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Old Dec 14th, 2004 | 07:40 AM
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Emergency Medical Care While Traveling

My mother-in-law lives in Italy where her medical care is government-funded.
She is planning to visit California for a few months. If she were
to receive emergency medical treatment while in California, who pays for the medical bills?
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Old Dec 14th, 2004 | 08:13 AM
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She probably would pay, so she needs to buy travel insurance which includes health coverage. My mother has to do this when she visits from Scotland.
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Old Dec 14th, 2004 | 08:14 AM
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I'd consult the Italian health care officials instead of a travel board.
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Old Dec 14th, 2004 | 08:23 AM
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Mammamia,
I was stunned when I read your post. My mom lives here in Canada and was travelling through Italy last Spring and required emergency medical care. I realize this is the opposite situation to your question but just so you know, she had travel insurance and all of her medical expenses in Italy were covered by it. It was a very good thing that she had purchased it because she ended up having to stay in the hospital in Rome for close to a month and the tests, treatment and hospital stay would have ran close to $100,000 CDN.

Make sure your MIL gets travel insurance, you won't regret it and it is usually relatively inexpensive as compared to the alternative.
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Old Dec 14th, 2004 | 08:43 AM
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Not quite sure why it is controversial. Your MIL needs travel insurance, as others have said. Otherwise, she will have to foot the bill herself. The hospital also will likely come after you. When friends visited from Ireland, one ended up in the emergency room. She had travel insurance, but the company took awhile in sending payment to the hospital. The hospital hounded us for payment, as she had given our address.

Check that the insurance will cover such an extended stay. Mine (I live in the UK) covers trips up to 45 days, and will extend the coverage to 90 days if I pay extra.
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Old Dec 14th, 2004 | 08:54 AM
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Youthinks wrong, GoTravel... mammamia not a troll...just one who wishes to minimize risk whenever possible. Haven't posted before since I don't travel much these days, with 3yrold Mia getting car sick whenever she's in a vehicle more than 10 minutes.
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Old Dec 14th, 2004 | 09:11 AM
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I'd suggest your mother-in-law check for the terms of her Italian healthplan. My health insurance policy (company provided) covers my costs for emergency treatment anywhere in the world and doesn't require that I purchase additional travel insurance.

I don't know that the Italian government would offer the same benefit as a Swiss financial institution, but it won't hurt for her to ask.

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Old Dec 14th, 2004 | 09:18 AM
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My Father-In-Law was in Dallas for the winter and had a heart attack. He was taken (as uninsured) to Parkland and basically received incredible care just like the scores of illegal immigrants that rely on Parkland everyday.
As a Canadian who lived only on a small social security income, he was unable to pay and they never tried to collect once the situation was explained.
I can't say enough about Parkland and the care they provided.
3 years later he had a heart attack in Canada and died waiting for the urgent care he needed.
If your Mom needs emergency medical care just have them take her to the closest urgent care facility (they know which) and work out the details later.
Gotta love the USA, where ANYONE can expect care in such a crisis!!!!
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Old Dec 14th, 2004 | 09:23 AM
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Before I get flamed for the last statement, it's great to have a plan and know exactly what to do BUT IF YOU DON'T HAVE A PLAN you will still be OK!
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Old Dec 14th, 2004 | 09:28 AM
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TxTravelPro, I am not sure why you would advise someone to burden an American medical institution with their medical costs. It would be far more adviseable to get the travel insurance and have a third party pay for the expenses than to expect an American hospital to shoulder that burden. And, I would suspect that your FIL got lucky by recieving "free" health care. Mammamia's MIL may not be so lucky if something goes wrong.
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Old Dec 14th, 2004 | 09:29 AM
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TxTravelPro is correct that she will receive good care at the hospital. But does she have money? If yes, then the hospital and their collecting agencies will come after until she pays (not necessarily the "rack rate", as prices are negotiable).

TxTravelPro is talking about someone who doesn't have much money, and the hospital probably decides it's not worth the effort to collect.
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Old Dec 14th, 2004 | 09:39 AM
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I had medical care in England....another medical welfare state like Italy. I payed nothing, got no bill, and never heard about it again.
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Old Dec 14th, 2004 | 09:49 AM
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Nope, Atilla... in the USA emergency medical care is available to ALL.
And my experience was a sudden emergency, he was a healthy man (we thought) and like MANY healthy people traveling, we never really considered anything happening. Maybe stupid, but very common.
As a tax payer I am against people 'using' the US medical system without the intention of paying but isn't it wonderful that they can count on quality care either way?
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Old Dec 14th, 2004 | 09:55 AM
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You are absolutely right, that is wonderful and thank you for elaborating. I now understand that your point was that the care would be there if need be. I personally think that anyone entering a foriegn country should do what they can to avoid being a burden that country's system with their expenses. That being said, sometimes the unexpected happens and it is fortunate that your FIL was able to get the care he required.
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Old Dec 14th, 2004 | 10:32 AM
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Hospitals are turning away those that are uninsured.

http://www.amsa.org/tnp/myths.cfm
 
Old Dec 14th, 2004 | 10:39 AM
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There are very specific laws regarding urgent care for the uninsured. Hospitals can turn away someone with a cold using the emergency room as a 'primary care' source but many hospitals cannot turn away an urgent care issue. They are required by law to stabilize the patient.
As I said above, the EMT's will know which hospital will accept uninsured urgent care patients in any given city.

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Old Dec 14th, 2004 | 09:05 PM
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American Express Platinum costs over $300 a year, but if you have to get medvaced (air ambulance) out of anywhere they cover it and it can cost into tens of thousands. We've seen fellow travelers flown out of foreign and US locations for medical reasons, and you could just hear the cash register ringing. Be prepared and don't be arrogant about your health or safety.
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Old Dec 15th, 2004 | 03:38 AM
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As an RN whose clients are all poor - the way it works is that a hospital will give emergency free care in life-treatening situations to anyone - and later deal with the payment.

For situations that are not IMMEDIATELY life-threatening, the patient meets with a hospital financial person (or social worker) and answers questions indicating whether or not they qualify for free care. Not wanting to pay, deciding not to buy health insurance, being a foreign visitor - are not reasons to qualify for free care. Being very poor is. Urgent is not the same as life threatening. (For example, a temperature of 103 with strep throat may be urgent, but it is not life-threatening). In Massachusetts, there is a pool of money dedicated to "free care", shared by hospitals. The cost is not born solely by the hospital the patient visits.

If a person is deemed to be financially able to pay - either at the time or in the future - information is collected so the hospital gets paid. That includes address, credit card numbers, etc. Not sure how successful a hospital would be in collecting from a person once they leave US - that's for the legal types to answer.

Other states may have somewhat different practices - such as specific hospitals being designated for free care. Also, not sure how various "walk-in" clinics work. I suspect that unless they are publicly funded (state, city, etc.), they can serve whoever they want.

My version of an answer is that your mother-in-law would be required to pay for any care, and might be turned away unless it is a life-threatening situation. Some of the legal immigrants with which I work have tried to get foreign-living relatives care while they are in US. Usually does not work, unless they can pay or have legal immigrant status.
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Old Dec 15th, 2004 | 05:49 PM
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Today I went through preadmission... I am having major surgery Friday
Due to several factors out of my control, I am having the surgery in a Class B hospital in a rural East Texas town.
It was interesting to talk to the business office about this issue...
Not sure all the details about Class B, but basically they stabilize trauma patients and prepare them to be airlifted to Parkland or Baylor in Dallas.
They are not required to accept patients without insurance and she said they turn them away all the time... primarily they turn away people using the facility as a 'doctors office'.
They do have a program for verified low income local residents and each applicant is qualified... so the facility gives back to the community.
It was a peaceful place, needless to say. Very different from the big Dallas hospitals I am accustomed to!
Thanks for the information Gail, and thanks for being a nurse!
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Old Dec 15th, 2004 | 07:40 PM
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Another nurse (and a Texas) here who also has lots of experience with indigent care. The law is that no hospital can refuse care in life threatening situations, they are obligated to stabilize but then may transfer to another facility - usually the public hospital. In Texas public hospitals are funded by the county (e.g., Parkland) while other states follow a different program.
Regardless - in response to the OP, travel insurance is a good idea. It can cover things not provided by public hospitals. Not sure how this works with residents of Italy, but when we (US citizens) travel I go to www.insuremytrip.com
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