Foreigners accessing US healthcare.

[Dizzy]

I need to make a decision about whether to cancel my trip or not.

My main concern is obviously needing to access the hospital if something happens. I have insurance, so that should cover any medical needs financially (I'd need to speak to them about my recent admissions though), but would I just be able to turn up at a hospital and get treated/scans etc??

Would I have to pay then wait for insurance to pay, or would they just contact the insurance and they pay immediately? Do they need to have proof I can pay before they'd treat me??

If there was an emergency could I just call 911? Would they come out to me?

I'm assuming there's plenty of medical facilities everywhere (I'm going to major places, but travelling inbetween? And yosemite..?).

Anything else to consider???

 

[Fran27]

I'd contact your healthcare system here to see how it would work.

 

[Dizzy]

Huh where? Here? I don't think they'd know we have the NHS here..?

 

[xpaeanx]

Hospitals have an obligation to treat. Basically you would go in to the ER, if you weren't a need to be rushed in right now or else you will die emergency than they'll ask you to fill out paperwork(this is where you list your insurance) and sign a release saying if your insurance refuses payment you'll pay. You don't need any sort of proof you can afford to pay, and most people without insurance can't. (They actually have employees for us residents that help you file for government insurance OR they have money put aside that they will use to help offset your cost...how much is based on income and only covers care at that hospital). Yes you can just dial 911 for an ambulance to the hospital and yes they will come... But if you are with it and able to drive I would just drive myself there.

They have a billing department that will contact your insurance company and try to work out payment with them. You will be mailed copies of everything and only get a bill if your insurance doesn't cover something.

What I would do though is contact your insurance company and ask them how claims work when traveling and if there are any special considerations that you should know about. I've heard of companies wanting everything on a special form and not accepting anything else.

If you need treatment you will get it. It's the payment afterward that might be more of a headache, but they're not going to hold you captive until they're paid. LOL.

 

[Dizzy]

Thanks. My insurance is travel insurance, not specific health insurance, but covers illness/injury. I think I may need to call them and disclose anything that might come up between then and now (I don't recall having to disclose any health concerns, but I didn't have any when I got it!!).

I just want to get everything straight before I decide, and my decision will be based on how confident I am there won't be any problems!!!!!!

It's good to know they will treat, I just don't want to be left with a massive massive bill.

 

[release the hounds]

Then you'll want to find out exactly what your insurance will and won't cover and where. It's not uncommon to have an emergency and be billed for the facilities, the treatments, and the various specialty Doc's that may treat you. A simple visit to get checked out and sent home usually isn't more than a couple hundred bucks to an ER. But anything serious with a stay and treatment? you can pay insurance and still be socked with a huge bill because they cover the facility, but not the doctor. They cover "X" drug, but not "Y". They cover Drug "X" but only if administered by doctor "B", not Dr. "A"

Insurance is a funny thing these days and I've seen it all.

 

[SoCrafty]

There is a Federal act called EMTALA (Emergency Medical Treatment and Active Labor Act). This requires hospitals to diagnose and treat individuals regardless of their citizenship, legal status or ability to pay. It's also anti-dumping, which means they can't discharge you or transfer you to.another hospital unless you are stable. It applies only to those hospitals that participate with Medicare, but I would say the majority of hospitals do. If you needed urgent care, versus emergency care, you could also go to an urgent care facility (like let's say you are coughing and need an antibiotic, you could go to urgent care versus the hospital for that). Urgent care is much more affordable than hospital for minor health concerns.

I would call your travel insurance provider and a) ask what they cover b) if they have participating providers c) how you would get your care covered through them. Dealing with Medicare population, I sometimes see claims for doctors that don't take any insurance and the person pays in full and submits for reimbursement. They just need the.ICD-9 (diagnosis) and CPT or HCPCS (procedure codes). I don't think you go by the same codes we do, so if you have to send for reimbursement, I would have them write out your diagnosis in words, as well as the procedure performed.

If you are having an emergency, you would call 911. I would also ask about this: sometimes paramedics can treat you at the scene without needing to be transported. I would make sure that this is also covered with your travel insurance.

ETA: two things- if they prescribe medications you need to take after your visit is over, make sure it is available in the generic. Generics work just as well (same active ingredients) and are usually cheaper. If they are pushing a fancy drug name on you (if its easy to say like Cow instead of it being long with multiple syllables) it usually means its the newest drug and they probably had a rep come in and talk with them. If they can't write you a prescription for something similar that has a generic see if they can give you samples of the med they are trying to push.

 

[Dizzy]

Thanks. Very helpful. I will certainly chase all this up... I will have 4 days nothing like cutting things fine.

 

[katielou]

Honestly the pay up is a nightmare but getting the treatment is no issue at all.

You will have to disclose your recent admissions and it will likely void your insurance and you will have to pay to keep it if you want those things covered.

The hospitals generally really pressure tourists to pay up front not rely on the insurance. DONT DO IT!

 

[Dizzy]

Ok... Think I will call the insurance provider tomorrow..... It was a proper bargain too! Great cover and a great price! Suspect this may tip the balance!!!

Technically the hospital never gave me a formal diagnosis when I went in, so that may be in my favour, as I'm certainly not going to be saying I have something I don't have (even if I know what it is).

Thanks.

 

[GipsyQueen]

Shouldn't be a problem at all if you have your health care card with you.

I went to the ER while I stayed with a friend because I smushed my thumb in a car door the day before I was about fly, they didn't even ask more than, do you have insurance in Germany. They sent the bill home (took about 6 months, and they totally overcharged - $1000 to be exact.) but my insurance covered it, no questions asked. Just DONT PAY UPFRONT. They WILL send a bill, just like they do with anyone else.

 

[Dizzy]

Well I called my insurance provider and they weren't too concerned. I just need a letter from the dr saying I'm fit to fly. Which I don't know if I am yet, so we will see.. I didn't disclose the hospital trips yet, didn't see the point till I saw the dr next week. Will cross that bridge then.

But they pretty much cover most complications so that's good