What happens if you can't pay medical bills? (USA)

[RedDeadReflection]

What happens, as a tourist, if you can't pay your medical bills?

I know as a resident depending on the state they can bankrupt you, seize assets, get priority during probate if you die, sometimes your spouse is responsible after that too.

But what happens if you aren't American? Assuming no (or poor) health insurance.

Reading about the woman who went to Florida without health insurance and has now been in hospital for five weeks. Repatriation not yet possible, and even if it was it's £130k. The gofundme has "only" raised £38k. If she recovers well enough to leave the hospital what happens? There must be a fairly robust procedure in place or nobody would get travel insurance if they could just walk out and fly home with no consequences. In this case the woman is a pensioner with few assets so I've no idea what they could do.

They will bankrupt her same as they do their own I assume.

Would that only be a bankruptcy in the USA or can it extend to England? I know you can't declare bankruptcy in England/Wales if you live in NI/Scotland for example.

And I suppose if she has no assets it won't matter much.

I believe most western countries have reciprocal arrangements re debt so it would either be an international debt collector after the person or debt collectors in the home country.

Of course they’ll chase her for the debt, op.
She took a (very stupid) chance and lost. Why should she evade the consequences?

Don't know for tourist, but I know an American citizen who fell in the too poor to get own insurance category.

She fell and broke her ankle in two places. She afforded the ambulance and the x-ray, but couldn't do beyond that. So the doctors put a bandage on her ankle and cheerfully waved her off with the words that if she tried to walk on it too soon she'd probably end up permanently disabled.

Where did I say, or even imply, she should evade consequences?

I'm specifically asking how they enforce those consequences.

I did assume there would be, but the cost will end up being astronomical so realistically she'll never actually pay it back. In certain states it's then taken from your estate as a prioritised creditor when you did, or it falls to your husband/wife but I wouldn't have thought they'd have that same reach here.

This doesn't surprise me. Even just watching USA medical dramas you can see they do the bare minimum for the uninsured but if this woman is unconscious for such a long period of time it's not like they can turf her out, she's just racking up insane costs day after day.

I'm not sure of the facts in this case, but she seems to be still under hospital care so she hasn't been thrown out. YET. That's something at least.

The logistics of getting her home is another matter and that may prove to be the biggest issue.

As for pursuing the debt, well I'm sure they will try but sometimes if there are no assets there's no point. But they'd have to find out what she does (n't) have I suppose.

I know this doesn't solve any current problems, but for future reference anyone travelling to America without hefty health insurance is just asking for trouble.
When a friend went to Canada she was warned not to try to go across the border. "Why? Will I be arrested?", she said.
"No, but you won't have any health insurance".

That's what I'm assuming too.

I know there are big issues if you have a debt somewhere like Dubai. You can be arrested leaving the country (or re-entering). I expect the US isn't this harsh but I did have visions of her not being able to leave the country/passport being flagged.

I definitely agree with the premise of your post but I'd add it's not just about having insurance. With somewhere like the US and the costs that can be involved I'd go further and say you need to ensure you have good insurance. Not just the bare minimum.

They bring a claim against her in the courts here, where she lives. She doesn't pay. They make her bankrupt here using the law of England and Wales.

That's more or less what I'm saying. For health insurance anyway. But I suppose for other kinds of insurance as well whenever you go.

I don't know whether she owns her house, if so may as well kiss that goodbye. But if not, once she's home she's effectively got away Scot free then? No assets, nothing to take, no need for big credit at her age (mortgage etc).

I think if your situation is life threatening then they treat you and chase the money later. As soon as you are stable (not about to die) then they want payment before proceeding.

I have no idea what this woman’s financial situation is like but I suspect usual debt collection policies apply. Hospital can sell the debt to an international collector but if you want to have teeth you need to get a court judgement. It’s quite possible if she doesn’t have a house / substantial assets that it won’t be worth enforcing.

I think the next crisis will be when she is well enough to leave hospital but not well enough to fly. Repatriation flights with medical care are £££s

Chasing debt is a full-time job. Sadly, this is not done well and we end up paying £££££££s for tourist patients.
Anyone who goes abroad without insurance deserves what they get; and the nhs should refuse to pick up the pieces

There always these stories - similar person hospitalized in Thailand, Australia, Brasil …. Seriously tho - why should other people pay your bills?

Big hospitalization costs money! Regardless of country, no one giving it away for free.

By the way - NHS bills foreigners for treatment in A&E (at least tries). At least they do where I live as we had a visitor who got injured, thought getting a freebie on NHS. The A&E did bare minimum and discharged & made them pay.

Some years ago, flying into NZ, I needed to sign on entry in airport - proof of insurance, confirm I’m not having a baby, proof of funds. All countries should do it.

I assume the US can't flag/block a passport so you can't leave the country without clearing the debt first? I wonder if repatriation flights have to be paid for in advance too?

I agree it's shitty behaviour! But "deserves what they get" I suppose is my question because if she has no assets I suppose the punishment is nothing, once she (or anyone in that position) is back home.

Set up a go fund me by all accounts. Fucking joke. If you can afford 3 weeks in Florida you can afford insurance.

I agree, if you go abroad then you need to have good travel/health insurance. In particular though with the US and their charges being as extreme as they are I do think it's a whole different ball game.

The NHS I believe is supposed to flag passports as well, so if you re-enter and hadn't paid they can deal with it.

Don't try to find out. USA is the one country in the world I wo uldnt travel to without insurance. And now I've had cancer, my insurance isn't affordable - so I won't go.

Definitely not a risk I'd take. I actually lived in the US for a few years as a child but health insurance was a job for mum and dad, I didn't give it a moment's thought obviously.

My DH went to USA without the right insurance several years ago (we had personal insurance but he was on a self employed work trip) and fainted leading to an ambulance being called by his hotel. The hospital also did a CT scan before he was with lucid enough to decline it. He wasn’t actually ill and left the country on his scheduled flight a day or two later having not paid anything. We assumed ignoring it would eventually lead to issues with him returning to USA which was required for both work and family reasons, so paid the medical bill. It was originally around $12000 but when he said he was uninsured the hospital immediately dropped it to $8000(!) so seems there is some discretion.