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Can I Go to the Emergency Room with No Insurance?

Someone without insurance can visit an emergency room for serious health issues.
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  • Written By: Christine Hudson
  • Edited By: C. Wilborn
  • Last Modified Date: 09 March 2014
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In the United States, a person can go to the emergency room with no insurance, but only if certain conditions are met. In 1986, a federal law was passed requiring all hospitals that participate in the federal Medicare program, which is almost every hospital in the United States, to accept emergency room patients regardless if they have insurance or the financial resources to pay. This law does, however, have some stipulations as to what counts as an emergency. It is not possible in many situations to receive treatment in an emergency room without insurance if your condition does not meet these requirements.

Some conditions that justify medical care in an emergency room with no insurance would include a situation that places a person's health or life in serious jeopardy or where bodily functions or organs are seriously impaired. This would also include a pregnant woman who is currently in labor if there is not enough time to safely transfer her to another hospital. Many conditions, illnesses, and injuries may be deemed "non-emergency" if they do not pose a direct threat to a patient's life. In these cases, patients who do not have insurance can be turned away and referred to other medical facilities.

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Federal law requires the receiving hospital assess the patient's condition and provide necessary care to stabilize him or her without inquiring about the ability to pay. The hospital cannot transfer a patient until his or her condition has been stabilized or when the condition requires facilities beyond the scope of the receiving hospital. For example, a small hospital may transfer a patient to a larger hospital with a trauma center in order to better care for the patient.

The law also applies to insurance companies who may try to illegally require pre-authorization for an emergency room visit. It clearly states that a patient cannot be denied care in an emergency room while waiting to receive pre-authorization from their insurance provider. After receiving treatment, however, the patient may face a battle with his or her insurance company for receiving unauthorized treatment.

Hospitals have some obligations under this federal law to accept and treat a patient in the emergency room with no insurance, but it does not mean the patient is not responsible for the resulting medical bills. If the patient does not have insurance, he or she will need to work out a payment arrangement with the hospital for the care received. There are very few instances in which a patient will be pardoned from payment, and it is not true that homeless people or low income families are safe from the high cost of emergency treatment.

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Discuss this Article

anon927316
Post 5

@Judybug62: The situation you described with the ER does sound a little hinky, but I'm not sure if it was illegal. If this was a county hospital that receives federal funds, then they did have an obligation to at least make you stable. A few tests would have ruled in or ruled out an actual heart problem. I wonder if they meant they would have to bill you for the entire visit or did they expect a complete cash payment that night?

If this was a private urgent care center, however, the rules are a little different. Since they're a for-profit, privately owned medical service company, they do have the right to refuse services to uninsured visitors. I know one such place in my town also charges at least double the going rate of a regular ER visit because their doctors are essentially independent contractors. If I were uninsured and having what I thought was an emergency, I'd only go to a county hospital that definitely has to treat the uninsured in an ER.

judybug62
Post 4

I went to an 24 hour emergency room. I have medicaid, which they do not take. Cash only, they said. I told them I was having chest pains, nausea and sweating. I told them my primary care doctor had sent me for a heart test because my ankles were swelling and I had an irregular heartbeat. My test came out abnormal. I told the emergency room person this.

She said I would have to pay. I was sent away. Isn't this illegal? I just got back. I am still having chest pains.

turquoise
Post 3

I think there is something seriously wrong with the federal law about emergency room costs. If there is an emergency, people shouldn't be charged for it. Especially if they can't afford to pay!

burcidi
Post 2

@feruze-- I had a similar experience. I went to the emergency room due to stomach cramps. The ER doctor suspected a stomach ulcer and ordered an X-ray. Nothing came out of it and I was charged a lot of money for it.

Unless one has lost a limb or something, it's a terrible idea to go to the emergency room with no health insurance.

bear78
Post 1

I went to the emergency room without insurance once but I didn't have a life-threatening condition. It felt life-threatening to me though because I was having severe back-to-back anxiety attacks and I was worried that I might hurt myself. I needed a sedative.

My friend took me to the emergency room and I basically had another anxiety attack there. I remember crying that I wouldn't be able to pay the hospital fees if I saw a doctor. Anyway, the nurses calmed me down and convinced me to see an emergency doctor who gave me a prescription drug.

The hospital gave me a form to fill out about my financial situation. I submitted the form and a few days later, I got a call from the hospital saying that my form was accepted and that they wouldn't charge me for my emergency visit. I was really happy, until I got a bill a week later. Yes, the hospital didn't take any money but the doctor did. I ended up paying more than $200 to the doctor for that small visit.

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