Can I Go to the Emergency Room with No Insurance?

Christine Hudson

In most places it is entirely possible to go to the emergency room with no insurance, but whether or not this means that the visit is free is largely a matter of circumstance. Some places, including the United States, have passed laws that require emergency room (ER) personnel to care for anyone who comes in, regardless of the patient’s ability to pay. In many cases these patients receive discounted care, but not always. A lot depends on the seriousness of the condition and the costs involved in running labs, performing examinations, and doing diagnostic tests. Even people with insurance often find that ER visits are very expensive. If you don’t have insurance or don’t have full coverage, you might want to look at alternatives, like walk-in clinics or urgent care centers, for times when your condition isn’t life-threatening.

A pregnant woman who is without insurance and in labor may be allowed medical care in an emergency room.
A pregnant woman who is without insurance and in labor may be allowed medical care in an emergency room.

How ERs Work

An emergency rooms is usually the most accessible part of any hospital. It is where patients arrive when being transported by ambulance, and is where people often enter the hospital when they need immediate care. Most hospitals organize their ERs on a triage system, where people are treated in order of the severity of their condition rather than based on who arrived first. This way, medical personnel are able to provide the best treatment possible to people who have life-threatening or otherwise critical injuries.

Someone without insurance can visit an emergency room for serious health issues.
Someone without insurance can visit an emergency room for serious health issues.

Things in ERs tend to be really fast-paced, particularly in true emergencies. As such, it’s relatively rare for doctors or administrators to ask a person about insurance coverage before beginning treatment. In the United States and some other places, asking about the ability to pay is actually illegal. In this respect, then, if you go to the emergency room with no insurance you will be treated. This is really important if your life is on the line. You will probably be billed for the visit, though, and the costs involved could be really steep.

Individuals who lack health insurance often end up seeking medical attention at the emergency room.
Individuals who lack health insurance often end up seeking medical attention at the emergency room.

Jurisdictional Differences

Different countries and even different localities run their emergency medical services according to their own sets of rules and stipulations. You might find policy disparities between countries, and the sort of care you receive will often depend on where you are and what rules are in force. In many places, there are a number of public hospitals where anyone can go for treatment, but private hospitals are for people with certain health plans or insurance packages only. You probably won’t be able to gain admittance to one of these sorts of facilities if you aren’t a member or if you haven’t been pre-approved. Medical personnel might treat you if you’re dying or near death, but they might also refer you to public facilities no matter your circumstances. A lot depends on the place and the overarching laws.

U.S. Policies

In the United States, a person can go to the emergency room with no insurance, but treatment will usually only be covered by the government’s social health plan 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 of whether they have insurance or the financial resources to pay. This law does, however, have some stipulations as to what counts as an emergency, and has a “sliding scale” of what hospitals can charge for various services provided.

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 unless 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 an insurance provider. After receiving treatment, however, you might face a battle with your insurance company if you received treatments the company deems as “unauthorized.”

Allocating Costs

Even hospitals that accept and treat patients without insurance rarely provide their services free of charge. Getting treatment does not mean the patient is not responsible for the resulting medical bills. If you do not have insurance, you will probably need to work out a payment arrangement with the hospital for the care you received in the ER. There are very few instances in which a patient will be pardoned from payment, and it is not usually the case that homeless people or low income families are spared from the high cost of emergency treatment.

Measuring a Condition’s Seriousness

Whether an ER visit makes sense might depend to some extent on the seriousness of your condition. Some conditions justify medical care in an emergency room no matter the cost; usually these are situations that place your health or life in serious jeopardy or where bodily functions or organs are seriously impaired. This would also usually include something like a pregnant woman who is 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 instances, patients who do not have insurance might be turned away and referred to other medical facilities. If this is your situation you might also want to look at different alternatives — like urgent care clinics or community-based walk in health centers — purely as a cost-saving measure.

The United States and other nations have passed laws requiring emergency rooms to treat all patients regardless of ability to pay.
The United States and other nations have passed laws requiring emergency rooms to treat all patients regardless of ability to pay.

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Discussion Comments


The Emergency Medical and Treatment Labor Act, or EMTALA, has been a federal law since 1986. Centers for Medicare and Medicaid Services, or CMS, oversees EMTALA enforcement.

So, basically, any hospital (but maybe not limited to?) that's funded or has a contract agreement with CMS is required by law to determine the EMC and if the condition is acute, like chest pain, shortness of breath, sudden/unexplained lightheadedness, confusion, physical trauma, thoughts of suicide, etc., the hospital/doctor is responsible for treatment and necessary tests until stabilized. Of course, if the hospital is not equipped to handle the acute condition, like no psych unit, limited availability of specialists, ER on divert, or patient needs higher or highest level care for trauma (Level l Trauma Center for most severe cases), then the hospital is responsible for setting up a transfer to the appropriate facility for the patient.

Any hospital/doctor in a contract agreement with CMS that simply refuses treatment to an uninsured patient with an apparent acute condition is subject to a maximum $50,000 fine, possible malpractice liability and likely CMS will terminate the contract with the provider. This happens only when the person in need of emergency care finds an accepting (compliant, rather) facility and explains what happened so the facility will report the hospital they initially went to for treatment.

I worked in two different Magnet designated hospitals for over 12 years


@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.


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.


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!


@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.


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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