Health care costs at the hospital can be high. If you have health insurance, your plan may cover a large part of your bill. What do you do though if you don’t have insurance? Can you still get help in an emergency?
In the U.S., there are laws and types of hospitals that make sure all people get the care they need.
Hospitals must treat you in an emergency
The Emergency Medical Treatment and Active Labor Act says that hospitals who get Medicaid funds can’t refuse to see you if you come to the emergency room and ask for treatment. If you have an emergency medical condition (which includes being in labor), the hospital must treat you. They can’t send you to a different hospital until your condition is stable. They also must treat you even if you already owe them money.
This law applies to most U.S. hospitals, since most get Medicaid funds. The law makes sure that all people are treated in an emergency. There are some limits:
- The law does not protect you from bills or payments after you get the treatment you need.
- The law does not make the hospital treat you after your condition is stable.
- The law does not make the hospital treat you if the provider confirms that your condition isn’t an emergency.
- The law does not apply once you are admitted to the hospital. The hospital can transfer you to a different hospital if you have a new emergency.
- The law does not require an ambulance to take you to a specific hospital.
Some hospitals offer charity care
Though the law helps make sure you get treatment in an emergency, it doesn’t mean the care is free. What happens when you can’t pay the bill?
Some hospitals offer uncompensated health care. This includes:
- Charity care (also called community care or indigent care)—Care that a hospital doesn’t charge a patient for because they decide the patient can’t afford it.
- Bad debt—Care that a hospital expects payment for but doesn’t get from the patient.
How much charity care a hospital offers can depend on the hospital’s mission or location. Just because a hospital doesn’t offer charity care doesn’t mean they don’t serve the community. There may be other reasons why a hospital doesn’t offer charity care.
Who can get charity care?
Most hospitals limit charity care programs to:
- People who don’t qualify for government assistance programs.
- People who can’t pay their medical bills.
- People who have very little money.
The patient services department at your hospital can often tell you more about your eligibility. If you want to apply for charity care, you’ll have to help the hospital confirm your income. The process can vary by hospital, but often follows these steps:
- The patient fills out an application. This is sometimes called a determination of eligibility form.
- The patient fills out a financial statement. It includes income, assets, and liabilities. The patient must provide proof of their income and other debt. Examples include W-2 forms, pay stubs, tax forms, and loan documents.
- The hospital looks at federal poverty guidelines and family size. They also confirm third-party coverage if it applies.
- A hospital staff person interviews the patient. They see if the patient either:
- Can pay their bill in full.
- Can pay their bill with a monthly payment plan.
- Qualifies for General Relief.
- The hospital tries to get federal, state, or local funding for the patient if they can.
- If the hospital thinks the patient doesn’t have enough funds, income, or health care benefits, the claim goes to a final review committee. The committee includes administrative, business, social services, and nursing staff.
How do patients learn about charity care?
Hospitals may give you details and an application for charity care, either:
- At registration.
- In the emergency room.
- At a financial services office.
- In your admission packet.
- With your bill.
Some hospitals offer financial counseling either before you’re admitted to the hospital or after. You may see signs about charity care services. Hospitals may also have information online or in local newspapers.
Hill-Burton Program in Wisconsin
From 1946–1974, many hospitals in Wisconsin were part of the Hill-Burton program. The program offered federal funds to help build or renovate health facilities. In exchange for the funds, the hospitals agreed to give a certain amount of care for free or at lower rates. This was meant to help people who couldn’t afford health care.
Some hospitals today still have to pay back their Hill-Burton obligations. These hospitals must follow federal requirements for confirming that patients qualify. You can find more information about the Hill-Burton program through the U.S. Department of Health and Human Services.