Isabella Carter
Knowing when to go to the emergency room can be confusing, especially when symptoms seem severe and your regular doctor's office is closed. The answer is not always simple, but understanding the difference between a walk-in clinic, an urgent care center, and an emergency room can help you get the right care and save money. This is especially important because treatment in an emergency department can cost 2 to 3 times more than the same care in your provider's office, and your health insurance may require you to pay a higher copayment.
| Characteristics | Values |
|---|---|
| When to go to the emergency room | When an illness or injury occurs, decide how serious it is and how soon you need medical care. If it is life-threatening, call 911 or go to the hospital emergency room. |
| Emergency medical condition | Experiencing contractions, cardiac arrest, major trauma, etc. |
| Treatment | The hospital must offer to treat the condition so that it does not worsen. |
| Stabilization | If the hospital cannot stabilize the patient, they must arrange an appropriate transfer to another hospital. |
| Screening examination | Hospitals are required to provide a medical screening examination to determine whether an emergency medical condition exists. |
| Insurance | The hospital can ask about health insurance, but only if it does not delay the screening or treatment. |
| Cost | Treatment in an emergency department can cost 2-3 times more than the same care in a provider's office. |
| Non-emergencies | Patients may visit the emergency room for non-emergencies, but insurance companies may deny coverage. |
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What You'll Learn
When to use an emergency room
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), or casualty department, is a medical treatment facility specializing in emergency medicine. It provides acute care for patients presenting with or without prior appointments, either by their own means or via ambulance. The department must offer initial treatment for a wide range of illnesses and injuries, some of which may be life-threatening and require immediate attention.
When deciding whether to go to an emergency room, it is important to assess the severity of your illness or injury and how soon you need medical care. Treatment in an emergency department can be significantly more expensive than receiving the same care from your regular healthcare provider. Additionally, your health insurance may require a higher copayment for emergency department visits.
If your condition is not life-threatening or risking disability, but you are concerned and cannot see your provider soon enough, consider visiting an urgent care clinic. Urgent care clinics can treat common mild illnesses like colds, flu, earaches, sore throats, migraines, low-grade fevers, and minor injuries such as sprains, back pain, minor cuts, burns, minor broken bones, or minor eye injuries.
In the event of a suicide attempt or other life-threatening situations, call 911 or your local emergency number immediately. Do not delay seeking medical attention, and do not leave the person alone, even after help has been called.
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Emergency room costs
The cost of visiting an emergency room varies depending on several factors. In the United States, the average cost of an emergency room visit in 2025 is $2,715, with some cases exceeding $3,000. Without insurance, the average cost falls between $2,400 and $2,600. The amount you pay will depend on your insurance coverage, the nature of your condition, and the tests and treatments you receive.
There are several types of fees associated with emergency room visits:
- Triage fees: Registration fees that typically range from $200 to $1,000.
- Facility fees: Charges for using the facility, including the room and nursing staff, which can average around $1,100 to $1,200. These fees are based on the severity of your condition and can make up 80% of the total cost.
- Professional fees: Charges for physician and specialist services, which vary based on the treatment provided.
- Supplies and medications: Costs for items such as IV fluids, wound dressings, sutures, and prescribed medications.
It is important to note that emergency room visits are significantly more expensive than receiving the same care from your regular healthcare provider or an urgent care clinic. Urgent care clinics can treat non-life-threatening issues such as mild illnesses (e.g., colds, flu, sore throat) and minor injuries (e.g., sprains, minor cuts, minor broken bones). If you have insurance, visiting an urgent care clinic may be a more cost-effective option, as the average cost of treating a non-emergency condition is $185 or less.
Additionally, if you are facing high hospital bills from an emergency room visit, you may be able to negotiate your bill or request a discount based on your age, income, or ability to pay the full amount upfront. Membership-based plans like Mira can also help by providing access to affordable urgent care, virtual primary care, mental health services, and discounted prescriptions.
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Medical screening examination
When deciding whether to go to the emergency room, it's important to assess the severity of your illness or injury and how soon you need medical care. Treatment in an emergency department can be significantly more costly than at a provider's office, and health insurance may require a higher copayment.
The Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals that participate in Medicare and provide emergency services to offer an appropriate medical screening examination to anyone who comes to their emergency department seeking treatment. This is to determine whether an emergency medical condition exists. This applies regardless of the patient's insurance status, ability to pay, citizenship, national origin, race, creed, or colour. Hospitals must also offer necessary stabilising treatment or transfer to another medical facility if an emergency condition is detected.
The CMS defines a dedicated emergency department as "a specially equipped and staffed area of the hospital used a significant portion of the time for initial evaluation and treatment of outpatients for emergency medical conditions." This includes not only what is generally considered to be a hospital's emergency room but also other departments, like labour and delivery or psychiatric units, that meet the one-third criteria. This means that hospital-based outpatient clinics not equipped to handle medical emergencies are not obligated under EMTALA and can refer patients to a nearby emergency department.
If you are unsure whether to go to the emergency room, urgent care, or a walk-in clinic, it is recommended to contact your primary care doctor’s office first to see if you can get a same-day appointment. Urgent care clinics can treat common mild illnesses, such as colds, the flu, earaches, sore throats, migraines, low-grade fevers, minor injuries, and limited rashes. If your condition is life-threatening or risking disability, go to the emergency room or call 911 or your local emergency number immediately.
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Emergency medical conditions
When an illness or injury occurs, it is important to decide how serious it is and how soon to get medical care. This will help you choose whether to go to the emergency room, a walk-in clinic, or an urgent care center. Treatment in an emergency department can cost 2 to 3 times more than the same care in your provider's office, and your health insurance may require you to pay a higher copayment for care in an emergency department.
An emergency department (ED), also known as an accident and emergency department (A&E), is a medical treatment facility specializing in emergency medicine and the acute care of patients who present without prior appointment. The emergency department is usually found in a hospital or other primary care center. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention.
The federal Emergency Medical Treatment and Labor Act (EMTALA) requires any hospital that participates in Medicare and provides emergency services to provide an appropriate medical screening examination to anyone who comes to its emergency department asking for treatment. Hospitals must offer this screening exam even if the patient cannot provide insurance information or proof of ability to pay. If an emergency medical condition is detected, the hospital must offer to treat this condition so that it does not materially worsen. If the patient's emergency medical condition cannot be stabilized by the staff and facilities available, the hospital must offer an appropriate transfer to a hospital that can stabilize the condition.
Examples of emergency medical conditions include cardiac arrest and major trauma. Symptoms that can be evaluated and treated at an urgent care clinic include mild illnesses such as colds, the flu, earaches, sore throats, migraines, low-grade fevers, and limited rashes, as well as minor injuries such as sprains, back pain, minor cuts and burns, minor broken bones, or minor eye injuries.
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Treatment and stabilisation
If an emergency medical condition is identified, the hospital must offer treatment to stabilise that condition. This may include providing necessary medications, procedures, or interventions to resolve or improve the patient's condition. Stabilisation aims to prevent the condition from materially worsening and ensure the patient's vital signs are stable. For example, in cases of cardiac arrest or major trauma, defibrillators, automatic ventilation, CPR machines, and bleeding control dressings may be used to stabilise the patient.
The hospital must continue treating the patient until their emergency medical condition is resolved or stabilised. If the hospital lacks the necessary resources or specialised capabilities to treat the patient effectively, they must facilitate an appropriate transfer to another hospital that can provide the required level of care. This transfer must be done in accordance with EMTALA provisions, and the receiving hospital must accept the transfer.
It is important to note that emergency rooms are designed to handle acute care and life-threatening situations. In cases where the condition is not an emergency, individuals may consider seeking treatment from their primary care provider, an urgent care clinic, or a walk-in clinic. These alternatives can provide treatment for mild illnesses, minor injuries, and non-life-threatening conditions, helping to free up emergency rooms for the most critical cases.
Urgent care clinics can treat common mild illnesses like colds, flu, earaches, sore throats, migraines, low-grade fevers, and minor injuries such as sprains, back pain, minor cuts, burns, and minor broken bones. They are typically more cost-effective than emergency rooms and can provide timely care for conditions that do not require the intensive resources of an emergency department.
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Frequently asked questions
An emergency room, also known as an emergency department (ED), accident and emergency department (A&E), or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment.
Generally, emergency use of an emergency room is constituted by a medical condition that requires immediate attention. This could include cardiac arrest, major trauma, or other illnesses and injuries that are life-threatening.
Under the Emergency Medical Treatment and Labor Act (EMTALA), you have the right to a medical screening examination and treatment regardless of your insurance status, ability to pay, or citizenship status. If your medical condition is deemed an emergency, the hospital must offer to treat it so that it does not materially worsen. If they are unable to stabilize your condition, they must arrange an appropriate transfer to another hospital.
