Financial Costs of Calcium Oxalate Crystals

The large impact of calcium oxalate crystals on society and individuals

US Healthcare System

The US healthcare system has an estimated cost of over $10 Billion annually for crystal interventions.* Despite the fact calcium oxalate crystals have an overall low risk for bad outcomes and procedures to address calcium oxalate crystals lead to complications that require hospitalization or emergency care for one in seven patients.*

  • $30,000 per patient is the average cost of an emergency room visit for calcium oxalate crystals*
  • Outpatient surgery for crystal removal can cost up to $40,000. The average cost in the USA is $19,000**

Individuals (You)

Hopefully you have healthcare insurance as surgically procedures for crystals will be expensive, even in most cases, when you have insurance!

  • Work Place Insurance
    • Approximately 50% Patients have $1000+ deductible**
    • Average deductible for single coverage is $1,836 in small firms, compared to $1,105 for workers in large firms.
  • Medicare
    • After your deductible is met, an individual typically pays 20% of the Medicare -approved amount ($1,288 is the deductible for each benefit period but that can change in the future)
  • Commercial
    • Insurance plans after ACA or “Obamacare” was implemented have been standardized into “metal” tiers – bronze, silver, gold, and platinum. For an example, a bronze plan has an actuarial value of approximately 60%, meaning that the insurer expects to pay for 60% of total costs associated with covered medical services, and that – as a group – the enrollees would pay for the remaining 40% of total costs through their combined co-payments, coinsurance, and deductibles.***
  • Out-of-Pocket Maxium
    • Health plans sold in the Marketplace must have an out-of-pocket maximum for in-network services of no more than $6,850 for an individual plan and $13,700 for a family plan.
    • For better or worse, the ACA under “Trumpcare” is likely to change deductibles and out of pocket expense for all of the above.