You will be treated in any hospital ER regardless of insurance status — federal law (EMTALA) requires it. But expect a substantial bill. Without insurance, you're billed at the full chargemaster rate, which averages 4–8x what Medicare pays for the same visit.
What to do during the ER visit
- Don't sign financial responsibility forms that waive your right to negotiate or apply for charity care. You must consent to treatment; you don't have to agree to pay any specific amount before knowing the total cost.
- Ask about financial assistance while you're still there — nurses and patient advocates can start the paperwork.
- Keep notes on what tests and treatments you actually received. This matters for auditing the bill later.
- Ask for the itemized bill before leaving if possible — or request it immediately in writing afterward.
What to do when the bill arrives
- Audit the bill first. ER bills are among the most error-prone. Common issues: facility level upcoded (level 5 vs. level 3), duplicate charges for supplies, physician charge billed separately from facility. Use BillKarma to check every CPT code against Medicare rates.
- Apply for charity care. Nonprofit hospitals are required to have financial assistance programs. Income limits are often 200–400% of the federal poverty level — much higher than people expect. A family of four earning $75,000/year may qualify.
- Request the self-pay / uninsured discount. Most hospitals have a standing discount of 20–50% for uninsured patients who ask. You don't have to qualify for charity care to get this.
- Negotiate to Medicare rates. The Medicare rate for a level 3 ER visit (CPT 99283) is approximately $130 facility + $95 physician. If your bill shows $2,500 for the same, cite the CMS rate in a formal dispute letter.
- Set up a payment plan. Most hospitals offer 12–24 month 0% interest payment plans. This keeps your account current while you dispute and negotiate.
How ER billing actually works
An ER visit generates at least two separate bills: the facility fee (from the hospital) and a physician fee (from the emergency medicine group). You may also receive separate bills from radiologists, anesthesiologists, or labs. Each bill can be negotiated independently.
The facility fee is coded on a scale of 1–5 by complexity (CPT 99281–99285). Level 5 is the most expensive — a common upcoding target. Check your medical records to verify the documented complexity matches what was billed.