What happens if you go to the ER and don't have insurance?

Health insurance is a way to pay for medical care. Who pays when it's non-existent?
Health insurance is a way to pay for medical care. Who pays when it's non-existent?
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Ah, you've found the loophole! There's so much talk about how terrible consumer protection is in regards to insurance and the entire health care system in the United States, that we've overlooked the amazingly simple fix. Just don't buy insurance, and waltz into the ER every time you need an antibiotic or want that checkup. Those docs have to treat you or be stripped of their license under some Hippocratic Oath, right? You've entirely scammed the system!

So it turns out, that loophole has been found, stitched up, covered with concrete and surrounded by bulletproof glass. The health care industry has been happy to charge for treatment and medicine since darn near the beginning of time, whether it's an emergency or not. If you don't have insurance to cover the cost of a visit, the joke really is on you: You're responsible for the bill. Period.

Now if you're looking back and forth in horror between the bloody stump where your hand used to be and your empty bank account, please take heed: You should absolutely go to the emergency room, even if you don't have thousands of dollars need to pay for treatment. While hospitals, providers and the like will still charge you, they're not going to run a credit report or ask for a down payment before care.

In fact, the federal Emergency Medical Treatment and Labor Act (EMTALA) is designed to guarantee a person's right to receive emergency treatment, regardless of if they can pay or not [source: CMS]. It basically says that if you need emergency medicine, you must be treated at any emergency room, to the best of the staff's ability, until you're in stable condition for transfer. It's also designed to make sure that private hospitals aren't "dumping" uninsured or Medicaid patients on public hospitals, by transferring folks before treatment.

So sure: You'll get treated at an ER, regardless of insurance. But that doesn't mean that you can walk out without a bruise in the wallet. Remember that if you have insurance, a hospital or provider charges your insurance company for your visit. The insurance company pays whatever your plan specifies, and you are responsible for whatever balance is leftover. Without insurance? You're just looking at the whole of the bill, and it can be a whopper. And do remember that the cost of treatment and procedures varies wildly from hospital to hospital [source: Caldwell et al.].

Since the Affordable Care Act went into effect, fewer Americans are walking into the ER without insurance. But if you're still a holdout, do know that you're still going to have to pay your bill, although the ACA does have provisions that ensures hospitals only use things like liens or wage garnishing after they make a patient aware of available assistance [source: Brino].

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  • Brino, Anthony. "New Affordable Care Act rules target aggressive billing, collections." Healthcare Finance. (April 9, 2015) http://www.healthcarefinancenews.com/news/new-affordable-care-act-rules-target-aggressive-billing-collections
  • Caldwell, Nolan et al. "'How Much Will I Get Charged For This?' Patient Charges for Top Ten Diagnoses in the Emergency Department." PLOS One. Feb. 27, 2013. (April 9, 2015) http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055491
  • Centers for Medicare and Medicaid Services (CMS). "Emergency Medical Treatment & Labor Act (EMTALA)." March 26, 2012. (April 9, 2015) http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html?redirect=/EMTALA/01_overview.asp
  • Murphy, Tim. "No, You Can't Just Go to the Emergency Room -- Unless You Want to Go Broke." Mother Jones. Oct. 18, 2013. (April 9, 2015) http://www.motherjones.com/politics/2013/10/emergency-rooms-instead-health-insurance
  • National Public Radio. "FAQ: Understanding The Health Insurance Mandate And Penalties For Going Uninsured." Oct. 11, 2013. (April 9, 2015) http://www.npr.org/2013/10/11/230851737/faq-understanding-the-health-insurance-mandate-and-penalties-for-going-uninsured
  • Prater, Connie. "IRS to Tax-Exempt Hospitals: Go Easier on Medical Debt Collection." FoxBusiness. July 5, 2012. (April 9, 2015) http://www.foxbusiness.com/personal-finance/2012/07/02/irs-to-tax-exempt-hospitals-go-easier-on-medical-debt-collection/
  • Zadrozny, Brandy. "Obamacare Has a New Problem: It Won't Fix Emergency Rooms." The Daily Beast. Jan. 2, 2014. (April 9, 2015) http://www.thedailybeast.com/articles/2014/01/02/obamacare-has-a-new-problem-it-won-t-fix-emergency-rooms.html