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.

Interesting! My limited knowledge extended to knowing about hospital networks but not much else. I remember my parents talking about their choice of in-network hospitals for the birth of my siblings. In theory does this also mean if I had an accident away from my normal hospital that I'd have to self fund treatment at an out of network hospital? Or at least the emergency treatment before transferring to an in network hospital.

It's known as Keynesian economics, so they would have to mention that at least if they are teaching the principles of it. The map analogy doesn't work because whoever charted it isn't the originator of maps and maps are not a theory.
But I tend to agree that the origin of Keynesianism is getting more obscure with time. Boomers would have heard of him but probably not as many gen xers or millennials do, not unless they have studied economics or pay a lot of attention to economic issues and the various theories about economics. So I wouldn't assume a person who hadn't heard the name was particularly ignorant.

I appreciate this response. There's a decent way to respond when someone else doesn't know something, contrary to a few posters, without calling them ignorant or implying they're uneducated.

If you're unable to be safely transported to 'your' nearest hospital or if you're away from where you live and need medical treatment then HMO insurance pays costs. But if you can be safely transported or if you could have safely gotten to 'your' hospital and choose to go elsewhere, they pay nothing. HMOs have hospitals within their 'service area', people who live outside that area can't get that insurance.

If you have a PPO and you choose to go to a non-participating they normally pay less and you have to pick up the difference. But I think if there is no participating facility where you are, they pay the participating rate. Participating rate is normally around 80% (edit: of the negotiated set fee). And a participating hospital agrees to 'write off' anything over the remaining 20% (edit:over the negotiated fee) . In a 'non-part' they pay less of a percentage (anywhere from 40-60%) and you're stuck with the balance.

PPOs generally have participating facilities all over. My accident was 800 miles and 3 states away from my residence. The hospital I was taken to was a participating facility AND my policy covered 100% of accidental injuries so I paid nothing out of pocket.

Wouldn't surprise me if certain things varied by state as well I suppose?

They can. I was in a 'different category' because I worked for the US Govt and the policies offered had to be 'nationwide' to cover all my Agency's employees across the country using the same rules. But generally speaking if you're dealing with a national insurance company (Blue Cross, Aetna, and the like) their policies are pretty general in nature regardless of where you live, unless the state you live in has specific laws governing coverage. Dealing with a smaller company or a company that only offers insurance in a particular state, YMMV.

Feels so complex but I suppose it's much more natural to understand as a system when you grow up with it!

If I don’t know something mentioned in a post …. I google it. & learn.

Don’t get arsy & lash out!

When a friend of mine was living in New Jersey as an undocumented migrant, fell down the stairs and shattered her leg, the ambulance took her to three different hospital A and E departments before one would treat her, because she had no insurance. She had a bone fragment sticking out through her flesh.

I was surprised to find that if you haven't had all of the vaccinations thst you are entitled to, so all the red book ones for kids, flu and covid if you're offered them then your insurance can be (will likely) be invalid. Most are invalid for anything to do with the vaccines you haven't had but I wouldn't be shocked if they could be used to get out of paying they would.

Can anyone remember the couple who left their child at home, went to an island somewhere and gave birth, but couldn't travel home as baby was unregistered or similar?
She had it on a boat or something?
I didn't hear what happened. Weird story.

Yes she was very very foolish indeed to do what she did, she was elderly and had A LOT of health problems, including respiritory ones. I'm astonished she risked it.

And look what shes done now. To her family.

All because Disney was "her happy place".

I go to NZ annually. Never had to sign whatever the document you are referring to. Absolutely never heard of it.

Yes I remember this! There were "rumours" that the baby wasn't theirs? I think in order to issue an emergency passport it was necessary to undertake DNA testing, assuming to rule out child trafficking, but that's the last I'd read. Would love to know how that all ended up.

That must have happened a very long time ago @BeeLight . A law was passed in 1986 forbidding that:

https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

Yes, it's just 'what it is' so you're used to it.

I feel the 'complex' thing about NHS when posters talk about not being able to change doctors if you don't like yours because there aren't any others 'in your area'. And 'post code lotteries'. Can't figure out why where you live has anything to do with what treatment or meds you can get.

Pluses and minuses in both systems.

last time we went to the US DHs insurance cost £600 for a top up on our free insurance we get. It has to be done.
Hos brother who has the same condition just for normal insurance and didn’t tell them what he had!

Im sure she could have gotten it cheaper than £3k if she had shopped about or rather not gone!

I can’t believe they had the brass neck to set up a go fund me!

It's part of what you'd be familiar with if you studied history in any detail. I never studied economics but I'm familiar with Keynesian tenets and the effect of his theories on life all over the world. He was a major figure of the 20th century. A towering figure in fact.

This is one of the reasons I keep coming back to Mumsnet, one minute talking about the American healthcare system, and the next someone is being a dickhead about John Maynard Keynes. Unrivaled variety, thanks all.

Mumsnet going into 2025 as strong as ever eh 😂

Collection agencies don't all work as direct agents of the creditor, though some do.

In some cases, hospitals auction off the debts. They don't hire collection agencies. The debts are paid by the collectors who then go after the patient. Any money they make goes straight to the collection agency coffers.

Sometimes they act on commission, earning a portion of money successfully wrung from a debtor.

It helps to know what sort of debt collector you're dealing with.

I'm not sure they would treat you! You would get emergency care but nothing else.

Evidently not though. Like I said it's not taught in schools, so we're talking about outside learning. "History in any detail" doesn't seem fair at all. Won't come up in the majority of any learning about WW1, WW2, the Titanic, the Aztecs, the American revolution, Mao's China, ancient Greece, the Roman empire, the history of American slavery etc. Seems like you could study history in masses of detail and still not recognise the name.

Or more likely you need to have studied or taken a greater than average interest in economics or the history of economics.

I’m a millenial and have never heard of John Milton Keynes either, haven’t ever studied economics but did study history up to a A-level and he wasn’t mentioned. I have read all of the Freakanomics books but don’t remember him being in them and that’s as far as my knowledge of economics goes. I am still a functioning member of society, promise.