Getting medical treatment

Thanks for sharing Rosalyn. Your experience is a good example why travel medical insurance is a very good idea. Since most reimburse, have a couple credit cards with higher credit limits . Also have medical evac coverage in case the emergency requires an extended hospital stay.

A long wait for somebody coughing up blood with a written diagnosis? Where does this "English speaking" doctor work?

6,000 € is armed robbery.

The best advice is contact your travel insurer first. They will direct you and then you’ll usually be able to get treatment without paying upfront. €6000 seems extremely expensive for European private healthcare that did not involve surgery or an admission.

I can't speak to the costs, since (knock on wood) I've never needed to go to a private Italian hospital. However I hope the OP could clarify a couple of points. As a retired nurse, with time spent working in EDs, I can't imagine a doctor who would recommend that a patient who is coughing up blood go to an urgent care, and not the nearest Emergency Department. And I thought Urgent care clinics were located separately from hospitals.

Of course the take away remains the same: always have medical insurance coverage when travelling. I hope you have fully recovered from your pneumonia Rosalyn. That can really knock you off your feet.

“ I haven’t gotten the bills translated into USD yet; but the big one - - from the hospital- - was around €6000, including 2 hours of doctor time and several tests.”

You should not only translate the Euro amount on the bill into USD, but also the text on the bill itself. €6000 seems like an extremely excessive amount for the treatment you describe you received. It seems like they overcharged you big time. Or is this a typo and did you mean to type €600?

Do you have a private, Medicare supplemental insurance policy? Or other private, US health insurance?

If so, that policy may provide you coverage for your medical expense in Europe. Worth checking.

I also work in a hospital system. I think what the doctor meant is best translated with emergency not urgent care. Urgent care centers, as we intend in the US (basically the ubiquitous doctors clinics where you just walk in) don’t really exist in Italy. The term “ricovero d’urgenza” is not the same as “urgent care” as intended in the US.

I don’t know what they did, but 6,000€ seems excessive unless there was an admission and maybe some surgery. Typically private hospitals in Italy would charge that amount for multiple inpatient stays or for surgeries. The average cost at a private hospital is 600€ to 1400€ a day (the latter in ICU) while more is charged for surgeries.For example I read that a complex laparoscopic cholecystectomy can easily cost over 4,000€ plus the pro fee from the surgeon. In our hospital an uninsured (self pay) patient would be charged at least twice that amount (even after the 50% discount we, as a public hospital, automatically apply to all self pay patients).

I’ve had two experiences with regular emergency room visits in Italy, once for myself and once with a travel companion. My friend had a bad fall and was taken to the ER by ambulance. She also had a CT scan. In both our cases, we had hours long waits, but neither one of us was ever billed anything.

The experience that Becky had of zero charges may not be applicable anymore.
The National Health System in Italy is managed by the individual Regions, and some Regions, such as Tuscany, have started to implement the national requirement that non EU tourists pay for the hospital services. Since 2025 the Region of Tuscany has set certain fee schedules, for each type of services. Services under what they call code red (life threatening) are still free, but now they charge for diagnostic services administered and also for each day in observation. A day in ICU observation now costs almost 500€/day. Not all Regions have implemented this, but the day of getting free medical service in emergency courtesy of Italian taxpayers may be over, at least in some regions. Obviously the costs will be very low compared to the same in the US (my hospital's charges for ICU day is well over $10,000), but it may not be free as it used to be when Regional health districts did not have charging mechanisms and therefore would charge only the copay they would have charged Italians at the highest tier (copays in Italy are set by income level in 3 separate tiers), and in many cases totally free since certain services in emergency carry no co-pay.
So it is a good idea not to skimp on medical coverage insurance when traveling to Italy.

To clarify. . . I don’t buy insurance because my Kaiser Senior Advantage plan will reimburse any costs incurred. I also get prescription drugs with little or no co-pay. The prescriptions I got in Rome were very cheap compared to what I have heard about U.S. prices.
Where we went was a part of a private hospital, not an er, nor an urgent care center. The doctor wanted to admit me for a couple of days; but I declined, feeling that being isolated from my family would only increase my misery.
Btw, my point in posting about this was to share the information about NED in Italy, which my daughter knew of. It might be a good starting place if it’s unclear how serious an illness or accident may be.

Rosalyn, I’m glad you received care and were pleased with the result. It is hard to be sick anywhere,but especially in a foreign system.

I will say the advice to contact your insurer as soon as possible once life threatening issues are addressed is very sound. Whether it is travel insurance or medical, contacting them in a timely manner is an important step.

I tried to google NED in Italy and came up empty.

In May last year I went into AFIB while in Florence. Usually it lasts less than an hour or so for me but after 3 days I went to the ER at Santa Maria Nuova. Two doctors, two nurses, blood work, EKG and electro cardio version (CLEAR!). I was there for seven hours. Back in sinus rhythm, I checked out. Total cost $480.

FWIW, I required hospital care in Italy several years ago and was taken to what I assume was a public hospital. It turned out that Orthopaedic surgery was required and I spent a week in hospital. I felt that I received excellent care and was impressed by the Italian health care system. I always have medical insurance when I travel, and I provided that information to the hospital when I was admitted. I was never presented with a bill, and have no idea how much it cost.

“Btw, my point in posting about this was to share the information about NED in Italy, which my daughter knew of. It might be a good starting place if it’s unclear how serious an illness or accident may be.”

Like Carol, I tried to Google NED in Italy, but came up with nothing. I did find a place called FirstMed Italy. A medical service with 2 English-speaking multi-specialty clinics in Italy (Rome and Milan).
Was this were you went to? If not, can you share the contact details of NED in Italy?

I like to say that public hospitals in Italy are usually working pretty well. For not urgent matters is true: the waiting time could be very very long, but if you arrive in an Emergency Room spitting blood you receive a full visit and exams in few hours. In touristic cities there is always a doctor who speak English, but is easy to be found even in small hospitals, because remember that there are even the foreign immigrant workers who use the hospitals and sometimes they need translation.
Being a public service everybody can receive a free cure paying only the "ticket": usually around 25/60€.

BTW: for that cost you can ask even if they give you the bill just translated in English!

Emergency rooms work on a code systems: at arrival you are assigned a priority code, from "immediate danger to life" down to "non urgent matter that should have been dealt by an ordinary physician". People are dealt not in order of arrival, but in order of priority, so an easy condition may easily translate in a 4 to 6 hours wait, while dangerous conditions are treated as soon as possible. The lowest priorities are often charged more, in order to deter improper use of ERs.

Yes, of course, the bill was €600, not €6000, including two doctor visits, lab work, and scans. All I can say about NED Italy is that that is what my daughter told me. That doctor came to the house. Everything else was done at Salvatore Mundi hospital.

Rosalyn
I hope you have recovered well

It would be helpful if you edited or added to your original post with the fact that your bill was just 600 euro, not 6000 euro and maybe provide some actual info on NED-like what does the acronym stand for and how do you contact them

As it is your post tells your story but not really in the useful way I believe you had intended

Rosalyn

Thanks for your two clarifications and follow ups.

I’ve followed this post a few times and I agree with Christine that it would be great if you could edit your first post to read 6000 (CORRECTION: 600) Euros. That way, the folks you hope to educate can follow the story and your lessons better.

I also want to add that your story adds a fine point for those of us who used to travel with no insurance and now that we’re older, retired and on Medicare need to consider the issues of

1. what if any coverage might we have in Europe for those of us who have a supplemental Medi-Gap type of insurance policy, and
2. What coverage any of us - at any age - might want to get to cover international travel in light of age, health, length of trip and style of travel.

For you, I assume that your Kaiser Medicare Advantage plan is great for you here in the US, but that it includes zero coverage in Europe. I don’t know that and you should check that with Kaiser to see about (1) your past expense and (2) to consider what you may choose to get for any future international travel.

We all have different coverages, needs and circumstances. One size does not fit all.

Thanks again for following up with your replies.

@Fred- Kaiser Medicare Advantage covers urgent and emergency care worldwide. Just because the OP struggled with parts of her post doesn’t mean she doesn’t know her coverage.

That said, it is prudent to have some sort of additional insurance because this particular plan requires further case by case authorization once the patient is stabilized to cover costs such as hospitalization. It has no provisions for medical evacuation. In addition, patients are expected to cover costs to provider and then seek reimbursement from Kaiser.

I am not a risk taker when it comes to health insurance coverage. I combine my Kaiser Medicare Advantage Plan, an Annual travel policy by Allianz, and a Medjet policy for evacuation. Hopefully, I never have to use them.