A Virginia woman was in the midst of a life-threatening allergic reaction and was asked to pay hundreds of dollars before a nurse would administer a potentially life-saving EpiPen, according to a report.
Stephanie Rowell, who is uninsured, was stung by a wasp at her parents' home in July. Her symptoms rapidly progressed, and she was taken to a TruHealthNow urgent care center after experiencing throat tightness during the drive to an emergency room. At the urgent care facility, a nurse practitioner diagnosed her with anaphylaxis, a severe and potentially deadly allergic reaction that can cause airways to swell and blood pressure to drop.
Despite the diagnosis, Rowell stated that a medical assistant requested $400 upfront before she could receive the epinephrine injection. "I asked, ‘If I didn’t have the money, would you have just let me die?’ And they said, sorry, that is their policy," Rowell recalled.
Officials at TruHealthNow confirmed to KFF Health News that Rowell was asked to pay before the injection but stated their policy is to "give the shot and worry about the money later." The company also claimed Rowell's condition was stable when the payment was requested and that the request occurred while the injection was being prepared, denying any delay in treatment.
Federal law requires hospital emergency departments to stabilize patients regardless of their ability to pay, but this protection does not typically extend to urgent care clinics unless they are hospital-owned. Urgent care centers are not generally equipped to handle life-threatening emergencies, though patients sometimes seek care there in critical situations.
After receiving the EpiPen, Rowell's symptoms eased. She was monitored for about 30 minutes before being discharged. The total cost for her treatment was $605, including the medication, an administration fee, and the visit charge. Rowell stated she was not upset about the cost itself but believed she should not have been asked to pay before receiving the epinephrine. She now carries her own EpiPen.
Rowell's experience highlights the challenges faced by millions of uninsured Americans. The number of uninsured working-age adults in the U.S. increased to 11.2% in 2026, up from 8.9% in 2024, according to an October analysis by the Commonwealth Fund. This rise follows the expiration of enhanced federal subsidies that had made Affordable Care Act plans more affordable during the pandemic. The Commonwealth Fund estimates that 37 million Americans could be uninsured by 2036.