Most of us don’t plan on ending up in an emergency room. Often, you don’t even realize that you’ve been transported there until you wake up on a gurney in a hospital gown. As anyone who has experienced this knows, emergency room bills can be costly, even after your insurance pays its portion.

If you don’t have insurance, the cost of a visit to the ER can be devastating. According to a study published in JAMA Internal Medicine, patients with no health insurance are charged four times what those with Medicaid coverage for ER services.

A practice that is referred to as “balance billing” allows hospitals to overcharge patients and their insurers for some of their services. If the insurance company deems a charge to be excessive, patients are left to foot the bill for the balance not covered by their insurer. Sometimes, because hospitals work with third-party service providers, patients are required to pay out-of-network prices even if they went to an in-network hospital.

The lead author of the study said that his researchers found large pricing disparities based on the location a patient’s insurance status, race and economic status as well as where they are admitted to a hospital. He says that this “points to the practice of price gouging by hospitals because patients often can’t pick their doctors in the emergency department.” Hospitals in areas with a large population of African Americans may charge as much as five times more than the Medicare rate.

Medical expenses are the leading cause of bankruptcy in this country. However, you don’t have to have a serious or chronic medical condition to be hit with medical bills you can’t handle. Any injury or illness that sends you or a loved one to an emergency room can wreak havoc on the family finances.

If you’re facing overwhelming debt due to medical expenses, it’s wise to seek legal guidance from a New Jersey attorney who can discuss your options with you and help you determine the best way to handle the situation.

Source: Second Nexus, “Patients Being Hit with Monster ‘Balance Billing’ from Hospitals,” June 12, 2017