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Increasing numbers of American hospital emergency rooms are demanding up front fees for services they don’t consider true emergencies. The demands have been put into place to relieve pressure on emergency rooms overburdened by patients using them as walk-in clinics or substitutes for doctors’ offices.

The imposition of these fees makes it especially important for international patients to make sure they have proof of health insurance with them when presenting to emergency rooms so admissions staff can verify their coverage.

All U.S. hospitals with emergency rooms are required by law to treat emergencies and stabilize patients regardless of  their ability to pay or if they are uninsured.  But if the service is not considered a true emergency, or if they can’t verify coverage, the hospitals can decline to provide service or they can demand the up front payments, some of which are running as high as $350.

According to Kaiser Health News Service, about 80,000 emergency room patients at HCA-owned hospitals left without being treated last year when told they would have to pay up front because their cases were not truly urgent. HCA is the largest for-profit hospital system in the country.  Other for-profit hospital networks have followed HCA’s lead as have some non-profits.  It is estimated that at least half of all hospitals nationwide now charge the up front emergency room fees.

Hospital spokesmen also claim the emergency room fees are necessary to help them offset mounting debt left behind by the uninsured, many of whom can’t pay their bills.

All travel insurers advertising on this site meet TravelinsuranceFile’s acceptability criteria for out-of-country health benefits for Canadian residents. All provide proof of coverage documents acceptable to hospital admissions staff. You can also complete your applications and buy online.