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.

Jesus Christ, how pompous can you get?!

Does he travel within the EU ? If so make sure he has a free European Health insurance card which will at least cover some medical expenses (not sure how much but I think emergencies are covered).
This is assuming you're from the UK.

You should have insurance every time you step on a plane. I'm 99% sure it's in the t n c's for every flight. If you become ill onboard and the flight has to land elsewhere etc the costs can be enormous.

Until you research it you're in the position of not knowing it, are you saying you're ignorant until that point? Because in that case we're all ignorant every second of the day because we don't know everything.

I read more than plenty.

And for someone so well read you'd expect to know the difference between current and currant. But as long as you know who Keynes is you're winning, right?

People who think everyone travelling from abroad who gets treatment in the UK has medical insurance are very naive. There are hundreds of people a year who become mentally unwell whilst on holiday or visiting family in the UK and end up sectioned with costly inpatient admissions. I can't see what the alternative to this would be, in the states for example, let mentally unwell people remain a risk to themselves or others or deport them? I absolutely believe our system has it right which is to offer essential treatment first, ask questions later or just give treatment regardless. In terms of mental health, it seems the ethical thing to treat someone regardless of their citizenship. The same should apply to physical health. No one chooses to have a heart attack whilst on holiday.

Oh come on, surely you realize this poster is dried fruit enthusiast 😅

Jesus Christ? Who's he then?

(Just trying to get a new derail in)

Sure, that happened… it’s actually illegal but let’s not let the facts get in the way of a good story…

I’m an American and live in Florida. Hospitals are not “pay as you go”. It’s not a case of “how much money do you have? Oh that’s only enough for a bandage so that’s all we will do”. You don’t pay until after all treatment has been completed. Under the EMTALA law, it’s illegal to deny the required treatment purely based on financial circumstances. The story the OP is talking about is proof of that - the lady had no means to pay but the hospital is continuing to treat her.

Most hospitals and medical facilities have financial assistance programs. The hospital where I was treated a few years ago has a program where, depending on your income, you can have up to 95% of the bill waived. And the rest they will put on a payment plan and you make payments based on affordability. Also remember that while most of us pay money for insurance premiums, we also pay much lower taxes so the cost up the individual is not much different than living in a country with state-funded healthcare but much higher taxes.

In answer to the actual question, without the usual British tabloid scaremongering, if this lady cannot pay they will continue to treat her (as they have been doing) and after discharge they will contact her regarding affordability. If she cannot even pay $1 a month then the debt may eventually be written off. They cannot collect what she doesn’t have. They would need to take her to court to be able to do such things as seize assets. As she lives overseas, the practicalities of that may not be worthwhile or even possible. What value would assets in another country have, if any? It’s extremely rare that cases even get to that stage as this kind of litigation is costly, time-consuming, and not always on the best interests of those concerned.

Come on, there's clearly no rhyme or raisin here

Thank you, confirmation that realistically they won't recover their costs. It's a shame because of her negligence US taxpayers will see increased costs to cover the deficit, especially as they're already extremely expensive.

I don’t think one negligent tourist will affect US taxpayers or US insurance companies who are extremely wealthy. I am sure occasionally similar cases happen in the UK too.

Not just hers specifically, but in the same way as theft increases our supermarket prices I'm sure it'll have an impact there. Agree same as our NHS but the costs are certainly not as high here. Surgeons and doctors are salaried under the NHS but in America it's possible to be paid per surgery, per prescription etc.

We were just discussing this at home, what happens when staff retire, do they have to buy separate medical insurance?

At age 65 you are eligible for Medicare (govt health insurance). If you are disabled you may be eligible younger than 65.

My husband's employer fully funded our family's health insurance (we paid nothing) until he retired at age 55. Upon retirement they continued to cover him at 100% but I pay 50% of the cost of my insurance. At 65 we will both be eligible for Medicare.

I'm in my 60's and have been covered by health insurance my entire life. In all these years I can count the number of times I've ever had to even speak to someone at an insurance company on one hand. It actually runs pretty smoothly!

The main problem with the insurance model is obviously cost. Very low income will be subsidized by the govt (Medicaid). Over 65/disabled - by the govt (Medicare). The people who tend to struggle are the "squeezed middle" who earn too much to qualify for govt assistance but find that health insurance eats up a large portion of their income.

The pp seemed to think people who hadn’t heard of Keynes were uneducated thick oiks who never watched the news and barely went to school. That’s what people are taking offence at.

i’ve not heard of him. I am a voracious reader, I’ll read anything and could probably quote the back of the cornflake packet.

i have a science PhD. So not uneducated. I will admit I probably have significant gaps in my history/geography/humanities/arts knowledge, and most things I do know come from fiction.

I have got to my advanced age without ever knowing the name and it’s not a subject I’m particularly interested in so likely will do no more than register the name of the bloke who had something to do with economics.

in my circles it would be strange not to know names of some of the key players in medical intervention and advances, but I wouldn’t be calling a historian or economist uneducated for not knowing. To me names such as Watson, black, Röntgen, Morton, Coley etc are basic foundational knowledge when understanding medicine that everyone would know. But not being a prick I wouldn’t get snobby and call someone ignorant for saying they hadn’t heard of them.

Oh please. These are billion dollar companies, a few uninsured cases are peanuts for them. It’s a massive industry (I am currently in Florida). My relatives who live here say absolutely they will go after the estate when that lady dies.

But it doesn't sound like she has an estate though, that's the point. And unlike areas of the US the debt will die with her, her relatives can't be chased for it. So everything happening now is money down the drain for the US healthcare system.

My relatives who live here say absolutely they will go after the estate when that lady dies

But in this particular case it sounds like there is no estate to pursue. Even if there was, it's not clear how successful debt collection would be given the different laws in the UK.

The hospital will most likely just write it off.

And unlike areas of the US the debt will die with her, her relatives can't be chased for it

In the US if you are married then any debt incurred by one of you during the course of your marriage will be the responsibility of the surviving spouse (in most cases).

And parents are generally financially responsible for any minor children.

Other than that though relatives (adult children, siblings, etc) aren't liable for your debt. They could of course lose any inheritance if debts are outstanding at the time of your death and need to be paid by your estate.

Whereas that isn't the case here, and if it's being pursued via the UK courts it would need to follow that basis. Sounds like they've not a hope in heaven of recouping much either way.

To make things even more complicated, different states have different debt collection laws. In Florida for instance debtors can not take your home to satisfy outstanding debt. If you are considered "head of household" they can't even garnish your wages.

It can vary quite a bit by state.

I think everyone can agree the lesson for tourists at least is to have very decent travel insurance!

Maybe so, but you seem to be in the minority of knowing about this mysterious chap!

LeavesOnTrees · Today 13:37

Thornybush · Today 07:04
My dfil is almost 90 and refuses to pay holiday insurance as it costs so much. They go on holidays about 5 times per year. I keep saying to dh that one day his luck will run out.

In Euro an EHIC card will cover for treatment. The problem arises if you need to return to the UK - maybe by air ambulance - which it won't pay for; that's when Health Insurance is essential.

EHIC doesn't "cover you" for treatment, it allows you to be treated for the same cost as a local, which isn't necessarily free. In France, from memory, you'll pay 30% of the cost and the other 70% is covered just as if you were a resident.