes

You're not imagining things if you feel that healthcare costs have shot up in the last few years.

In fact, medical costs have inflated even more than other sectors. According to Health System Tracker data from Peterson-KFF, medical care costs have increased 114.3% since 2000, while the costs of all goods and services have increased 80.8% since 2000.

And when you're dealing with an injury or chronic pain the typical process of visiting the doctor, then perhaps going to a specialist before getting an MRI can take weeks. One Utah clinic has found a way to bypass the headaches of waiting for a doctor's appointment and dealing with the hassle of insurance.

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Low cost MRI for $399 doesn't require a doctor's order and without insurance

You're not imagining things if you feel that healthcare costs have shot up in the last few years. In fact, medical costs have inflated even more than other sectors. According to Health System Tracker data from Peterson-KFF, medical care costs have increased 114.3% since 2000, while the costs of all goods and services have increased 80.8% since 2000. And when you're dealing with an injury or chronic pain the typical process of visiting the doctor, then perhaps going to a specialist before getting an MRI can take weeks. One Utah...

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The Possible Collapse of the U.S. Home Insurance System

A times investigation found climate change may now be a concern for every homeowner in the country..

This transcript was created using speech recognition software. While it has been reviewed by human transcribers, it may contain errors. Please review the episode audio before quoting from this transcript and email [email protected] with any questions.

From “The New York Times,” I’m Sabrina Tavernise. And this is “The Daily.”

[MUSIC PLAYING]

Today, my colleague, Christopher Flavelle, on a “Times” investigation into one of the least known and most consequential effects of climate change — insurance — and why it may now be a concern for every homeowner in the country.

It’s Wednesday, May 15.

So, Chris, you and I talked a while ago about how climate change was really wreaking havoc in the insurance market in Florida. You’ve just done an investigation that takes a look into the insurance markets more broadly and more deeply. Tell us about it.

Yeah, so I cover climate change, in particular the way climate shocks affect different parts of American life. And insurance has become a really big part of that coverage. And Florida is a great example. As hurricanes have gotten worse and more frequent, insurers are paying out more and more money to rebuild people’s homes. And that’s driving up insurance costs and ultimately driving up the cost of owning a home in Florida.

So we’re already seeing that climate impact on the housing market in Florida. My colleagues and I started to think, well, could it be that that kind of disruption is also happening in other states, not just in the obvious coastal states but maybe even through the middle of the US? So we set out to find out just how much it is happening, how much that Florida turmoil has, in fact, become really a contagion that is spreading across the country.

So how did you go about reporting this? I mean, where did you start?

All we knew at the start of this was that there was reason to think this might be a problem. If you just look at how the federal government tracks disasters around the country, there’s been a big increase almost every year in the number and severity of all kinds of disasters around the country. So we thought, OK, it’s worth trying to find out, what does that mean for insurers?

The problem is getting data on the insurance industry is actually really hard. There’s no federal regulation. There’s no government agency you can go to that holds this data. If you talk to the insurers directly, they tend to be a little reluctant to share information about what they’re going through. So we weren’t sure where to go until, finally, we realized the best people to ask are the people whose job it is to gauge the financial health of insurance companies.

Those are rating agencies. In particular, there’s one rating company called AM Best, whose whole purpose is to tell investors how healthy an insurance company is.

Whoa. So this is way down in the nuts and bolts of the US insurance industry.

Right. This is a part of the broader economy that most people would never experience. But we asked them to do something special for us. We said, hey, can you help us find the one number that would tell us reporters just how healthy or unhealthy this insurance market is state by state over time? And it turns out, there is just such a number. It’s called a combined ratio.

OK, plain English?

Plain English, it is the ratio of revenue to costs, how much money these guys take in for homeowner’s insurance and how much they pay out in costs and losses. You want your revenue to be higher than your costs. If not, you’re in trouble.

So what did you find out?

Well, we got that number for every state, going back more than a decade. And what it showed us was our suspicions were right. This market turmoil that we were seeing in Florida and California has indeed been spreading across the country. And in fact, it turns out that in 18 states, last year, the homeowner’s insurance market lost money. And that’s a big jump from 5 or 10 years ago and spells real trouble for insurance and for homeowners and for almost every part of the economy.

So the contagion was real.

Right. This is our first window showing us just how far that contagion had spread. And one of the really striking things about this data was it showed the contagion had spread to places that I wouldn’t have thought of as especially prone to climate shocks — for example, a lot of the Midwest, a lot of the Southeast. In fact, if you think of a map of the country, there was no state between Pennsylvania and the Dakotas that didn’t lose money on homeowner’s insurance last year.

So just huge parts of the middle of the US have become unprofitable for homeowner’s insurance. This market is starting to buckle under the cost of climate change.

And this is all happening really fast. When we did the Florida episode two years ago, it was a completely new phenomenon and really only in Florida. And now it’s everywhere.

Yeah. And that’s exactly what’s so striking here. The rate at which this is becoming, again, a contagion and spreading across the country is just demolishing the expectations of anyone I’ve spoken to. No one thought that this problem would affect so much of the US so quickly.

So in these states, these new places that the contagion has spread to, what exactly is happening that’s causing the insurance companies to fold up shop?

Yeah. Something really particular is happening in a lot of these states. And it’s worth noting how it’s surprised everyone. And what that is, is formally unimportant weather events, like hailstorms or windstorms, those didn’t used to be the kind of thing that would scare insurance companies. Obviously, a big problem if it destroys your home or damages your home. But for insurers, it wasn’t going to wipe them out financially.

Right. It wasn’t just a complete and utter wipeout that the company would then have to pony up a lot of money for.

Exactly. And insurers call them secondary perils, sort of a belittling term, something other than a big deal, like a hurricane.

These minor league weather events.

Right. But those are becoming so frequent and so much more intense that they can cause existential threats for insurance companies. And insurers are now fleeing states not because of hurricanes but because those former things that were small are now big. Hailstorms, wildfires in some places, previous annoyances are becoming real threats to insurers.

Chris, what’s the big picture on what insurers are actually facing? What’s happening out there numbers-wise?

This is a huge threat. In terms of the number of states where this industry is losing money, it’s more than doubled from 10 years ago to basically a third of the country. The amount they’re losing is enormous. In some states, insurers are paying out $1.25 or even $1.50 for every dollar they bring in, in revenue, which is totally unsustainable.

And the result is insurers are making changes. They are pulling back from these markets. They’re hiking premiums. And often, they’re just dropping customers. And that’s where this becomes real, not just for people who surf balance sheets and trade in the stock market. This is becoming real for homeowners around the country, who all of a sudden increasingly can’t get insurance.

So, Chris, what’s the actual implication? I mean, what happens when people in a state can’t get insurance for their homes?

Getting insurance for a home is crucial if you want to sell or buy a home. Most people can’t buy a home without a mortgage. And banks won’t issue a mortgage without home insurance. So if you’ve got a home that insurance company doesn’t want to cover, you got a real problem. You need to find insurance, or that home becomes very close to unsellable.

And as you get fewer buyers, the price goes down. So this doesn’t just hurt people who are paying for these insurance premiums. It hurts people who want to sell their homes. It even could hurt, at some point, whole local economies. If home values fall, governments take in less tax revenue. That means less money for schools and police. It also means people who get hit by disasters and have to rebuild their homes all of a sudden can’t, because their insurance isn’t available anymore. It’s hard to overstate just how big a deal this is.

And is that actually happening, Chris? I mean, are housing markets being dragged down because of this problem with the insurance markets right now?

Anecdotally, we’ve got reports that in places like Florida and Louisiana and maybe in parts of California, the difficulty of getting insurance, the crazy high cost of insurance is starting to depress demand because not everyone can afford to pay these really high costs, even if they have insurance. But what we wanted to focus on with this story was also, OK, we know where this goes eventually. But where is it beginning? What are the places that are just starting to feel these shocks from the insurance market?

And so I called around and asked insurance agents, who are the front lines of this. They’re the ones who are struggling to find insurance for homeowners. And I said, hey, is there one place that I should go if I want to understand what it looks like to homeowners when all of a sudden insurance becomes really expensive or you can’t even find it? And those insurance agents told me, if you want to see what this looks like in real life, go to a little town called Marshalltown in the middle of Iowa.

We’ll be right back.

So, Chris, you went to Marshalltown, Iowa. What did you find?

Even before I got to Marshalltown, I had some idea I was in the right spot. When I landed in Des Moines and went to rent a car, the nice woman at the desk who rented me a car, she said, what are you doing here? I said, I’m here to write a story about people in Iowa who can’t get insurance because of storms. She said, oh, yeah, I know all about that. That’s a big problem here.

Even the rental car lady.

Even the rental car lady knew something was going on. And so I got into my rental car and drove about an hour northeast of Des Moines, through some rolling hills, to this lovely little town of Marshalltown. Marshalltown is a really cute, little Midwestern town with old homes and a beautiful courthouse in the town square. And when I drove through, I couldn’t help noticing all the roofs looked new.

What does that tell you?

Turns out Marshalltown, despite being a pastoral image of Midwestern easy living, was hit by two really bad disasters in recent years — first, a devastating tornado in 2018 and then, in 2020, what’s called a derecho, a straight-line wind event that’s also just enormously damaging. And the result was lots of homes in this small town got severely damaged in a short period of time. And so when you drive down, you see all these new roofs that give you the sense that something’s going on.

So climate had come to Marshalltown?

Exactly. A place that had previously seemed maybe safe from climate change, if there is such a thing, all of a sudden was not. So I found an insurance agent in Marshalltown —

We talked to other agents but haven’t talked to many homeowners.

— named Bobby Shomo. And he invited me to his office early one morning and said, come meet some people. And so I parked on a quiet street outside of his office, across the street from the courthouse, which also had a new roof, and went into his conference room and met a procession of clients who all had versions of the same horror story.

It was more — well more of double.

A huge reduction in coverage with a huge price increase.

Some people had faced big premium hikes.

I’m just a little, small business owner. So every little bit I do feel.

They had so much trouble with their insurance company.

I was with IMT Insurance forever. And then when I moved in 2020, Bobby said they won’t insure a pool.

Some people had gotten dropped.

Where we used to see carriers canceling someone for frequency of three or four or five claims, it’s one or two now.

Some people couldn’t get the coverage they needed. But it was versions of the same tale, which is all of a sudden, having homeowner’s insurance in Marshalltown was really difficult. But I wanted to see if it was bigger than just Marshalltown. So the next day, I got back in my car and drove east to Cedar Rapids, where I met another person having a version of the same problem, a guy named Dave Langston.

Tell me about Dave.

Dave lives in a handsome, modest, little townhouse on a quiet cul-de-sac on a hill at the edge of Cedar Rapids. He’s the president of his homeowners association. There’s 17 homes on this little street. And this is just as far as you could get from a danger zone. It looks as safe as could be. But in January, they got a letter from the company that insures him and his neighbors, saying his policy was being canceled, even though it wasn’t as though they’d just been hit by some giant storm.

So then what was the reason they gave?

They didn’t give a reason. And I think people might not realize, insurers don’t have to give a reason. Insurance policies are year to year. And if your insurance company decides that you’re too much of a risk or your neighborhood is too much of a risk or your state is too much of a risk, they can just leave. They can send you a letter saying, forget it. We’re canceling your insurance. There’s almost no protection people have.

And in this case, the reason was that this insurance company was losing too much money in Iowa and didn’t want to keep on writing homeowner’s insurance in the state. That was the situation that Dave shared with tens of thousands of people across the state that were all getting similar letters.

What made Dave’s situation a little more challenging was that he couldn’t get new insurance. He tried for months through agent after agent after agent. And every company told him the same thing. We won’t cover you. Even though these homes are perfectly safe in a safe part of the state, nobody would say yes. And it took them until basically two days before their insurance policy was going to run out until they finally found new coverage that was far more expensive and far more bare-bones than what they’d had.

But at least it was something.

It was something. But the problem was it wasn’t that good. Under this new policy, if Dave’s street got hit by another big windstorm, the damage from that storm and fixing that damage would wipe out all the savings set aside by these homeowners. The deductible would be crushingly high — $120,000 — to replace those roofs if the worst happened because the insurance money just wouldn’t cover anywhere close to the cost of rebuilding.

He said to me, we didn’t do anything wrong. This is just what insurance looks like today. And today, it’s us in Cedar Rapids. Everyone, though, is going to face a situation like this eventually. And Dave is right. I talked to insurance agents around the country. And they confirmed for me that this kind of a shift towards a new type of insurance, insurance that’s more expensive and doesn’t cover as much and makes it harder to rebuild after a big disaster, it’s becoming more and more common around the country.

So, Chris, if Dave and the people you spoke to in Iowa were really evidence that your hunch was right, that the problem is spreading and rapidly, what are the possible fixes here?

The fix that people seem most hopeful about is this idea that, what if you could reduce the risk and cause there to be less damage in the first place? So what some states are doing is they’re trying to encourage homeowners to spend more money on hardening their home or adding a new roof or, if it’s a wildfire zone, cut back the vegetation, things that can reduce your risk of having really serious losses. And to help pay for that, they’re telling insurers, you’ve got to offer a discount to people who do that.

And everyone who works in this field says, in theory, that’s the right approach. The problem is, number one, hardening a home costs a fantastic amount of money. So doing this at scale is hugely expensive. Number two, it takes a long time to actually get enough homes hardened in this way that you can make a real dent for insurance companies. We’re talking about years or probably decades before that has a real effect, if it ever works.

OK. So that sounds not particularly realistic, given the urgency and the timeline we’re on here. So what else are people looking at?

Option number two is the government gets involved. And instead of most Americans buying home insurance from a private company, they start buying it from government programs that are designed to make sure that people, even in risky places, can still buy insurance. That would be just a gargantuan undertaking. The idea of the government providing homeowner’s insurance because private companies can’t or won’t would lead to one of the biggest government programs that exists, if we could even do it.

So huge change, like the federal government actually trying to write these markets by itself by providing homeowner’s insurance. But is that really feasible?

Well, in some areas, we’re actually already doing it. The government already provides flood insurance because for decades, most private insurers have not wanted to cover flood. It’s too risky. It’s too expensive. But that change, with governments taking over that role, creates a new problem of its own because the government providing flood insurance that you otherwise couldn’t get means people have been building and building in flood-prone areas because they know they can get that guaranteed flood insurance.

Interesting. So that’s a huge new downside. The government would be incentivizing people to move to places that they shouldn’t be.

That’s right. But there’s even one more problem with that approach of using the government to try to solve this problem, which is these costs keep growing. The number of billion-dollar disasters the US experiences every year keeps going up. And at some point, even if the government pays the cost through some sort of subsidized insurance, what happens when that cost is so great that we can no longer afford to pay it? That’s the really hard question that no official can answer.

So that’s pretty doomsday, Chris. Are we looking at the end of insurance?

I think it’s fair to say that we’re looking at the end of insurance as we know it, the end of insurance that means most Americans can rest assured that if they get hit by a disaster, their insurance company will provide enough money they can rebuild. That idea might be going away. And what it shows is maybe the threat of climate change isn’t quite what we thought.

Maybe instead of climate change wrecking communities in the form of a big storm or a wildfire or a flood, maybe even before those things happen, climate change can wreck communities by something as seemingly mundane and even boring as insurance. Maybe the harbinger of doom is not a giant storm but an anodyne letter from your insurance company, saying, we’re sorry to inform you we can no longer cover your home.

Maybe the future of climate change is best seen not by poring over weather data from NOAA but by poring over spreadsheets from rating firms, showing the profitability from insurance companies, and how bit by bit, that money that they’re losing around the country tells its own story. And the story is these shocks are actually already here.

Chris, as always, terrifying to talk to you.

Always a pleasure, Sabrina.

Here’s what else you should know today. On Tuesday, the United Nations has reclassified the number of women and children killed in Gaza, saying that it does not have enough identifying information to know exactly how many of the total dead are women and children. The UN now estimates that about 5,000 women and about 8,000 children have been killed, figures that are about half of what it was previously citing. The UN says the numbers dropped because it is using a more conservative estimate while waiting for information on about 10,000 other dead Gazans who have not yet been identified.

And Mike Johnson, the Speaker of the House, gave a press conference outside the court in Lower Manhattan, where Michael Cohen, the former fixer for Donald Trump, was testifying for a second day, answering questions from Trump’s lawyers. Trump is bound by a gag order. So Johnson joined other stand-ins for the former president to discredit the proceedings. Johnson, one of the most important Republicans in the country, attacked Cohen but also the trial itself, calling it a sham and political theater.

Today’s episode was produced by Nina Feldman, Shannon Lin, and Jessica Cheung. It was edited by MJ Davis Lin, with help from Michael Benoist, contains original music by Dan Powell, Marion Lozano, and Rowan Niemisto, and was engineered by Alyssa Moxley. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly.

That’s it for “The Daily.” I’m Sabrina Tavernise. See you tomorrow.

• May 23, 2024   •   34:24 I.C.C. Prosecutor Requests Warrants for Israeli and Hamas Leaders
• May 22, 2024   •   23:20 Biden’s Open War on Hidden Fees
• May 21, 2024   •   24:14 The Crypto Comeback
• May 20, 2024   •   31:51 Was the 401(k) a Mistake?
• May 19, 2024   •   33:23 The Sunday Read: ‘Why Did This Guy Put a Song About Me on Spotify?’
• May 17, 2024   •   51:10 The Campus Protesters Explain Themselves
• May 16, 2024   •   30:47 The Make-or-Break Testimony of Michael Cohen
• May 15, 2024   •   27:03 The Possible Collapse of the U.S. Home Insurance System
• May 14, 2024   •   35:20 Voters Want Change. In Our Poll, They See It in Trump.
• May 13, 2024   •   27:46 How Biden Adopted Trump’s Trade War With China
• May 10, 2024   •   27:42 Stormy Daniels Takes the Stand
• May 9, 2024   •   34:42 One Strongman, One Billion Voters, and the Future of India

Hosted by Sabrina Tavernise

Featuring Christopher Flavelle

Produced by Nina Feldman ,  Shannon M. Lin and Jessica Cheung

Edited by MJ Davis Lin

With Michael Benoist

Original music by Dan Powell ,  Marion Lozano and Rowan Niemisto

Engineered by Alyssa Moxley

Listen and follow The Daily Apple Podcasts | Spotify | Amazon Music | YouTube

Across the United States, more frequent extreme weather is starting to cause the home insurance market to buckle, even for those who have paid their premiums dutifully year after year.

Christopher Flavelle, a climate reporter, discusses a Times investigation into one of the most consequential effects of the changes.

On today’s episode

Christopher Flavelle , a climate change reporter for The New York Times.

Background reading

As American insurers bleed cash from climate shocks , homeowners lose.

See how the home insurance crunch affects the market in each state .

Here are four takeaways from The Times’s investigation.

There are a lot of ways to listen to The Daily. Here’s how.

We aim to make transcripts available the next workday after an episode’s publication. You can find them at the top of the page.

Christopher Flavelle contributed reporting.

The Daily is made by Rachel Quester, Lynsea Garrison, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Lisa Chow, Eric Krupke, Marc Georges, Luke Vander Ploeg, M.J. Davis Lin, Dan Powell, Sydney Harper, Mike Benoist, Liz O. Baylen, Asthaa Chaturvedi, Rachelle Bonja, Diana Nguyen, Marion Lozano, Corey Schreppel, Rob Szypko, Elisheba Ittoop, Mooj Zadie, Patricia Willens, Rowan Niemisto, Jody Becker, Rikki Novetsky, John Ketchum, Nina Feldman, Will Reid, Carlos Prieto, Ben Calhoun, Susan Lee, Lexie Diao, Mary Wilson, Alex Stern, Dan Farrell, Sophia Lanman, Shannon Lin, Diane Wong, Devon Taylor, Alyssa Moxley, Summer Thomad, Olivia Natt, Daniel Ramirez and Brendan Klinkenberg.

Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Paula Szuchman, Lisa Tobin, Larissa Anderson, Julia Simon, Sofia Milan, Mahima Chablani, Elizabeth Davis-Moorer, Jeffrey Miranda, Renan Borelli, Maddy Masiello, Isabella Anderson and Nina Lassam.

Christopher Flavelle is a Times reporter who writes about how the United States is trying to adapt to the effects of climate change. More about Christopher Flavelle

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