Foreign hospitals requiring payment in cash before service?

It would help if you told us what country you were going to. Europe is a continent and each country has its' own health care system. What floats in the UK, won't go in Italy or Spain. Costs also vary wildly. There is a huge difference between going to a Dr. because you have a cold and going to the hospital to get your appendix out or for a broken leg. No hospital is going to turn you away or expect you to pay their bill before they operate.

You don't need to worry about carrying gobs of cash on your person in case you get hit by a bus. In a life-threatening emergency you won't be turned away. In the event that you need to see a physician for a minor illness, most people would be able to make a withdrawal from an ATM that would cover the fee. I have only had medical care in England 10 years ago. I did pay after my visit and the bill was quite reasonable. I would have paid significantly more to see an out-of-network doctor in the U.S. at the time. I then filed the claims with my U.S. insurance carrier and was reimbursed for the amount over my deductible. The link below is a schedule of fees for a private medical clinic in London (Medicentre) which is what I used when I lived there. www.medicentre.co.uk/Medicentre_fees.html

thanks Jo and Laura! I am taking the 2 wk RS Best of Europe tour: France, Switzerland, Germany and Italy. Laura the fee schedule was interesting. A bit less money than USA and do-able with an ATM withdrawl. I understand that in many foreign countries you can tell the pharmacist what is wrong and they might give you something? I also read that you can get Acetaminophen (Paracetimol)with Codeine in France over the counter, but don't know if that's still true.

Hi Holly. My husband was taken to a hospital by ambulance in Arles, France and spent the night in the ER. When he was released, I asked where I should pay and I was told they would bill me. A couple months later we got a bill (all in French, of course) for €113. We submitted it to our provider (Kaiser) and they paid all but our co-pay. Our only other experience with hospital care in Europe was in Wales for an ER visit and they told me they were not set up to take any payment. I thought they might bill me, but I never heard from them again.

Holly, Although this wouldn't work for serious medical problems requiring an ER, one option you might have a look at is IAMAT. They provide their members with a list of English-speaking Physicians and Clinics in various places in the world, and treat minor problems for a set fee (as I recall, it used to be ~US$80). I had to use their services in the past during a trip to Rome, and it worked well. When does your tour take place? Do you know yet who your Guide will be? If you've never taken a RS tour, you're in for a treat! Happy travels!

My husband needed to consult an emergency doctor in Nice last year. I did have to walk a few blocks from the hospital to an ATM, in order to withdraw the consulting fee upfront (less than $100). Our travel insurance reimbursed us in full when we got back.

Wow luck at the ER in some of your cases was great! Can you imagine an overnight ambulance/ER visit in the states? Hundreds and hundreds of dollars! I will check out IAMAT. Good idea. Ken, to answer your thoughtful question: I arrive in Paris around noon Sept 14, and join the RS group on the afternoon of the 17th! I have 3 days to knock around by myself, and thank goodness for this msg board and the internet. I have a lot planned!!
It is my first RS tour, and I am over the top excited. Don't know who the guide is yet, or even if I'll be the only solo traveler on the tour. Exciting! Thanks everyone :)

I was taken off a cruise ship and put in a hospital in Naples where no one spoke any English and I could not find out what treatment I was going to have. The hospital was a "charity" hospital (free) with no toilet paper in the bathroom, no paper towels, and people were smoking in the hallways. Before I would go into a hospital for any treatment I would try to find out what type of place it was- private, public, English speaking doctors, etc. My family eventually moved me to a teaching hospital in Rome where I received excellent treatment but they wanted to be paid on discharge. They did accept a credit card. The problem is when you return home and try and get reimbusement from your insurance company. My advise is to get primary coverage (which unfortunately I didn't have) Less hassle, less paperwork, faster results. JUDY

Holly, I can only tell you about Italy. Pharmacists generally are able to give you medication that you might need a prescription for in the States, at a much lower cost. If you need a hospital, you will probably be asked to pay your bill when you are discharged, and you'll be surprised at how much lower the cost is. Several years ago I needed an emergency room visit in Rome at Fatebenefratelli hospital (on Tiber Island) and the bill was about $35. If you take medications, as I do, it's good to have your doctor here write out a prescription in case you need an emergency refill.

I broke my leg in April in Vienna. At the public hospital (Allegemines Krankenhaus) the fee was 250 euro up front, which covered the visit, xrays, cast, crutches, and a 3 day supply of Lovenox. I then got a bill for 300 more euro about 2 months later.
I did not have travel insurance, but my regular medical insurance reimbursed me for almost 70% of my out-of-pocket costs. Yours might too. Call them.

Only €113 for an ambulance service, ER visit, and an overnight in the hospital in France? In the U.S. that would have set you back thousands of dollars...probably $500 for ambulance, several hundred to several thousand for ER, and several thousand for a hospital stay. Did you feel the care was somehow subpar compared to the U.S., because that's what we're all told over and over again? A family member recently had to go to the ER in Seoul...less than $200 USD...care was same as in U.S. I met a couple from Montreal whose friend had emergency heart surgery in Phoenix...$50,000 but covered through her Canadian insurance...Canadian doctor said it would have been $5000 in Canada for exact same care. And we don't need a new system in the U.S.? Whatever. Regular medical insurance should cover you, but Medicare will not. In either case, the cost of a basic travel insurance policy that covers everything from airline change fees to medical expenses is worth its weight in gold.

True that Medicare itself doesn't cover care outside the US, but several Medicare supplemental policies do cover emergency care in other countries, depending on which plan you pick. You can find details at http://www.medicare.gov/ These stories make you wish that the US had a universal coverage, single-payer plan - like every European country. Seems like a national health plan would be a huge improvement over our current haphazard, for-profit, employer-based system.

Well, sure, fine...but don't forget about those Death Panels. You know those sneaky French have them quietly hidden away somewhere.

Michael, Tom, David, I hope you're all voting for Obama, who has been the only president to tackle the health care problem. 25 years ago my wife's grandmother, while visiting her daughter (my wife's mother) in Massachusetts, was hospitalized, and when her family in Sweden was sent the bill from her daughter, they believed her relatives here were trying to scam her because they couldn't believe the amount of the charges. The families never talked again because of that.

My French mother-in-law was in an excellent Alzheimer's unit for five years at a fraction of the US price, all covered by the so-called socialized French medical plan and her secondary insurance, a mutual fund. Every time we've had medical care in France it has been as good or even more complete than in the States and again much lower price. With a $900 deductible for out-of- network services, we've never even bothered submitting our French bills! Most of the time we pay up front, but we once got a bill for ambulance and emergency room once we got home. That one was 60 euros all x-rays, medicines, and doctors' care included.

Obama isn't the first president to tackle health care reform & try to bring our country some form of national health care. FDR tried, Truman tried, LBJ tried, Carter tried, and Clinton tried. Those of a certain age may remember that, when Congress finally passed Medicare in 1965, LBJ flew to Independence, Missouri, to sign the law in the presence of Harry Truman.

Robert - And your point is???
I am sure that you are trying to make a certain "point" by saying your relatives required hospitalization in Massachusetts twenty five years ago, but Romney was not the governor of Massachusetts until 2002. I believe your relatives must have visited during the reign of Michael Dukakis.

But to get this type of health care are you willing to pay taxes at the rate many Europeans do? Be careful what you wish for. 10. Ireland Highest income tax rate: 48% Top marginal tax rate kicks in at: $40,696 (32,801 euros) 9. Finland Highest income tax rate: 49% Top marginal tax rate kicks in at: $87,222 (70,300 euro) 5. (Tied) United Kingdom Highest income tax rate: 50% Top marginal tax rate kicks in at: $234,484 (150,000 pounds) 5. (Tied) Japan Highest income tax rate: 50% Top marginal tax rate kicks in at: $228,880 (18,000,000 yen) 5. (Tied) Belgium Highest income tax rate: 50% Top marginal tax rate kicks in at: $45,037 (36,300 euros) 5. (Tied) Austria Highest income tax rate: 50% Top marginal tax rate kicks in at: $74,442 (60,000 euros) 4. Netherlands Highest income tax rate: 52% Top marginal tax rate kicks in at: $70,090 (56,492 euros) 3. Denmark Highest income tax rate: 55.38% Top marginal tax rate kicks in at: $70,633 (423,803 krone) 2. Sweden Highest income tax rate: 56.6% Top marginal tax rate kicks in at: $85,451 (574,300 kroner) 1. Aruba Highest income tax rate: 58.95% Top marginal tax rate kicks in at: US $171,149
.

Considering the fact that our ridiculously healthy family of five uses very little services over the course of a year, yet loses about 20% of our gross household income to family health insurance premiums, I would be perfectly happy to pay higher taxes for it. ...That, and the tedious little fact that it's just the right thing to do for society...

Those "high" tax rates Europeans are paying are deceiving. They typically include everything lumped into one single tax: social security, property taxes, local taxes, income tax, school tax etc. When you add up all the individual taxes Americans pay to all the different bureaucracies, its just a little bit less than they pay in the long run.

I am more than willing to pay those really high taxes that Randy advocates.
I would prefer to wait a few more years until I retire so I won't be close to any of those top rates. ALthough, when I think about it, I'm not sure there is really that much difference between paying a tax and paying a premium.....it's not going to increase my net pay and what I actually take home is all that counts.

The tax rates that Barry lists are not only for health care. For example, the high taxes in Sweden also cover a myriad of other benefits like 480 days of paid parental leave following the birth of a child, education through university, a pension, healthcare, and other things. After living in Sweden for a couple of years, there is something to be said about quality of life when you live in a society where everyone gets adequate health care, things are clean and safe, employees can count on 5 weeks of vacation and good working conditions, and it is rare to encounter a beggar or a homeless person. If you want a McMansion and lots of stuff, don't live in Sweden. If you want a nice quality of life, it is a good choice. No it is not perfect and Sweden has its own unique problems, but what society is perfect? The World Health Organization ranked France health system as #1. The U.S. is #37. In 2009, the U.S. spent $7,960 per capita for healthcare. France spent $3,969. Clearly, the U.S. has a problem. While there are many great things about the U.S., our system for paying for healthcare needs some work. We are not getting value for our money.

Tom, I agree; I should have said that Obama is the first President to have "successfully tackled" the problem. And Elaine obviously didn't understand the point. It had nothing to do with Massachusetts or Romney, or even Dukakis. Just the US' terrible health care system. Yes, America has great medical facilities for those who get very sick and can can afford top-notch care. But it's very poor when it comes to the averaged-out results.

Would I be willing to pay those rates? You betcha, and so would a majority of Americans. Unfortunately, big insurance, big pharma, and big medicine have got the ears of our so-called representatives, not the majority of Americans. When I went into labor prematurely in France, was hospitalized and had a baby in an incubator for a few weeks, we never saw a bill for anything. Nothing, nada, rien.

Nothing wrong with higher taxes if you feel like you are getting a good return on them. As Laura says, those taxes also include your contribution to your health insurance, pension plan, etc. I like that my daughter can attend a great university for about 700 euro a year. I like that the public transportation is good enough that I haven't had to own a car for 26 years. Imagine the savings you can have just from that? I like that my health insurance only costs me 220 euro per month, with no cap, and my only co-pay is 10 euro per quarter, and 10 euro per prescription. That premium would increase though, if I had a higher income. Each country has its' own health plan though, so though they are sort of comparable they are not all alike. The UK especially has a totally different system. One huge plus which no one seems to mention is the lack of malpractice suits and the lack of court cases suing this person, this company, etc. There is no need to sue if all of your medical problems are covered, unless it is really gross malpractice. This would save the US billions. I imagine lawyers would lose some income. I get asked on almost a daily basis about the "free health care", and the "socialist government" of Germany. It does make me wonder what exactly the news shows are presenting in the US. Certainly not the truth. Too many people seem to think: Social programs = Communism. You don't hear them lump in Social Security into those fears though, which of course is a social program. Back to the OP though. You probably will be billed in cash, but depending on what it is, it will be considerably lower in costs. The itemized bill can be very itemized or not so much at all. It really depends on the country, and what it is that you needed the medical service.

I would much rather take my money that I pay every month for health care and pay it to the government...and I would like that choice. At least then I might have a small say in what happens versus paying the ceo who runs Humana and earns 13 million a year and I have no say and little choice...despite what the supposed 'free market people' say. Ask any of the people on Medicare if they want to go back to the free market with vouchers and the overwhelming answer is NO. If we are looking for a country of 'family values' I think we need to take a good look at Sweden.

Regarding Barry's statistics, I'm confused. Where did he get those statistics? I live in the UK and have done for quite a while. As far as I know the previous government had a 50% tax. This one is either 40 or 42%. In fact Labour is talking that is they are elected in the next general election in 2015 they want to put the 50% back. I make an average salary and pay 20%. The vast number of British taxpayers pay either 20, 10, or zero. Very few benefits are means tested (income based) and medical care certainly is not. Basing a discussion on top tax rate which very few pay may be valid but not particularly relevant. Perhaps on median tax rate?

"I also read that you can get Acetaminophen (Paracetimol)with Codeine in France over the counter, but don't know if that's still true." Paracetimol, yes, cough syrup with codeine, no (or at least, not much longer). I'm not sure where it stands now, but as of a few months ago, France was moving to make it prescription-only. Although this probably wasn't the only deciding factor, a few US soldiers stationed in Germany got caught making "codeine" runs to and from France. This is why we can't have nice things... In the European countries I know best, drugs are not sold "over the counter", but you can get the same sort of medications through a pharmacist without a prescription.

Here is a link to the site I used. http://www.group11advisors.com/so-you-think-your-taxes-are-high/

@Barry, This Group 11 doesn't cite where it got these stats. They could have been made up by someone way down the line. It wouldn't be the first time people made up their own facts.

Bets, you can look at anyway you want, Nigel asked where I got it and I supplied the link. If you do a search you'll find similar lists.