Insurance companies cover hospital bills at a reduced rate. The amount of the discount varies per insurance company. When the insurance company pays its half, the reduced amount (adjustment) is deducted to represent the patient's real obligation (co-insurance). If the patient cannot pay his or her share of the bill in full, then the insurance company can request that the patient pay a partial amount (deductible). As long as the patient meets this deductible requirement, all of the remaining balance is his or hers to use as he or she sees fit. When a patient arrives at the emergency room without insurance, they are responsible for all costs upfront. Emergency rooms usually have a list of local resources that patients can access if they are unable to pay their bill in full. If a patient has the ability to do so, they should try to resolve their issue with their primary care physician before arriving at the ER. This will help keep costs down and get them into treatment faster. It is important to know your insurance coverage limits. For example, if you have hospital indemnity insurance, there may be a limit to how much it will cover each year. If you exceed this limit, you could be on the hook for any excess charges. In addition, some policies also have a limit on how much can be spent on medical services during an annual visit.