HCA Midwest Health - December 06, 2017

There are a lot of different types of health concerns that bring people to the ER. For the (seemingly) less serious ones, you might be tempted to ask how much the visit will cost when you check in. But the staff at the ER can’t tell you because it could delay your treatment in an emergency, and the staff needs to treat you as quickly as possible. In fact, for your own protection there’s actually a federal law that prevents healthcare providers from asking you about payment and coverage in the ER.

Before you roll your eyes, consider this: The law was created to keep patients (and some healthcare providers) from making bad medical choices for financial reasons.

It’s called the EMTALA or Emergency Medical Treatment & Labor Act (the labor part refers to childbirth, not labor unions). In a nutshell, the law says (paraphrasing):

A hospital may not delay providing medical screening, examination or treatment in order to ask the patient’s method of payment or insurance status.

Here’s why it makes sense: You have a weird feeling in your chest and it’s after hours for your doctor’s office. You tell yourself “it’s probably heartburn but better safe than sorry” and head to the ER. But before you check in, you want to know how much this visit is going to cost. A nice desk clerk helps you and confirms that the ER copay on your insurance is $250. By now, your chest pain seems a little better… it can surely wait until tomorrow. So you head home. If that chest pain was a heart attack, you just missed your best opportunity for a good outcome.

The law is designed to prevent worst-case scenarios like this. It’s not just that the ER team isn’t allowed to tell you the cost—they aren’t allowed to get enough information from you to even find out what the cost would be. They will ask your name, birthdate, Social Security number and chief complaint before you see the physician/provider who will decide immediate care and treatment steps. If there is time while you are waiting for test results or receiving care (like an IV), you’ll go through a full registration—but nothing that would delay the ER team in providing the help you need.

If you are concerned with ER costs, there are a few things you can do, now, before you need care:

  1. Call your insurance company, or have a loved one call, to find out the ER co-pay or cost for your insurance plan. Make sure to ask about in-network vs. out-of-network costs.
  2. Find ERs near you not just near your home, but also near work or where your kids play soccer–any place else you go regularly. That way, in an emergency, you’ll already know where to go.

HCA Midwest Health facilities are only minutes from where you live, work and play. Check out our locations.