I'm guessing he had no health insurance because he is self employed. Almost all plans have a max out of pocket, which is the maximum you have to pay before insurance covers 100% of the cost. Our's is $6000. After we spend $6000 for the family, everything else for us is no cost. This year my insurance has been billed almost $300,000 and we only had to pay $6000. Trying to get in all of my visits and tests now before the end of the year. I think most health insurance has a similar policy. If it's " out of network ", our max is $18,000 I think. We never do that. If you have a medical emergency and the hospital is out of network, the bills are covered as if it were in network.