Can I go to the ER without insurance, and what can I do about the bill?

Can a hospital refuse to treat me if I can't pay?

No, not in an emergency. A hospital that takes part in Medicare and has an emergency department must give anyone who comes asking for care a medical screening exam, whether or not they can pay. If there is an emergency medical condition, including active labor, it must treat it until it is stable or arrange an appropriate transfer Source 11.

This federal law is called EMTALA. Nonprofit hospitals also must have a written policy to give emergency care whether or not you qualify for financial assistance Source 22.

The care is not free. You may get a bill afterwards, and the rest of this guide explains what you can do about it.

Can they ask for payment before treating me?

They can't make you wait for care while they ask. The hospital may not delay your screening exam or treatment to ask how you will pay or whether you have insurance Source 11. A nonprofit hospital may not demand payment before it treats an emergency condition Source 22.

Questions about payment can come once you are stable. You can say that you don't have insurance and ask to speak with a financial counselor about financial assistance and Medicaid.

Can I get financial assistance for an ER bill?

Often, yes. A nonprofit hospital's financial assistance policy must cover all emergency care and other medically necessary care, say who qualifies and list the providers it covers Source 22. Most US community hospitals are nonprofits. Their share is 58% (American Hospital Association, Fast Facts on U.S. Hospitals 2026, FY2024).

1. Ask for the policy and the application. A nonprofit hospital must post them free online, hand out free paper copies, put up notices in the emergency room and in admissions, and translate them for large language groups in its community Source 22.
2. Apply as soon as you can. A nonprofit hospital must accept your application for a set time after the first bill it sends after you leave. That time is at least 240 days (IRS, published July 2, 2026).
3. Ask the hospital to pause collection while it decides, and include the proof of income the application asks for Source 44.
4. Check the separate bills. The emergency room doctors may bill you apart from the hospital. The hospital's policy must list the providers it covers, so check whether they are on it, and if not, ask each one for its own policy Source 22.

If you qualify, the hospital may not charge you more for emergency care than the amounts generally billed to people with insurance Source 55. These federal rules cover nonprofit hospitals. For-profit and government hospitals are not covered by them, though state law may still apply Source 66, so ask any hospital what help it offers.

Our charity-care checker gives you a quick estimate, and our guide to charity care explains how to apply.

Can Medicaid cover an emergency after the fact?

It may. In many states, Medicaid can cover care you got in the months before the month you applied, if you would have qualified when you got it Source 77. Today the number of months is 3 (42 CFR 435.915(a) (eCFR), published 2026). This may not apply in every state, so ask your state Medicaid office or the hospital's financial counselor what applies to you.

• Apply soon. A recent federal law will shorten how far back Medicaid can go for new applications Source 88. Our guide to Medicaid retroactive coverage has the details.
• Ask about coverage on the spot. Some hospitals that take part in Medicaid can decide from basic information that you are presumptively eligible, which gives you Medicaid coverage for a time while you make a full application (presumptive eligibility) Source 99.

If you have questions about emergency Medicaid or how any benefit could affect an immigration case, see the last section of this guide.

What about the ambulance bill?

It usually comes separately, from the ambulance service. If you have insurance, the federal surprise-billing protections cover air ambulance services Source 1010, but ground ambulance rides were left out of that federal ban Source 1111. Some states protect you from surprise ground ambulance bills.

Without insurance, ask the ambulance service for an itemized bill, a discount and a payment plan. Our guide to ambulance bills explains your options.

Does emergency Medicaid affect immigration status?

We answer immigration questions in one place: our guide on immigration status and medical bills.