Uninsured woman asked to pay $400 before receiving life-saving allergy shot

Stephanie Rowell was told to pay $400 up front for a life-saving epinephrine injection before she received the shot at a Virginia urgent care center in July. The 53-year-old manager suffered a severe allergic reaction to a wasp sting while standing on her parents' porch in Round Hill, Virginia. Her arm burned, her body itched, and her face swelled. She took Benadryl, but her throat tightened and breathing became difficult. Her father drove her 10 minutes to a TruHealthNow facility in Purcellville, rather than the nearest emergency room, which was 25 minutes away.

Rowell has been uninsured since 2025. A nurse practitioner diagnosed her with anaphylaxis and determined she needed epinephrine. A medical assistant then informed Rowell she had to pay the $400 medication cost before the injection. Rowell returned to the waiting area to get her debit card from her father. After paying, she received the shot. Her symptoms eased within minutes. She asked if she would have been allowed to die if she lacked the funds. The staff member said it was their policy.

TruHealthNow operates eight urgent care centers in Northern Virginia and Maryland. CEO Preet Takhar stated the company's standard policy is to treat patients first and handle billing later. However, officials confirmed Rowell was asked for payment. Medical Director Manbir Takhar explained that the nurse practitioner deemed Rowell stable before the payment request was made. The request did not delay the shot. Manbir Takhar is married to Preet Takhar.

The total bill for the visit was $605. This included $400 for the medication, a $40 administration fee, and $165 for the visit. A medical assistant monitored Rowell for 30 minutes after the injection and checked her vital signs. Federal law requires hospital emergency departments to stabilize patients regardless of ability to pay. Urgent care centers are generally exempt from this requirement unless owned by a hospital, according to Barry Furrow, a health law director at Drexel University.

The Urgent Care Association reported that more than 15,000 centers handled about 185 million patient visits in 2025. These clinics typically treat minor ailments but are not designed for life-threatening emergencies. Alan Ayers, an industry consultant, noted that while collecting copays at check-in is standard, it should not apply to anaphylaxis. Arthur Caplan, a medical ethics professor at New York University, said doctors have an ethical obligation to treat emergencies without demanding up-front payment.

Rowell went home after the visit. Her brother stayed with her to monitor for complications. She felt wiped out and took several days to recover. Her daughter posted about the experience on a Facebook community page, generating hundreds of comments. Rowell said she was not upset about the price, which was higher than the generic EpiPen cost of about $175, but objected to the timing of the payment demand. She now carries an EpiPen.