Many people across the United States do not have health insurance. Although reasons vary, ranging from affordability, employment changes, legal status, and other life circumstances, not having medical insurance can be overwhelming and challenging.
Several federal and state laws protect uninsured individuals, allowing them to access the care necessary while avoiding unfair, costly medical bills and medical debt. This article outlines the rights of uninsured patients and what care hospitals and clinics are required to provide by law.
What is Health Insurance?
Health insurance is a type of coverage that helps patients pay for parts, if not all, of their medical treatments. Health insurance companies charge a monthly fee, also known as a premium, which covers costs such as doctor and hospital visits, medical tests, and other treatments a patient may need. However, even with insurance, people pay out-of-pocket, whether by choice or necessity, meaning the patient has to cover the portion of the bill that the insurance company did not pay. Uninsured patients do not have this option and are typically responsible for paying the full medical bill. Not having health insurance can make access to medical care difficult and often more expensive, however, uninsured people still have basic patient rights.
Right to Emergency Medical Care
If an uninsured individual has a medical emergency, hospitals legally cannot refuse to treat them because they don’t have insurance or a guaranteed method of payment.
Under the Emergency Medical Treatment and Labor Act (EMTALA), hospitals are required to:
Provide medical screening exams
Stabilize the diagnosed emergency condition
Not delay care to ask about insurance, payment, or immigration status1
Medical emergencies include any conditions that could result in serious harm or death without immediate professional care. This can include:
Chest pain
Trouble breathing
Heavy and uncontrolled bleeding
Labor and childbirth
Mental health crises
Severe injuries
Signs of stroke or heart attack
Right to Fair and Non-Discriminatory Treatment
Healthcare providers are legally not allowed to discriminate against patients based on their insurance status. Patients are also protected from discrimination based on income, race and ethnicity, immigration status, language, disability, gender, and religion.1 If language is a barrier, patients have the right to:
An interpreter to translate clearly in a language you understand
Respectful and culturally sensitive care2
Right to Know the Cost of Care
If an individual is paying for a treatment without insurance, they have the right to ask about the costs before receiving any non-emergency care. This includes asking how much a visit or test may cost, whether less expensive options exist, and what payment plans are available. Hospitals and clinics are expected to be transparent about their prices and billing.¹
Under federal law, uninsured and self-pay patients (individuals who choose to pay out-of-pocket) have the right to a good faith estimate of expected charges at least 3 business days before receiving any scheduled, non-emergency care.3 A good faith estimate includes the expected cost of services such as tests, procedures, facility fees, and room and board fees. It does not include services scheduled separately, such as pre-surgery appointments or follow-up visits. If the final bill is higher than the estimate, the individual has the right to dispute it.4
Uninsured patients are often charged higher prices, but they have legal rights to ensure they are being charged fairly. These rights include:
Disputing a bill if it's $400 or more above the good faith estimate4
Asking about payment plans and negotiating bills with the billing department5
Right to Financial Assistance
Most nonprofit hospitals are legally required to provide financial assistance, which is a type of community benefit offered for free or at a reduced cost for those who cannot afford to pay for their medical services. Under the Affordable Care Act, nonprofit hospitals are required to clearly explain their financial assistance policies during patient intake and discharge, and display them publicly throughout the hospital.6 Patients also have the right to ask a hospital’s financial assistance policy, apply for it even after receiving care, and get help completing their application. Although there is no federal eligibility standard, requirements vary by state.
Right to Privacy and Medical Records
An individual’s medical information is protected under federal privacy law, or HIPAA, even without health insurance. According to HIPAA, every patient has the right to:
Keep their health information private
Access their health information
Decide who else can access their health information7
Right to Understand and Choose or Refuse Care
All patients, regardless of insurance status, have the right to informed consent. This includes:
Asking as many questions as needed about diagnosis, procedures, and treatment
Understanding all the benefits and risks
Refusing treatments they do not want8
Immigration Status and Healthcare
Patients, insured or not, are not required to disclose their immigration status to receive care. Emergency care is available regardless of immigration status, and most financial assistance programs do not require citizenship to apply.9
Low-Cost and Free Care Alternatives
Uninsured patients may qualify for affordable medical care options for primary care, mental health care, women’s health, and pediatric care. These include:
Community health centers
Federally Qualified Health Centers (FQHCs)
Local free clinics that offer annual checkups
County health programs10
You can use this tool to find affordable care near you: https://nafcclinics.org/find-healthcare-services/11
Not having health insurance can be scary and make healthcare difficult to access, but there are resources and protections in place to help uninsured people get the care they deserve without the financial strain.
Sources:
CMS. (2024, September 10). Emergency room rights. https://www.cms.gov/priorities/your-patient-rights/emergency-room-rights
U.S. Department of Health and Human Services, Office for Civil Rights. (2025, July 18). Limited English proficiency (LEP). https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/index.html
American Hospital Association. (2023, February). Fact sheet: Hospital price transparency. https://www.aha.org/fact-sheets/2023-02-24-fact-sheet-hospital-price-transparency
CMS. (n.d.). Know your rights when you aren't using health insurance. https://www.cms.gov/medical-bill-rights/know-your-rights/no-insurance
CMS. (n.d.). Action plan: Medical bill payment options. https://www.cms.gov/medical-bill-rights/help/plan/no-insurance-cannot-pay-bill
Singer, S., Wilson, E., & Carare, T. (2022, July 28). Understanding required financial assistance in medical care. Consumer Financial Protection Bureau. https://www.consumerfinance.gov/data-research/research-reports/understanding-required-financial-assistance-in-medical-care/
U.S. Department of Health and Human Services. (2022). Your rights under HIPAA. https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
American Medical Association. (2024). Patient rights. https://code-medical-ethics.ama-assn.org/ethics-opinions/patient-rights
National Immigration Law Center. (2024, November 20). Is it safe to apply for health insurance or seek health care? https://www.nilc.org/resources/health-insurance-and-care-rights/
HealthCare.gov. (n.d.). How to find low-cost health care in your community. https://www.healthcare.gov/community-health-centers/
National Association of Free & Charitable Clinics. (2025, February 4). Find healthcare services. https://nafcclinics.org/find-healthcare-services/