Your coverage in Ireland isn't going to help you in the US. You would have to pay for any treatment you receive. You can buy visitor medical insurance through the Automobile Association and I am sure other companies offer it - or buy travel insurance while you are still in Ireland. Check this website.
http://www.worldtravelcenter.com/eng/information/cm_category_products.cfm?sCategory=visitusa&affiliate=googlevisitor

Anyone travelling to the US should always take out healthcare insurance, whether or not you choose to take out further travel insurance. Many companies offer either European coverage (which covers the part the EU treaty doesn't) or worldwide which pays out to a much higher limit. Make sure you are insured for as high a sum as possible for the US.

I don't think most hospitals would accept someone who doesn't have medical insurance because of liability. Unless you have symptoms of a heart attack or something similar the first question they ask is to see your insurance card.

If you're marginally sick go to one of the emergency outpatient clinics for quick treatment. If you're really sick w/o insurance go to a Catholic hospital - they'll take you in and discharge you with the promise to pay.

Keep in mind that prescription medications are also very expensive.

Get travel health insurance for the duration of your trip.

My travel agent refuses to sell anyone a ticket or tour to the US unless they take out full medical insurance.

The USA has one of the world's most expensive medical systems and your Irish health care card will mean zilch (and why should it, this is for Irish citizens in their own country, why would the Irish government pay when you are out of the country?)

If you are thinking of travelling with a pre- existing medical condition be mindful that this may affect the level and type of insurance you can obtain.

But don't even think about travelling without insurance if there's a chance you may need medical help.

A case in point, my neighbour, who was involved in a relatively minor accident in America was charged over forty thousand American dollars for his medical attention - 'nuff said?

Some American hospitals are non-profit organizations. They7 are obligated to receive and treat charity patients without charge. I don't know how an ROI or a NI patient would be classified and billed.

A hospital cannot refuse an emergency patient, regardless of ability to pay, so you will receive treatment in a true emergency. What they call true emergency I don't exactly know.

A couple of tips.

Hospital emergency rooms are often overused by walk-in, non emergency patients. This can cause a backlog and a long wait before your are even evaluated by a triage nurse. If you truly require emergency care, call 9-1-1 and get brought to the hospital in an ambulance. You will get wheeled in and at least evaluated right away.

There are so-called urgent care centers in most areas that can handle a wide range of non-emergency situations, including sickness, broken bones, cuts, stitches, etc. By emergency I mean something that requires specialty care in hospital, either life threatening or otherwise severe, not just a doctor in her/his office or clinic.

These are much cheaper than a hospital for the same basic care. As others have said, medical care (esp. emergency care) is very expensive in the US, and hospital bills are very complex, convoluted.

I'm exaggerating now, but I could swear that the last ER bill I received had a so many unintelligible line items:

A charge for simply entering through the automatic doors, two for using the waiting room chairs (one for the patient, one for friend), itemized bill for the kleenexes used, and a bathroom charge per flush.

That's before the lab, pharmacy, and physician charges (and insurance co wouldn't pay 100% since I 'chose' an out of network MD). Don't get me started on that one.

I remember when my daughter made her first trip to the US.
She told her insurance company, "I get run over by a ten ton truck, I spend a year in hospital and the driver sues me for post traumatic stress. Insure me for all that!"

<<< I am wondering, if someone came from Ireland, and had a health card there (free medical) >>>

????

Last time I checked, Ireland had a free health system for ALL of it's residents

OP - think of the US medical regime as Ryanair - but not as friendly

In Los Angeles it is hard to find a US citizen in the emergency room.

Ditto what J62 wrote.

If care was needed for an emergency - read that as immediately life threatening - it would be provided and them billed for afterward, at the full "list price."

If care was needed for something not immediately life threatening, the patient would be asked to show proof of insurance (which would be verified) or put down a substantial deposit (cash or credit card) and sign promissory notes agreeing to pay any balance. Charges would again be billed according to "full list price."

adrienne - where did yo get he idea that catholic hospitals are any different? In fact, they are not, and some of the most heinous examples of hounding for payment I have ever seen came from catholic hospitals.

(free medical)

Many subscribe to the P. J. O'Rourke school of political thought:

"If you think health care is expensive now, wait until you see what it costs when it's free!"

You may not pay for it, but it's not "free".

Seriously, though. If you have a life-threatening episode you will be admitted and treated at any American hospital. Yes, you will be asked to pay...but your treatment will not be dependent on it. Best approach is to take out a temporary policy to cover all potential problems.

Good luck and good health!

alanRow wrote: "Last time I checked, Ireland had a free health system for ALL of it's residents"

Not exactly. Free hospital treatment. Other things (incl. GP consultations, prescription medicines, and more) have to be paid for unless one has a medical card, something that is issued to older people and those on low incomes. Under EU reciprocation arrangements, I am entitled to whatever level of care is afforded to denizens of other EU states when I visit, and they have similar entitlements here. [This reciprocity might be what prompted Shadow to think somebody from Ireland might be entitled to cover in the US, but it is an EU arrangement, not a wider international convention.]

The US has no system of government provided medicine, except for US senior citizens.

If you don;t have private health insurance (or buy it as part of your travel insurance) you are liable for any costs associated with your medical care.

In an emergency a hospital is not allowed to turn you away even if you don;t have insurance - but they will definitely collect all of your information - including credit card info - and bill you - A LOT - for any services you use.

If it's not a true emergency - car accident, heart attack, broken bone etc - typically a hospital will not admit you without insurance or some sort of guarantee of payment.

If your illness is not of an emergency nature and you need to go to a clinic (Doc in a Box - outpatient clinics associated with hospitals for more minor problems) it will be cash - or credit card up front. As will the costs of any medications you need at the pharmacy.

If you are aware of any chance of needing medical care in the US it is close to madness to arrive without health insurance.

(Typically US private health insurers - which is what most people have - cover your care anywhere in the world - although you may have to pay the bill up front, they then reimburse you.) If you have government paid insurance you are not covered outside the US and have to buy extra insurance. But this applies only to senior citizens (Medicare) and the poor (Medicaid).

Actually, the US does have govt. healthcare for some people other than senior citizens, such as for the active-duty military and their dependents (assuming that term refers to insurance, as it must if the reference is Medicare). Medicare isn't free for many services, anyway, it's just an insurance policy that is available they can buy (only inpatient hospital insurance is free, but there are still large deductibles) US senior citizens don't automatically get any free care for physician services or hospital ER services by the government, the part of Medicare that covers hospital outpatient services/ER is voluntary insurance, you have to buy it and pay premiums. TRICARE insurance does cover its beneficiaries outside the US, and that is the insurance for military dependents, such as wives and children.

However, that's really a side issue since the question was about non-citizens. I've been to an emergency room, about 18 months ago, and it wasn't that bad and I the bill didn't have any unusual or silly charges on it (I suspect the post above was trying to be funny in some cases in stating the bill had those charges, I don't know) and wasn't that difficult to understand -- physician charge, hospital room charge, lab charge, radiology charge, that was about it. It wasn't cheap, but it actually wasn't as expensive as I had feared from the horror stories I had heard. The total bill was definitely less than $1000. I didn't wait that long to be seen, either. I'm sure some hospitals are a lot worse than others, of course -- mine was near my home in a suburb, but wasn't a wealthy private hospital). Hospitals in a large urban inner city area might be worse in terms of time, etc.

They did ask me for my insurance, of course, they have to ask, but I don't think legally they could refuse to treat me if I said I didn't have any. Catholic hospitals are no different than any other not-for-profit hospitals -- and all ERs will discharge you without you having paid before leaving, they can't hold you prisoner. Catholic hospitals have been some of the worst in overcharging people who don't have insurance and trying to collect from indigents, and there have been cases of Catholic hospitals getting their not-for-profit status yanked because they were so abusive in trying to collect money from poor and uninsured patients.

Hi S,

Even in the US, you will get emergency treatment at almost all hospitals.

The problem is paying for it.

Does you national health insurance cover you outside Ireland?

Honestly, we live very close to the States, we could do daytrips there if so inclined. We would never, and have never stepped foot over the border without extra health insurance.. no way in heck..

Get supplemental health insurance, you may need it,,
One time my 2 yr old stuck a flower bud up his nose in Hawaii, cost 200 dollars ( 15 years ago) for us to go to a clinic where the doctor literally spent less then 5 minutes with us, tweezers, and viola.. and as I said that was 200 dollars 15 years ago,, ( which we were reembuirsed for by our insurance) I can't imagine how much something that took more then 5 minutes would cost, or bandages, or tests. YIKES, and someone here said their bill for emergency service was less then 1000 dollars, like that is some kind of a DEAL???

Don't take the chance, there is a Canadain girl in a hospital in California whose family is trying to bring her home right now. It is costing them 10,000 dollars a day for the care she is recieving there now, I mean, these people might have to sell their home to pay those types of bills, insane. Accidents happen, and only the foolish( like this young lady) would go to States without proper insurance.

In our county, the county medical center/hospital treats anyone who comes to the hospital without regard to their ability to pay. In addition to that are no-fee clinics. So perhaps it also depends where you go.

annw - don't know were you live, but you may want to check again. You may get treated, but increasingly the trend is that you will also get billed - and referred to collections if you don't pay. There are even companies that sell their services - some specifically catering to public hospitals - doing this sort of collections, and they work on commission. Because of the inane way health care is financed in the US these institutions have seen cuts in funding and increasing demand (and no, it is not illegal immigrants driving up the costs)they have little choice but to do this.

If you are a memeber of the VHI,a government owned health insurance company in Ireland,you will be able to have its cover extended to America while you are on vacation there.The cost is quite modest at €139 for all your trips for a year and I understand that there is no upper age limit. Please read the details before you buy it at www.vhi.ie . Incidentally if you are planning to retire in Ireland you will only be allowed to join the VHI if you do so before the age of 65.

Ditto those who have said to be sure to have health insurance that will cover you in the U.S. before you come here!

As for mysterious charges on emergency room bills, don't get me started. I once took my (then) husband to the emergency room to get rehydrated when he had a terrible case of the flu, and the bill came with a charge for TWO(1) Pap smears!!!! At least it was not difficult to get the charges removed, since as he wasn't born with a cervix, a Pap smear wasn't necessary.

Ditto those who have said to be sure to have health insurance that will cover you in the U.S. before you come here!

As for mysterious charges on emergency room bills, don't get me started. I once took my (then) husband to the emergency room to get rehydrated when he had a terrible case of the flu, and the bill came with a charge for TWO(!) Pap smears!!!! At least it was not difficult to get the charges removed, since as he wasn't born with a cervix, a Pap smear wasn't necessary. :0

Ah Road Crazy,, now think of the people who may not have known what a pap smear was,, I wonder how many people are too embarrassed to question their bills as they don't want to appear ignorant about tests etc. or they may not be sure what things mean. I bet there is a pretty penny made in that somewhere.

Getting treated in the States is NOT the question, it is a civilized country they tend not to let people die in front of them in hospital waiting rooms, it is the payments that kill you later at home when you get the bills, LOL

Thanks everyone!! Great replies...very helpful. I hope I don't need this information but it might happen....complex situation.
So, thanks so much for all the information and I have taken note!!

Shadow

Your Irish coverage wouldn't be accepted in the US as it only has a reciprical agreement with the EU. The US has government health care only for the poor or the elderly(medicaid/medicare) who are US citizens.. Having said that, ALL american emergency rooms, public or private MUST take anyone regardless, who shows up no matter how serious or minor the problem is, regardless of whether they have medical insurance or can afford to pay. It is federal law. Even some americans on this board don't know this. The emergency room must by law give those without the ability to pay the same treatment, however once stabilized, a private hospital will often send the uninsured to a public ones. If an Irish citizen with no insurance came to the US and needed emegency care, they would be given it and billed later. I'll also note that american citizens who travel to the EU, Canada etc. without insurance would be charged a lot for care too. Regardless of where you travel or your nationality, unless your country has a reciprical agreement , take out insurance.

"Don't take the chance, there is a Canadain girl in a hospital in California whose family is trying to bring her home right now. It is costing them 10,000 dollars a day for the care she is recieving there now, I mean, these people might have to sell their home to pay those types of bills, insane"

"A case in point, my neighbour, who was involved in a relatively minor accident in America was charged over forty thousand American dollars for his medical attention - 'nuff said?"

Yes, these people get billed but I'll bet they didn't pay. Look at all the mexicans who don't. I live in Texas and we spent 5 BILLION alone on mexicans at our hospitals who don't pay so they got their health care FREE. A big burden for us. As such, the hospital can bill the canadian girl or her family as well as the Brit who got in a car accident but that's all. (If I were the canadian or brit, I'd just split and not pay. ) If they don't pay they get the care for free just like the mexicans. Most people I know who go to the emergency rooms for things as minor as a cold and don't have insurance, NEVER pay or pay only what they can afford of the bill.

ronnie36 wrote: "If I were the canadian or brit, I'd just split and not pay."

That would be dishonest.

It is true that a hospital (not an MD's ofice or clinic) canot turn away a patient that needs medical care. But if you turn up at the average ER with a minor problem youwill be triaged to the end of the line - while the heart atacks, auto accidnents, stabbings, people with broken bones get treated - and might end up waiting 12 hours or more to see someone.

And they will get your full information so they can send you a bill - and do their best to collect on the spot - via credit card.

And - ify ou need medication you will get an Rx to go to a pharmacy where you will have to pay (very few hospitals dispense meds to outpatients).

Insurance ain't that expensive - I googled and got a quote of £26 including the land of the free and the moose botherers, giving £10m in medical cover - which should just aboput cover an ingrowing toenail in America

I had to take my cousin's wife to an Urgent Care last year when they were visiting from Ireland. She was throwing up and dehydrated etc. so it wasn't a true "emergency" necessitating the hospital emergency room. Luckily, she had taken out travel insurance. The first thing they did ask for was insurance coverage. When she stated she had travel insurance, they had her pay with her credit card and she would have to collect from the insurance when she got home. She did finally get the money but it took a while. If she went to the ER they would have to treat her and then either try to get her to pay immediately or try to collect later. Not sure how they would have handled it considering a lot of the people in the waiting room at my local hospital have no insurance and have no legal residency so their chances of collecting on them are slim.

I recall hearing that a Canadian court ruled that an uninsured Canadian who racked up a big US hospital bill had to pay up. The US hospital would have all the same collection tools at its disposal as any Canadian company owed payment by a Canadian. Unless one is judgement proof (no income, no assets) you better pay.

"ronnie36 wrote: "If I were the canadian or brit, I'd just split and not pay."

That would be dishonest."

True but sometimes you gotta do what you gotta do. One should take out medical insurance of course.

"Insurance ain't that expensive - I googled and got a quote of £26 including the land of the free and the moose botherers, giving £10m in medical cover - which should just aboput cover an ingrowing toenail in America"

Yeah, travel insurance is cheap and well worth it. Our medical care may be expensive but an uninsured american or canadian in western europe would also be charged very high prices too though prices vary somewhat from country to country, western medicine is still expensive anywhere for the uninsured.

"I recall hearing that a Canadian court ruled that an uninsured Canadian who racked up a big US hospital bill had to pay up."

Should that the mexicans ever be required to pay up.

Since insurance companies pay a much lower rate than the "rack rate" at hospitals, if you needed medical care in the U.S. and you had no insurance, you'd have to pay a very high rate. It's more than worth the cost of travel health insurance. It is also NOT a good idea to simply go to an outpatient urgent care facility - they are often not staffed by very knowledgable staff. Better to go to an emergency room for the care you need.

ronnie36 wrote: "sometimes you gotta do what you gotta do."

Even if you are Mexican?

""ronnie36 wrote: "If I were the canadian or brit, I'd just split and not pay."

This certainly appears to be the attitude of many non European visitors to the UK who have need of the NHS.

Insurance costs can also vary greatly. A colleague of mine has a husband who had a small melanoma removed from his leg about 2 years ago. He is planning to go to the US later in the year, but the cheapest insurance policy he can get is £700 for a week.

For the cost of travel insurance, is it worth the risk to not have it? The £700 rate for one week is more the exception than the rule.

An ER must treat you if you come in without insurance if it's dangerous to turn you away (you're broken and bleeding, heart attack, allergic reaction causing breathing problems, etc). However, that doesn't mean you won't get bills for the next 50 years. It's much easier to just buy the insurance and not worry about it.

I'd either pay the 700 pounds per week - or not go. US health care costs are not anything to fool around with. Even something so simple as breaking his arm could make him wish he had taken out insurance.

Don't get me wrong, I am a firm believer in carrying sufficient health insurance.

I realise that my quoted case is not the norm, but it was the quoted rate, and I did find it exceptionally high.

I was also puzzled as I did not expect that the condition (previous Melanoma) would put somebody at risk of a sudden need of hospitalisation - as oppossed to say history of heart attacks or strokes.

I just wanted to amplify the point made by kgh8m so that any Europeans coming over here will understand how indispensible insurance really is. Not only are you covering the contingency that you may have medical expenses, but also, you are ensuring that you won't be charged an excessive rate. Hospitals charge outrageous prices for services, but when the claim in covered by insurance, the insurance company has its own price list for what it will pay for any given procedure, and send the bill back to the hospital saying, "this is all you are getting from us." The hospital then, usually, absorbs the difference.

Now, if you decide that you are in good health and want to play the odds, if you lose and end up in the hospital, you'll end up getting that same bill that the hospitals send to the insurance company, but they will not accept your protestations as to the prices charged. So, not only does insurance conver the contingency of unexpected illness, it is also the only way to ensure that you will get a fair break on prices.

"ronnie36 wrote: "sometimes you gotta do what you gotta do."

Even if you are Mexican?"

I was just joking, but I'd be happy to send them to your country for medical treatment. I'm so sure ya won't mind paying the billions will ya.LOL Anyways, the mexicans don't gotta do anything, they have a socialized medical system. Funny, if socialized medicine is so great, why do so many mexicans and canadians come to the US for medical treatment, just wondering?

"This certainly appears to be the attitude of many non European visitors to the UK who have need of the NHS."

Need some mexicans?

ronnie - couple clarifications -
US ER's are required only to evaluate and stabilize if required, not treat beyond that. So the person who shoes up with a non life threatening situation will be given the equivalent of a band aid large enough to cove teh boo boo and instructions to follow up with a private doc.
Also, why do you think that Americans traveling in Western Europe are charged outrageous fees? That was certainly not he case for us, nor several others who have posted here.

And re: insurance negotiated discounts - hospitals or other providers are required to accept as payment in full insurance company discounts only of they have a contract with that company. If they do not, they are free to accept the insurance payment and go after the patient for the difference between that and what they bill. I always advise patients to NOT pay in full at the time of service if they have insurance, but rather make some payment and ask to be billed. Once the bill arrives, you can negotiate discounts. If you have already paid you can forget any discount.

"US ER's are required only to evaluate and stabilize if required, not treat beyond that. So the person who shoes up with a non life threatening situation will be given the equivalent of a band aid large enough to cove teh boo boo and instructions to follow up with a private doc."

Well, if it's a minor problem, the ER treats it and tells them to follow up with a private doc,nothing wrong with that. Of course for minor things, depending where you are, you may wait a long time for care. Better to go to a walk-in clinic.


"Also, why do you think that
Americans traveling in Western Europe are charged outrageous fees? That was certainly not he case for us, nor several others who have posted here. "

I agree that medical fees here have become outrageous and something needs to be done. I noted that medical costs vary from country to country however if an uninsured person needs medical care for something serious, the fees in Europe or any western country are not going to be cheap, even if they are not quite as bad as in the US. You'll still be looking at thousands, more than most can afford. This is definitely true for Canada. That's why one should take out medical insurance while traveling.

On the tripadvisor boards there was a thread running about how a lady had sprained her ankle and went to the emerg there. Apparently she was seen, xrayed, bandaged and sent off with a SEVENTY FIVE EURO BILL,, that seems pretty good to me. Don't know if that was an exception, but I have not heard of people paying 10,000 a day in a Europeon hostpital.
The Canadian girl I speak off cannot just leave, she is still very hurt, but stable( which explains her high daily care cost to a small degree) she just needs to go home to one of our hospitals, she will still be paying there( get this she let her Canadian insurance expire also) but she will pay alot less. American hospital prices are shocking, I have heard of 10 dollar aspirins , geesh, how to price gouge or what!

Google Robin Bayliss. She( a Canadian , my friend) died in an American hosptial in 1988. She was admitted and survived less then 30 hours. Her family was billed ( and paid btw) hospital bills in the SIX digits,, thats right the whole kabang was over 100,000. She was helicoptered to the hospital from a suburb, so that added alot I am sure, and she did have emerg surgery,, but still that is a sickening amount of money. And keep in mind, this was almost 20 years ago.

I know this is all getting a little too policitical , so I will let it go at :

You are not sane if you travel without EXTRA medical insurance no matter WHAT country you travel to!!

"The Canadian girl I speak off cannot just leave, she is still very hurt, but stable( which explains her high daily care cost to a small degree) she just needs to go home to one of our hospitals, she will still be paying there( get this she let her Canadian insurance expire also) but she will pay alot less. American hospital prices are shocking, I have heard of 10 dollar aspirins , geesh, how to price gouge or what! "

That may be true but unless you're a US citizen it's not your place to judge our healthcare, just take out medical insurance if you come here. I've heard of people in canada who can't even get emergency care on the weekend or who have to wait months for cancer treatment under their socialized system. You worry about your system and we'll worry about ours. Deal?