paying foreign medical bill - after the fact:( back from vacation

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blackcat allie
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paying foreign medical bill - after the fact:( back from vacation

Post by blackcat allie »

So please forgive if this post is somewhat disjointed and less than perfect style - the issue has me in quite the morass.

I recently went to italy, and incurred an approximately $6000 medical bill. Yesterday I received a certified international letter with bill :shock: asking for payment within 30 days of invoice.

Now I didn't do a good job reading the wise Boglehead posts, because I only carried a secondary travel policy from a company named AXA (via compiler site Yonder, that my tour company recommended). :oops:

AXA travel insurance told me right away that things would need to go first through my main medical insurance, and then possibly they would pay the remainder. (Yes I was eligible, but they didn't inspire big confidence in this feat of secondary reimbursement)

Next call - to my regular in-state medical insurance company (high deductible, ppo) - I was told that *if* I successfully filled out about 5 forms, I would be eligible for slightly less than $300 (Dollars - not Euros or thousands) in compensation.

So earlier today I called Italian hospital itself, and -without drafting a formal payment plan- did offer to send them 1000 Euros.
The administrator/clerk didn't sound like a fan of ye olde American negotiation on high bills.
She did give me her name, and sounded sympathetic, but said she "didn't want this to take a year."
At present my plan is to wire or mail the partial amount.

:confused A completely different approach, I'm told, would be "lol I'm not paying that." (This is from one of my less solvent friends.)
I'm wondering though, what would happen, what are the consequences of not paying in full?
--would it be reported to American or international credit bureaus?
--would it affect my ability to stay or live in that -or another- EU country?
--would I be given a blue letter or red letter, and marked an international deadbeat?

And is my 1000 Euro attempt completely irrational, or a small show of good faith, in the absence of administrators wanting to make a formal payment plan?

Thanks so much to anyone for reading this far, and any thoughts, suggestions, and/or ameloriating annecdotes..
“Nothing in life is as important as you think it is while you are thinking about it.” - Daniel Kahneman
HomeStretch
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by HomeStretch »

Glad to hear you received necessary medical treatment while in Italy and are OK. Likely $6,000 is a fraction of the cost for comparable treatment in the US. IANAL but my guess is that if you don’t pay, if the hospital gets a judgment against you you won’t be allowed entry into Italy until paid.

Why not go through the insurance submission process to your insurer and AXA? Perhaps you will be pleasantly surprised and a good portion of the bill will be reimbursed.
SQRT
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by SQRT »

Do you think the amount is unreasonably inflated in some way? Did you actually receive reasonable treatment? Do you feel you actually owe the amount? If the answer to these questions is yes, you should pay the whole amount. Whether or not you have adequate insurance is your issue not the hospital in Italy. They treated you without asking for payment up front-to their credit.

Incidentally, my wife has had medical treatment in Italy on two separate trips. She got excellent care and she was presented with bills once we got back home. They seemed quite reasonable and we paid them in full via bank wires. Granted they were quite a bit less than $6,000.

Also, a friend had a biking accident while in Sicily a few years ago. She was in intensive care for 12 days and at one point was close to death. Emergency surgery by a US-trained doctor saved her life. Her husband said total cost was about $14,000. He paid it happily.

Italy appears to have a high quality universal health care system with reasonable costs. They seem to treat patients first and ask to be paid later.
Last edited by SQRT on Fri Nov 01, 2019 3:07 am, edited 1 time in total.
MarkBarb
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by MarkBarb »

I'm missing something here. Why wouldn't you pay them the $6,000 and then submit your claims through your insurers? It isn't the medical providers fault that your insurance is slow to pay. It isn't unreasonable for them to expect to be paid in a timely fashion. Is there some reason that you don't think you owe them the money?
Trader Joe
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by Trader Joe »

blackcat allie wrote: Thu Oct 31, 2019 12:46 am So please forgive if this post is somewhat disjointed and less than perfect style - the issue has me in quite the morass.

I recently went to italy, and incurred an approximately $6000 medical bill. Yesterday I received a certified international letter with bill :shock: asking for payment within 30 days of invoice.

Now I didn't do a good job reading the wise Boglehead posts, because I only carried a secondary travel policy from a company named AXA (via compiler site Yonder, that my tour company recommended). :oops:

AXA travel insurance told me right away that things would need to go first through my main medical insurance, and then possibly they would pay the remainder. (Yes I was eligible, but they didn't inspire big confidence in this feat of secondary reimbursement)

Next call - to my regular in-state medical insurance company (high deductible, ppo) - I was told that *if* I successfully filled out about 5 forms, I would be eligible for slightly less than $300 (Dollars - not Euros or thousands) in compensation.

So earlier today I called Italian hospital itself, and -without drafting a formal payment plan- did offer to send them 1000 Euros.
The administrator/clerk didn't sound like a fan of ye olde American negotiation on high bills.
She did give me her name, and sounded sympathetic, but said she "didn't want this to take a year."
At present my plan is to wire or mail the partial amount.

:confused A completely different approach, I'm told, would be "lol I'm not paying that." (This is from one of my less solvent friends.)
I'm wondering though, what would happen, what are the consequences of not paying in full?
--would it be reported to American or international credit bureaus?
--would it affect my ability to stay or live in that -or another- EU country?
--would I be given a blue letter or red letter, and marked an international deadbeat?

And is my 1000 Euro attempt completely irrational, or a small show of good faith, in the absence of administrators wanting to make a formal payment plan?

Thanks so much to anyone for reading this far, and any thoughts, suggestions, and/or ameloriating annecdotes..
I would pay my bill asap.
ivk5
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by ivk5 »

Pay bill for services rendered. Submit applicable insurance claims. Be glad your ok and move on with life. (Consider different travel insurance next time, perhaps. Or perhaps not.)

It’s always tempting to think someone, like your deadbeat friend, is getting a “better deal” and we’re the losers getting the short end of the stick because we uphold our social/contractual/social-contractual obligations. But really, unethically or unlawfully refusing to pay what’s owed is nothing to be envious of.
IowaFarmBoy
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by IowaFarmBoy »

I agree that you need to pay this bill.

A couple of questions:
  • What reason did your primary carrier give for only covering $300? Is it because you haven't met your deductible or do they have limits/restrictions on coverage outside the US? If it is deductible, you would be expected to pay it in the US. If a international limit of some kind, maybe there is an appeals process.
  • If your primary carrier won't cover it, it sounds like this is what the AXA coverage is for. If it is a deductible issue, I'd would guess that AXA has that excluded (but that is a total guess.) Have you pursued AXA with this info?
csm
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by csm »

IIRC, AXA was the insurer via our American Express UK-issued credit card when my husband needed an emergency appendectomy while we were on vacation in Florida. We did not live in the U.S. at the time; he is a Danish citizen.

I called AXA from the emergency room at the hospital and they sent a fax authorization to the hospital for direct payment. We never saw a bill nor did we pay anything out-of-pocket first for subsequent reimbursement, but did ask for a print-out of the final invoice which was around $32,000 for a 36-hour hospital stay and surgery. AXA paid in full without an issue. We did not have U.S.-based health insurance at the time, although the AXA policy would have required us to use it first by disclosing the information on the form we had to fill out.

All of this is to say that AXA came through for us, big time. Have you tried to contact AXA to have them arrange payment? It might be as simple as providing them the details of your own insurance so they can negotiate with your primary insurer any payment they will make, then AXA would pay the balance.

You could keep in touch with the administrator of the hospital in Italy to let them know you are working on this with the insurance company if making the full payment in 30 days and filing for subsequent reimbursement with AXA is a hardship. Or you could pay and send a request for reimbursement to AXA but be sure to coordinate with AXA to find out what they need in documentation to settle the claim in get that from the Italian hospital in advance. It will be easier (for you) if AXA can work with the hospital and your primary insurer directly, but if they're not, you will need to pay and file a claim.

Why are you hesitant to pursue AXA? Sorry if that isn't the case but that's how it read in your post.
Deblog
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by Deblog »

This is the reason some places require payment by credit card before they treat. A friend had her sister call from Mexico and needed her credit card because her husband was having a heart attack and they had no travel insurance at all. They did not have $10,000 Available on their card, so my friend had to cover it. No treatment without payment. It sounds harsh but the sheer volume of foreigners coming to the country and requiring care, they would lose a lot of reimbursement with people not paying once they are home. Luckily you received treatment and are fine, now yes, you need to do paperwork for reimbursement. The secondary will not cover the high deductible so if that is part of why insurance only pays $500, you will be responsible for difference. There are travel insurance policies that medical is primary. That is the way to go.
theplayer11
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by theplayer11 »

My HDHP HMO states services are not covered outside the USA with the exception of emergency services. I would check your plan.
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HueyLD
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by HueyLD »

+1 for Deblog.

Even in the U.S., hospitals in some tourist heavy areas also ask for upfront CASH payment from uninsured foreign tourists. They don’t even trust credit card payments because some tourists (mainly Europeans) contest such CC payments after they are treated and sent home. So, hospitals require them to do cash advance beforehand.

If more Yanks refuse to pay those who saved their lives in another country, more Americans will be asked to pay for medical care upfront and the consequence could be one’s life.
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ResearchMed
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by ResearchMed »

IowaFarmBoy wrote: Thu Oct 31, 2019 5:14 am I agree that you need to pay this bill.

A couple of questions:
  • What reason did your primary carrier give for only covering $300? Is it because you haven't met your deductible or do they have limits/restrictions on coverage outside the US? If it is deductible, you would be expected to pay it in the US. If a international limit of some kind, maybe there is an appeals process.
  • If your primary carrier won't cover it, it sounds like this is what the AXA coverage is for. If it is a deductible issue, I'd would guess that AXA has that excluded (but that is a total guess.) Have you pursued AXA with this info?
This.

First, pay the bill.

Then, why in the world would you not submit the bills to both insurers, in the required order?
That is precisely why you have health care coverage, right?

Submit to primary, and when they have paid whatever they pay, and show what they won't pay, then submit the remainder to your travel insurance.

Note: IF you have primary travel insurance (we always get that; sometimes it costs $25 extra for the entire policy, to make it primary), then you probably could have contacted the travel insurer via [they may have a "call collect" number for overseas calls, but using Skype, it's very cheap anyway] and they may have been able to deal with the bill then, or at least start the ball rolling.

Why do you doubt AXA without even submitting the claim to see if they cover their claims?
Is there some terminology in the policy that suggests that you wouldn't have been eligible in the first place (like a pre-existing condition, or not purchasing within some sort of deadline)?

RM
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Jack FFR1846
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by Jack FFR1846 »

Just as a data point.....

If you decide to wait for your primary to send you notification of a $300 payment, then send that notification to AXA. Deal next with them while you fill out all the forms for your primary to get that $300.

Italy can wait. My wife and I were hospitalized in the ER in Maui and even there, they required payment by credit card before we left because they said that collecting on the mainland for them was near impossible. We did leave without paying and let our insurance handle it, which they did. If it's that difficult from Hawaii, then I would expect that Italy won't even try. Let them wait and if you're paid by your insurance, send that money along. If AXA doesn't pay them directly and instead sends you a check, then send that along.

If both insurance companies fulfill their obligations and you still owe something, pay that difference.

That's what I would do. You can do differently.
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rich126
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by rich126 »

This has always been a concern of mine when traveling outside the US. Usually I get some form of travel insurance that includes health but it is always hard to determine what all is covered. I'd rather pay $200 or whatever rather than risk the cost of something more,especially if transportation is needed.

Fortunately I've never needed anything. My brother, quite a few years ago, while skiing in France, fell and cut his head and needed stitches and was taken to a hospital. He was pretty surprised that the bill was almost nothing (I think under $100).

Hope you are feeling better.
obgraham
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by obgraham »

I know I'm just old fashioned, but I tend to look at a situation like this as "did the seller provide the service for which they sent me a bill?"
So in this case, the Italian hospital did indeed provide service, and without knowing the details, the bill sounds reasonable. (Now if this involved a quick ER visit and a tylenol, a different scenario will play!) Do they not deserve to be paid for the service?
I find it irrelevant that the service was foreign vs domestic.
If I were OP, I'd pay the bill. The insurance is my problem to work out, not theirs.
Shallowpockets
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by Shallowpockets »

The honest approach is to pay the bill. Then you can take it up with insurance.
A $6k bill seems like you were given care in response to something serious that you really needed to seek care. In essence, they saved your vacation, maybe your life. You should be grateful. You stated you had a high deductible plan and so are aware of the possibility of large amount of money out of your pocket.
All your queries are looking to do an end run around your bill and your responsibility. In fact, you stated what would happen if you ignored the bill since they were in Italy. You are more concerned about how that impacts you than the right or wrong of the action.
You went through the trouble to call the hospital in Italy which sounds like a lot of trouble instead of calling all your insurances.
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Doom&Gloom
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by Doom&Gloom »

Is there a rationale for not paying it other than you might be able to get away with it?

If not, follow the advice above: pay it, deal with your insurance carriers, and move on.
And be grateful that you were able to obtain medical treatment when you needed it.
SrGrumpy
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by SrGrumpy »

Don't be that American tourist. Do the right thing.
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ResearchMed
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by ResearchMed »

OP - a lot of people have responded.

Is there a reason that you are not *using* the insurance policies you have?
You paid for the policies, so just use them.

Then, *if* there isn't payment, you'll have a problem.
But if you have proper travel insurance, that should be precisely what is useful now.

RM
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Topic Author
blackcat allie
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by blackcat allie »

Thanks everyone, pardon I didn't get a chance to properly respond to the many good points and requests for clarification.

I guess I just hate hate insurance reimbursement forms, dealing with two companies, and before any vague chance of reimbursement, coughing up my own 6k. (I'm not in ye olde "two comma club").

It really wasn't a great healthcare value proposition, either, I must admit - without going into details of situation.

Still I must be overall thankful, and you are all encouraging me to do the responsible thing, and settle the tab. Just really wish the foreign hospital would negotiate fees with me, but do plan to send initial payment tomorrow and go from there.

Thanks esteemed Boglehead citizens
“Nothing in life is as important as you think it is while you are thinking about it.” - Daniel Kahneman
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ResearchMed
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by ResearchMed »

blackcat allie wrote: Thu Oct 31, 2019 10:21 pm Thanks everyone, pardon I didn't get a chance to properly respond to the many good points and requests for clarification.

I guess I just hate hate insurance reimbursement forms, dealing with two companies, and before any vague chance of reimbursement, coughing up my own 6k. (I'm not in ye olde "two comma club").

It really wasn't a great healthcare value proposition, either, I must admit - without going into details of situation.

Still I must be overall thankful, and you are all encouraging me to do the responsible thing, and settle the tab. Just really wish the foreign hospital would negotiate fees with me, but do plan to send initial payment tomorrow and go from there.

Thanks esteemed Boglehead citizens
We've had several travel insurance claims, and some for large figures.
They were not with AXA, but AXA isn't some "fly-by-night" company, so my guess (just a guess, obviously!) is that they'll pay, unless for some reason some term of the policy was violated.
(IF that happens, it's usually due to a pre-existing condition when the policy type did not include that, given what I've read on another forum that includes a sub-forum on travel insurance.)

For future reference, you might want to browse there:

https://boards.cruisecritic.com/forum/4 ... insurance/

Also, we use a broker, www.TripInsuranceStore.com - we learned about them at CruiseCritic.
(No extra charge to the traveler.)
We happen to get policies from Travel Insured, so we know they "pay".
But your insurance needs may well differ from ours, etc.

But CALL them to discuss your insurance needs/concerns. They may ask a couple of key questions that helps them to find a good fit policy for *you*.
[They don't "upsell". Indeed, once they (the owner, Steve) asked us if we really needed a policy for "this" trip. He had gotten to know us from several policies plus questions about claims. And... we didn't. So we didn't buy one that time.]

But the big insurers should pay. One advantage of TripInsuranceStore is IF there is any difficulty or delay, they'll step in with a reminder to the insurer (only if you ask; otherwise, they'd have no way to know).

For $6k, it's worth your time with some paperwork, right? :wink:

Good luck,

RM
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Gnirk
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by Gnirk »

obgraham wrote: Thu Oct 31, 2019 1:16 pm I know I'm just old fashioned, but I tend to look at a situation like this as "did the seller provide the service for which they sent me a bill?"
So in this case, the Italian hospital did indeed provide service, and without knowing the details, the bill sounds reasonable. (Now if this involved a quick ER visit and a tylenol, a different scenario will play!) Do they not deserve to be paid for the service?
I find it irrelevant that the service was foreign vs domestic.
If I were OP, I'd pay the bill. The insurance is my problem to work out, not theirs.
+1
9 years ago I suffered a stroke while on a cruise from New York to Quebec City, and was hospitalized for 4 days in Halifax, Nova Scotia. When I returned home, I submitted my claim to my Insurer, who covered only in emergencies when out of the country. I did have to pay the $800 ambulance bill, but was fully reimbursed. Basically, what they didn’t pay was paid by the travel insurance I purchased through the cruise lines.

You received the care, either pay the bill and go through the hoops for reimbursement, or submit the bills for payment to the insurance companies.
LISD
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by LISD »

SQRT wrote: Thu Oct 31, 2019 3:17 am a friend had a biking accident while in Sicily a few years ago. She was in intensive care for 12 days and at one point was close to death. Emergency surgery by a US-trained doctor saved her life. Her husband said total cost was about $14,000.
FYI - In the good ole USA intensive care is between $4000-6000 per day, and doesn't include all costs. $14k for 12 days is a bargain compared to US.
SQRT
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by SQRT »

LISD wrote: Fri Nov 01, 2019 12:36 am
SQRT wrote: Thu Oct 31, 2019 3:17 am a friend had a biking accident while in Sicily a few years ago. She was in intensive care for 12 days and at one point was close to death. Emergency surgery by a US-trained doctor saved her life. Her husband said total cost was about $14,000.
FYI - In the good ole USA intensive care is between $4000-6000 per day, and doesn't include all costs. $14k for 12 days is a bargain compared to US.
Yes, that’s what my American friend thought too. I was quite surprised how inexpensive yet effective the Italian health care system was. Even in Sicily (Catania).
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JoeRetire
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by JoeRetire »

blackcat allie wrote: Thu Oct 31, 2019 12:46 amAnd is my 1000 Euro attempt completely irrational, or a small show of good faith, in the absence of administrators wanting to make a formal payment plan?
Why don't you just send the 6000?

I like to pay what I owe.
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minimalistmarc
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by minimalistmarc »

I’m always amazed that Americans put up with their health care provision.

Why don’t you just give the Italian hospital your insurance details and then they can battle it out. Involving the patient seems utterly pointless.
student
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by student »

minimalistmarc wrote: Fri Nov 01, 2019 6:13 am I’m always amazed that Americans put up with their health care provision.

Why don’t you just give the Italian hospital your insurance details and then they can battle it out. Involving the patient seems utterly pointless.
Italy has a national health plan and it provides hospital and medical benefits for its citizen. This Italian hospital may not be familiar with the American insurance system and it is not its responsibility to contact OP's insurance. Passing the buck is not, in my opinion, the responsible thing to do.
mslaw
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by mslaw »

Sorry but from an office of medical providers, my advice is to not pay the bill in full at this time. Begin making small payments, and maintain the assistance of the providers’ office . Once you pay in full, the priority to help you with the claim is minimized.

Work thru all the insurance paperwork, keep detailed information, and photo copies of all correspond and payment deposits.

Try and educate yourself on the entire collection process. Keep in mind, I have to collect from patients that are domiciled out side of the USA, from USA patients who received the insurance money directly and refuse to pay that amount to a provider, from people with private planes who refuse to pay their bill, etc. But I also have patients who do not have the ability to pay for medical care and that is an important part of my job, to know when to allow a write off.
TN_Boy
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by TN_Boy »

student wrote: Fri Nov 01, 2019 7:10 am
minimalistmarc wrote: Fri Nov 01, 2019 6:13 am I’m always amazed that Americans put up with their health care provision.

Why don’t you just give the Italian hospital your insurance details and then they can battle it out. Involving the patient seems utterly pointless.
Italy has a national health plan and it provides hospital and medical benefits for its citizen. This Italian hospital may not be familiar with the American insurance system and it is not its responsibility to contact OP's insurance. Passing the buck is not, in my opinion, the responsible thing to do.
+1 Why in the world would we expect an Italian hospital to deal with American insurance providers?

OP, I am still a little puzzled by your description. I understand you might not want to provide details on the medical issue, but the question remains, if you had the same issue in the US, what would it have cost you? Unless the answer is "a lot less" I don't understand your reluctance to pay.

Also, you stated you had a "high deductible" plan. Tell us more about the plan. Where are you with respect to the deductible? If you had a $6k bill in the US, how much of that would the insurance pay? Did your insurance company tell you why they would only pay $300 (like, you haven't met your deductible yet?).

As others have said, you need to do the paperwork with your provider, then go back to the travel insurance folks.

If your insurance (correctly per your plan(s)) is going to leave you on the hook for most of the bill and paying it represents true hardship, then I would try and bargain with the hospital, though $1k on a 6k bill seems like a bit of a low ball offer. But I don't have much experience bargaining with European hospitals either.
minimalistmarc
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by minimalistmarc »

student wrote: Fri Nov 01, 2019 7:10 am
minimalistmarc wrote: Fri Nov 01, 2019 6:13 am I’m always amazed that Americans put up with their health care provision.

Why don’t you just give the Italian hospital your insurance details and then they can battle it out. Involving the patient seems utterly pointless.
Italy has a national health plan and it provides hospital and medical benefits for its citizen. This Italian hospital may not be familiar with the American insurance system and it is not its responsibility to contact OP's insurance. Passing the buck is not, in my opinion, the responsible thing to do.
I thought that was how insurance worked? It does with car insurance. Dont American hospitals go direct to patient’s insurer?

It is confusing for a U.K. citizen to understand as all of our healthcare is free at the point of use regardless of ability to pay. The American healthcare service appears bonkers in comparison, probably the worst in the world.
student
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Re: paying foreign medical bill - after the fact:( back from vacation

Post by student »

minimalistmarc wrote: Sat Nov 02, 2019 4:01 am
student wrote: Fri Nov 01, 2019 7:10 am
minimalistmarc wrote: Fri Nov 01, 2019 6:13 am I’m always amazed that Americans put up with their health care provision.

Why don’t you just give the Italian hospital your insurance details and then they can battle it out. Involving the patient seems utterly pointless.
Italy has a national health plan and it provides hospital and medical benefits for its citizen. This Italian hospital may not be familiar with the American insurance system and it is not its responsibility to contact OP's insurance. Passing the buck is not, in my opinion, the responsible thing to do.
I thought that was how insurance worked? It does with car insurance. Dont American hospitals go direct to patient’s insurer?

It is confusing for a U.K. citizen to understand as all of our healthcare is free at the point of use regardless of ability to pay. The American healthcare service appears bonkers in comparison, probably the worst in the world.
This is how insurance works in the US, not how it works in Italy. OP had medical service in Italy, and the hospital should not be the one who deals with OP's insurance. As other have suggested, pay the hospital and get reimbursed from the insurance company. Even in the US, sometimes you have to do this for some not in-network medical providers. https://www.thebalance.com/if-you-have- ... rm-2645672
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