Emergency services are an essential health benefit, which means that they are covered by all health plans sold through Get Covered Illinois. In the event of an emergency, you should seek treatment at the hospital that can best assist you at that time. Insurance plans cannot require you to get prior approval before getting emergency room services from a provider or hospital outside your plan's network.
Insurance plans also cannot make you pay more in co-payments or co-insurance if you receive emergency care from an out-of-network hospital. The out-of-pocket cost for your emergency room visit will depend on the plan that you are enrolled in and the hospital you visit. For example, the care may be subject to a deductible, or the hospital may have its own cost-sharing rules in place.