Nationwide, some insured patients are being asked by hospitals to pay larger portions of their bills upfront, and sometimes hospitals will not do the procedures until they get their co-payments. Hospitals administer emergency treatment without asking for payment first, but elective or scheduled procedures can be withheld depending on a patient's ability to pay. An informal survey of 22 hospitals in Florida's Broward and Palm Beach counties found that all have required upfront payments for elective surgeries for several years. Hospital officials said patients might be shocked by the larger amounts requested as insurance companies require patients to make higher out-of-pocket payments.