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ER aid guaranteed -- even if you can't pay

You're unexpectedly taken ill, or you're injured in an accident. You need a fast trip to the emergency room, but . . . your finances are shaky and you're not insured.

What do you do?

First -- by all means -- get treated. And, if at all possible, get to a hospital emergency room. Even if you're uninsured and broke, you can get emergency treatment when you need it under recent changes in the decades-old federal rules. What's more, a number of consumer groups and patient-help organizations such as the Health Assistance Partnership monitor and lobby for those rights under the law.

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Simply stated, hospitals must provide emergency treatment before they ask how you'll pay for it. But patients should be aware hospitals fall into two groups. One will treat you first and worry about collecting later. The other group, by law, is obliged to treat you as a charity case if you can't pay.

And don't forget: This is for emergency treatment only.

Emergency Medical Treatment and Active Labor Act

Under this law, also called EMTALA, patients with an emergency medical condition are entitled to a medical screening examination, stabilizing treatment and appropriate transfers before they are questioned about their ability to pay, explains Cheryl Fish-Parcham, a specialist with the Washington-based Health Assistance Partnership, part of Families USA.

"In an emergency, the hospital staff can't delay treatment just to get information about you, and they can't discourage you from remaining for further evaluation," she adds. In other words, they have to treat you and they can't delay treatment while you try to scrape up the cash.

Conditions such as severe pain, major impairment of body function, serious dysfunction of any body organ or any condition that left untreated could put your health in serious jeopardy are regarded as emergency medical conditions. A pregnant women whose own health or that of her unborn baby is jeopardized is also considered an emergency situation.

If you request ER treatment but you say it isn't an emergency, the hospital is only obliged to carry out screening to determine whether it's an urgent health threat.

If the hospital staff can't stabilize the patient, they can transfer the patient to another hospital, but only if the doctor in charge certifies in writing that the risk involved in the transfer is outweighed by the benefits.

Keep in mind the federal regulations guarantee you treatment when you need it but they don't obligate the hospital to give you free medical care or prohibit the hospital from billing you for any care you do receive. In most cases, if you can pay later, you'll be required to do so.

And make sure the aid you're seeking is from a hospital emergency room. "New regulations which took effect last year make it less clear about your entitlements to screening, emergency care and transfers if you go to an outpatient facility," warns Fish-Parcham. "The regulations are only clear about emergency room services."

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-- Posted: July 7, 2004
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