This will be directed to emergencies. All hospitals are held in emergency medical care and staff action (EMTALA). When you leave the hospital they need to undergo a medical examination regardless of their ability to pay. Then they need to strengthen you no matter what you can afford.
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So if you have a heart attack they should treat you according to medication or refer you to a treatment center if they do not have the skills. They continue to treat you until you 1) get better enough that they are no longer considered a life-threatening condition or 2) find that they do not have the ability to manage you. For example, if you have a type of heart attack known as STEMI you need a cardiac cath lab. If the first hospital does not have one then they have a legal obligation to find you and refer you there.
Now, please note two things. The first is that the need to manage even if you can afford it does not mean they will not charge you. It means that they must treat you according to the dosage. Second is the need for basic care that will solve the life-threatening threat.
So if you come in with a rash on your face you will be stitched by an ED doc or surgeon. If you are looking for a plastic surgeon, then the hospital may decide that this is beyond its duties if the general practitioner / traumatized surgeon and ED doc do not think that is true and the plastic surgeon falls under the category of specialized care.
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