U.S. hospitals, especially those in high tourism areas such as Florida and Las Vegas, are getting tough on foreign patients, demanding deposits for treatment services, and calling in debt collectors if bills are not paid on time and as submitted. This is no time to neglect travel insurance.
Faced with shrinking, or negative, operating margins, many American hospitals are being forced to pursue revenues wherever they can. The threat of pending health care reform, AKA Obamacare, is not helping, as it only raises the specter of further cuts in government reimbursements.
Consequently, many hospitals in areas catering to foreign tourists are hiring international and U.S.-based collection “specialists” (that’s the most charitable word I can use), to take over the billing of any patient who appears to be a non-U.S. resident. Normally that bill is first sent to the patient’s insurer and settled right then. But glitches happen, and you need to know of the possibilities.
Health insurers, including international travel insurers, normally get very substantial discounts on hospital bills—so long as they pay quickly and their clients (that’s you) are properly identified as qualified for those discounts on their insurance cards. But if those conditions are not met (perhaps the insurer disputes some charges, or your identification as a qualified patient can’t be verified) the collectors may nullify those discounts and demand full payment of you. They do this because you’re the most vulnerable party and they know that you will put pressure on the insurer to pay up—even if their demands may be unjustified. And because these collectors make their money on the percentages of recoveries they make for the hospital, they will use every trick in the book to get as much as they can—from you or your insurer.
In addition, many hospitals, those in the Las Vegas area being the best examples, now demand very substantial deposits—perhaps $2000 or $3000, based on what they are going to do to you—before you are discharged. By law, they must treat you for any medical emergency, whether you are insured or not. But that does not prevent them from hovering over you as you are being wheeled to or from the emergency room, “requesting” your signature on a credit card or other form of promissory note.
Your best defense is to carry your proof of insurance card, which contains an emergency number by which hospital admissions clerks can verify your verify your coverage, and which also contains the imprint of an emergency service or insurance carrier under which your coverage is guaranteed.
It’s best to carry your full policy with you. There are more than 1,500 different health insurance companies hospitals have to deal with, so don’t expect them to recognize your company instantly.
Obviously, if you are traveling without supplementary insurance—with only your provincial health plan as proof of coverage—you are in for a tough time, and you better have a lot of excess credit attached your card. I just recently saw a claim for $115,000, of which $42,000 was paid by the insurer as per its contractual agreement with the hospital. When the payment was made 48 hours late (because of a holiday weekend) the hospital’s collector went after the patient for the rest. Don’t let that happen to you.