Unexpected illness, injury, emergency-room visits, hospital stays, and other urgent medical needs can create expenses that are difficult to manage. If you are struggling to afford emergency healthcare or a medical bill, several types of assistance may be available depending on your income, insurance, location, age, and circumstances.
Emergency medical assistance can include government healthcare programs, hospital financial assistance, charity care, reduced medical bills, payment plans, prescription assistance, and local community resources. There is not one program that covers every emergency, so finding the right type of help is important.
Who May Qualify for Emergency Medical Assistance?
Eligibility depends on the specific program. You may have options if you:
- Have a low or limited household income
- Are uninsured or underinsured
- Recently experienced a medical emergency
- Have large hospital or emergency-room bills
- Are a senior or person with a disability
- Are pregnant or have children who need medical care
- Qualify for Medicaid, Medicare, or other government healthcare programs
- Are experiencing financial hardship after an unexpected illness or injury
Medicaid provides free or low-cost healthcare to eligible people, including certain low-income adults, children, pregnant women, older adults, and people with disabilities. Eligibility rules vary by state.
Check What You May Qualify For
If you are dealing with unexpected medical expenses, you may be able to find assistance based on your circumstances.
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Programs can vary based on your eligibility, location, household circumstances, and the type of assistance you need.
Types of Emergency Medical Assistance
Medicaid and CHIP
Medicaid can provide free or low-cost medical coverage to qualifying individuals and families. CHIP provides coverage for eligible children. Each state determines its own eligibility requirements and application process.
Medicare Assistance
People who qualify for Medicare may also qualify for programs that help with premiums, deductibles, coinsurance, or prescription costs. Assistance depends on income, resources, and other eligibility requirements.
Hospital Financial Assistance
Many hospitals have financial assistance programs for patients who cannot afford their medical bills. Nonprofit hospitals are required to provide financial assistance to eligible patients who meet their policies. This may sometimes be called charity care.
Reduced Medical Bills
Even when you do not qualify for a specific assistance program, a hospital or healthcare provider may be willing to reduce a bill or establish a payment plan. CMS recommends contacting the provider's billing department to discuss available options.
Prescription Assistance
If an emergency or serious illness results in expensive prescriptions, assistance may be available through government programs, pharmaceutical companies, state programs, community organizations, or lower-cost generic medications.
Local Community Assistance
Community organizations, nonprofit groups, clinics, and local assistance programs may help people facing medical hardship. Available services vary considerably by location.
How Emergency Medical Assistance Typically Works
- Identify the immediate medical need. Medical emergencies should be addressed promptly rather than delayed because of concerns about the bill.
- Check your health coverage. Review Medicaid, Medicare, Marketplace, employer insurance, or other coverage that may apply.
- Contact the hospital billing department. Ask whether the hospital offers financial assistance or charity care.
- Ask about payment options. Providers may offer reduced bills or payment plans.
- Check government programs. Your income, age, family size, disability, or other circumstances may qualify you for assistance.
- Look for local resources. Community organizations and healthcare assistance programs may provide additional support.
If you already have a medical bill you cannot afford, it generally helps to check the bill for errors and ask the provider about financial assistance or payment arrangements.
What If You Received Emergency Room Care?
Emergency-room care can result in unexpected bills, particularly when someone does not have adequate insurance coverage. For people with most types of private health insurance, the federal No Surprises Act provides protections against many unexpected out-of-network emergency medical bills. In covered situations, emergency services generally must be treated at the applicable in-network cost-sharing level.
If you receive an unexpected emergency-room bill, review your insurance explanation of benefits and contact your insurer or the hospital billing department.