Paying Overseas Medical Bills
March 10, 2019 11:35 PM Subscribe
Does the U.S. or the European Union offer any assistance to Americans who may have found themselves in a European emergency room and owing for medical services? They want to pay
their bill, but have problems with language, bureaucracy, bank transfers, currency conversions, etc.? Is there a mediator that can both, help to avoid international lawsuits and insure such debts are paid?
Are you asking in general or with a specific situation in mind? If it's a specific situation, you'll want to name the country. The European Union is not relevant except insofar as there are EU regulations for things like delayed travel compensation. It's not an entity that affects individual health billing situations or helps with consular difficulties. For the purposes of this question, the EU is similar to NAFTA.
If the Americans have US health insurance, their insurer may be on the hook to help, or able to connect with people who can. That's probably the place to start.
If the Americans have a credit card, they may already have concierge and emergency support services, e.g. this Chase card provides translation services and other medical help.
Failing both of those: the local US Consulate may be able to help.
posted by caek at 11:51 PM on March 10, 2019 [1 favorite]
If the Americans have US health insurance, their insurer may be on the hook to help, or able to connect with people who can. That's probably the place to start.
If the Americans have a credit card, they may already have concierge and emergency support services, e.g. this Chase card provides translation services and other medical help.
Failing both of those: the local US Consulate may be able to help.
posted by caek at 11:51 PM on March 10, 2019 [1 favorite]
Rick Steves has a short article which addresses your questions from the point of view of Americans visiting Europe. It is necessarily quite a top level response because it does depend on what medical condition you have and where you are. I do agree with his general take which is "don't worry" - most countries have a universal health care system which means that hospitals will treat you to the best of their ability without some condition on your travel insurance policy being a pre-requisite - and that any medical bills you do face will be very modest by US standards. It is also usually quite easy to find medical specialists who speak English - and this is most particularly the case in areas visited by tourists.
If you have questions about billing - then the people working in the appropriate hospitals are often helpful. As are hotels: they deal with issues like this all the time.
posted by rongorongo at 12:33 AM on March 11, 2019 [1 favorite]
If you have questions about billing - then the people working in the appropriate hospitals are often helpful. As are hotels: they deal with issues like this all the time.
posted by rongorongo at 12:33 AM on March 11, 2019 [1 favorite]
Their travel insurance company would probably be helpful, and worth reaching out to.
posted by Too-Ticky at 2:11 AM on March 11, 2019
posted by Too-Ticky at 2:11 AM on March 11, 2019
Echoing what everyone else has said about it varying from country to country, but also bear in mind
a) It is extremely likely there will be someone fluent in English in any major medical institution, who can help, even if it is not their specific job to do so
and
b) medical costs in Europe are, as a general rule, *vastly* lower than in the USA. Even for an overnight stay the odds are good you could probably settle in the cash you could get out from an ATM.
Finally: if it's a source of anxiety, consider getting medical insurance as part of your normal travel insurance. That way you'll have a third party to turn to if there is a problem.
posted by AFII at 2:13 AM on March 11, 2019 [1 favorite]
a) It is extremely likely there will be someone fluent in English in any major medical institution, who can help, even if it is not their specific job to do so
and
b) medical costs in Europe are, as a general rule, *vastly* lower than in the USA. Even for an overnight stay the odds are good you could probably settle in the cash you could get out from an ATM.
Finally: if it's a source of anxiety, consider getting medical insurance as part of your normal travel insurance. That way you'll have a third party to turn to if there is a problem.
posted by AFII at 2:13 AM on March 11, 2019 [1 favorite]
So assuming this relates to something not covered by travel insurance.
To make a payment they need an amount, the currency this is in and the recipient’s international bank account number (IBAN). It would probably be good to also have the actual payment reference to ensure the recipient can allocate the payment to the bill. That’s all that is required to transfer money internationally. This should all be on the bill they are trying to pay. The only item that may not be included is the IBAN because the standard billing template will assume a domestic payment, not an international one. If there is no IBAN it would be easiest to send an email to the contact on the bill, in English, asking for the IBAN. Even if the email recipient does not speak English, somebody they work with will have enough English to read and help with a response.
Once they have that information they need to work out how to transfer the money. From what i understand about the US banking system there is a chance that their bank is unwilling/unable to help with this or that the fees amount to daylight robbery. There are plenty of international payment services that will support this. Plenty of threads here on the green on this. Whatever they do, they have to make sure they cover the bank charges of their bank/provider. If this is taken out of the transferred amount they will underpay.
That’s it.
posted by koahiatamadl at 4:59 AM on March 11, 2019
To make a payment they need an amount, the currency this is in and the recipient’s international bank account number (IBAN). It would probably be good to also have the actual payment reference to ensure the recipient can allocate the payment to the bill. That’s all that is required to transfer money internationally. This should all be on the bill they are trying to pay. The only item that may not be included is the IBAN because the standard billing template will assume a domestic payment, not an international one. If there is no IBAN it would be easiest to send an email to the contact on the bill, in English, asking for the IBAN. Even if the email recipient does not speak English, somebody they work with will have enough English to read and help with a response.
Once they have that information they need to work out how to transfer the money. From what i understand about the US banking system there is a chance that their bank is unwilling/unable to help with this or that the fees amount to daylight robbery. There are plenty of international payment services that will support this. Plenty of threads here on the green on this. Whatever they do, they have to make sure they cover the bank charges of their bank/provider. If this is taken out of the transferred amount they will underpay.
That’s it.
posted by koahiatamadl at 4:59 AM on March 11, 2019
Family had an ER visit leading to hospitalization last year in Vienna, Austria. (AskMe thread here.)
My relative paid their bill with a credit card: it cost less than they expected, and later I got them a VAT refund.
All the hospital staff (medical and other departments) spoke English, though the final medical files were written in German -- which Google Translate did a fine job of translating for me, a guy with some rusty German language skills.
The staff at the American embassy/consulate in Vienna expressed a willingness to help with communication, but ultimately we never needed it. I did some back-and-forth emails with the billing staff and records staff, and Google translate was perfectly serviceable.
All that is to say, the bill might be less than they expect, and should be OK to go on a card. And if you do the paperwork after, you might even get some of it back. YMMV if it's not a big city. But this really needs some specifics, and also have they simply asked the hospital staff for help?
posted by wenestvedt at 7:43 AM on March 11, 2019
My relative paid their bill with a credit card: it cost less than they expected, and later I got them a VAT refund.
All the hospital staff (medical and other departments) spoke English, though the final medical files were written in German -- which Google Translate did a fine job of translating for me, a guy with some rusty German language skills.
The staff at the American embassy/consulate in Vienna expressed a willingness to help with communication, but ultimately we never needed it. I did some back-and-forth emails with the billing staff and records staff, and Google translate was perfectly serviceable.
All that is to say, the bill might be less than they expect, and should be OK to go on a card. And if you do the paperwork after, you might even get some of it back. YMMV if it's not a big city. But this really needs some specifics, and also have they simply asked the hospital staff for help?
posted by wenestvedt at 7:43 AM on March 11, 2019
Typically you would pay the bill with your credit card and then claim it from your US insurance when you get home.
I've never had any trouble getting fully reimbursed from Blue Cross, probably because the amounts were so much lower than US prices.
posted by monotreme at 9:07 AM on March 11, 2019 [1 favorite]
I've never had any trouble getting fully reimbursed from Blue Cross, probably because the amounts were so much lower than US prices.
posted by monotreme at 9:07 AM on March 11, 2019 [1 favorite]
Europe doesn't have a unified medical system, so more info would help here.
posted by DarlingBri at 12:33 PM on March 11, 2019 [2 favorites]
posted by DarlingBri at 12:33 PM on March 11, 2019 [2 favorites]
I broke my leg in Germany fifteen years ago, on the last full day of my trip. No travel insurance but it didn't matter -- X-rays, consultation, cast and crutches (plus some disposable syringes for self-injection to prevent deep-vein thrombosis ie 'Economy Class Syndrome' on the flight home) all for just €230 (which I paid with credit card). Given that a visit to the emergency room in the US even with insurance could be thousands of dollars I figure I got off so lucky, I didn't bother Aetna with a claim concerning the incident, once I got home.
posted by Rash at 9:12 PM on March 11, 2019
posted by Rash at 9:12 PM on March 11, 2019
This thread is closed to new comments.
posted by frumiousb at 11:51 PM on March 10, 2019 [1 favorite]