🚑 Emergency Only 是什麼？為什麼家長常常搞混？
在美國，無證移民（undocumented）通常只能使用一種非常有限的醫療補助，叫做：
Emergency Medicaid（Emergency Only）＝只限急診、只限救命。
這個制度是聯邦法律要求各州必須提供的最低限度醫療安全網，但它的覆蓋範圍非常狹窄，和一般的保險差很多。
很多家長會以為：
「Emergency Medicaid = 可以看急診 + 生病可以去掛號」
但其實完全不是這樣。
⚠️ Emergency Only 只能涵蓋這三大類「救命」情況
基本原則：必須是生命有危險、器官功能受威脅、急性惡化到不可延遲，才會被認定為 emergency。
- 1️⃣ 危及生命的急症（Life-threatening emergency）
包含：高燒引發抽搐、嚴重呼吸困難、敗血症、急性重度脫水、器官衰竭等。 - 2️⃣ 嚴重外傷或急性醫療狀況
例如：車禍、骨折、頭部外傷、大出血、被刀割傷、大面積燙傷。 - 3️⃣ 孕婦的緊急狀況（Emergency labor & delivery）
包含：臨盆、生產、急產、嚴重妊娠中毒等。
其他狀況 → 幾乎一律不算 Emergency。
❌ Emergency Only 不包括什麼？（家長最常誤會）
下面這些幾乎 100% 都不會被 Emergency Medicaid 付費：
- 🚫 普通的感冒、發燒、喉嚨痛
- 🚫 耳朵痛、腸胃炎、嘔吐腹瀉但沒有脫水到危急程度
- 🚫 小兒科例行健檢、校園體檢、疫苗
- 🚫 氣喘、過敏、濕疹、糖尿病等慢性病的追蹤與用藥
- 🚫 心理或情緒問題（焦慮、憂鬱、創傷）
- 🚫 牙科（除非是嚴重感染引發敗血症）
- 🚫 寶寶發展遲緩的評估、語言治療、OT/PT
一句話說清楚：
Emergency Only ≠ 看病
Emergency Only ＝ 保命
👶 為什麼家長會混淆「急診」與「Emergency Medicaid」？
因為有三個原因：
- 1️⃣ 美國急診必須收你（EMTALA）
急診室不能因為你沒有身份、沒有錢、沒有保險就拒診。
所以家長會以為：「既然急診一定會收，那就是有保險？」
➤ 其實不是。急診會收你，但費用可能全額自付。 - 2️⃣ 醫院會先治療後判斷是否屬於 Emergency
有時候看起來很嚴重，但醫師評估「不屬於危及生命」→ 不算 Emergency → 不給付。 - 3️⃣ 醫院可能先幫你申請 Emergency Medicaid
但只有符合 emergency criteria（急救標準）才會批准，其他費用仍然會寄帳單給你。
📋 家長需要記住的「Emergency Only 核心原則」
- 📌 醫院只會替「符合 emergency」的部分申請 Emergency Medicaid。
- 📌 不是每次去急診都會算 emergency。
- 📌 很多急診室會先救，再分帳單給你（很正常）。
- 📌 孩子有慢性病＝不能靠 Emergency Only，必須找社區診所。
🧭 如果孩子不是緊急狀況，該怎麼辦？
以下是沒有身份、也沒有保險的家庭最常用的替代方式：
- ✔️ 社區健康中心（FQHC）
Sliding scale（依收入計價），不會問身份，數百萬家庭靠這個生活。 - ✔️ 低收入診所 / 教會診所 / 學校健康中心
很多提供 $20–$50 基本看診。 - ✔️ 如果在加州或紐約 → 優先幫孩子申請正式保險
Full-scope Medi-Cal（CA）
Child Health Plus（NY）
這兩州對孩子相對友善。 - ✔️ 若孩子是美國公民 → 可正常申請 Medicaid/CHIP
家長身份不影響孩子資格。
🤝 最後一句話：Emergency Only，是「最低限度的救命線」
Emergency Medicaid 是一條必要但非常有限的安全線，它能保命、能急救，但不能代替日常醫療，也不能照顧孩子的長期健康。
如果你住在加州或紐約，請務必幫孩子申請正式兒童保險。
如果你住在德州或佛州，社區診所和 FQHC 會是你最重要的夥伴。
🚑 What Does “Emergency-Only” Actually Mean?
In the United States, undocumented immigrants usually have access only to a very limited form of medical assistance known as:
Emergency Medicaid (Emergency-Only) = life-saving care only.
This program is required by federal law, but its coverage is extremely narrow and very different from regular health insurance.
Many parents believe:
“Emergency Medicaid = emergency room + basic sick visits.”
But that is not how it works. At all.
⚠️ What Emergency Medicaid Does Cover
To qualify, the situation must involve immediate danger to life or severe impairment of bodily function. In practice, Emergency Medicaid usually covers only three categories:
- 1️⃣ Life-threatening medical emergencies
Examples: seizures with fever, severe breathing difficulty, septic shock, acute organ failure, or dangerous dehydration. - 2️⃣ Serious injuries or acute trauma
Examples: car accidents, broken bones, head trauma, deep wounds, major bleeding, extensive burns. - 3️⃣ Emergency labor and delivery
Includes: labor, childbirth, emergency C-section, severe preeclampsia.
If it is not truly life-threatening, it usually does not qualify.
❌ What Emergency Medicaid Does NOT Cover
Almost all of the following are not covered:
- 🚫 Common colds, fever, cough, sore throat
- 🚫 Vomiting or diarrhea (unless severe dehydration becomes life-threatening)
- 🚫 Regular pediatric visits, checkups, school physicals, vaccines
- 🚫 Asthma, allergies, eczema, diabetes — ongoing treatment or medications
- 🚫 Mental health care (anxiety, trauma, depression)
- 🚫 Dental care (unless severe infection threatens life or causes sepsis)
- 🚫 Developmental evaluations, speech therapy, OT/PT
In short:
Emergency-Only ≠ normal medical care
Emergency-Only = life-saving care only
👶 Why Do Parents Often Confuse “Emergency Room” with “Emergency Medicaid”?
There are three main reasons:
- 1️⃣ Emergency rooms must treat you (EMTALA)
ERs cannot turn you away because of immigration status or ability to pay.
This makes families think: “If they treated us, insurance must cover it.”
➤ Not true. Treatment ≠ coverage. You may still receive a bill. - 2️⃣ The hospital treats first, then determines if it qualifies
A condition may look serious, but after evaluation the doctor may decide it is not a federal emergency → Emergency Medicaid does not pay. - 3️⃣ Hospitals sometimes help submit an Emergency Medicaid application
But only the emergency portion is covered; the rest may still be billed to the family.
📋 Key Principles Parents Should Remember
- 📌 Emergency Medicaid only covers the emergency portion that meets the federal definition.
- 📌 Not every ER visit is considered an “emergency.”
- 📌 Hospitals may stabilize your child but still send a bill afterward.
- 📌 Children with chronic conditions cannot rely on Emergency Medicaid.
🧭 What If the Child Is NOT in a Life-Threatening Emergency?
Families without insurance or immigration status often rely on the following safe and low-cost options:
- ✔️ Community Health Centers (FQHCs)
Offer sliding-scale fees, do not require immigration documentation, and provide pediatric care for millions of families. - ✔️ Low-cost clinics, church clinics, and school-based health centers
Many provide basic sick visits for $20–$50. - ✔️ If you live in California or New York
Apply for full coverage programs:
– Full-scope Medi-Cal (CA)
– Child Health Plus (NY)
These states are significantly more supportive of children’s health. - ✔️ If the child is a U.S. citizen
They may qualify for Medicaid/CHIP — the parent’s immigration status does not affect the child’s eligibility.
🤝 Final Thought: Emergency-Only Is the Minimum Safety Net
Emergency Medicaid is a vital but very limited safety net. It can save a child’s life, but it cannot replace regular pediatric care, preventive visits, or long-term treatment.
If you live in California or New York, apply for full-scope children’s coverage as early as possible.
If you live in Texas or Florida, community clinics and FQHCs will be your most important long-term resources.