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Are emergency room visits covered under health insurance plans?

Yes, emergency room visits are covered under individual and group health insurance plans. Since 2014 the Patient Protection and Affordable Care Act (PPACA) has required insurance plans to cover emergency room visits. In fact, the PPACA makes these additional requirements:
  • Insurance plans cannot require you to get approval before you seek services from an emergency room provider or hospital that is outside of your insurance plan network of providers.
  • Insurance plans can't charge you higher copayments or coinsurance if you seek care at an out-of-network emergency room.
However, plans that have been in place since before March 23, 2010, known as grandfathered plans, do not have the same requirements. Read your own plan documents carefully to be sure you fully understand what is and is not covered.  

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.