Hospital Bill from Spanish Hospital

TravellingMan2022 said:

I may be misunderstanding but with regard to UK folks not paying bills, we are part of the EHIC/GHIC scheme so get free healthcare! Also doesn’t the last few lines imply UK is still in EU! Sorry if misunderstanding!

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I quoted the article merely as an example for the view from "the other side" and not from the individual traveller's side. The whole system of repayment of health care costs is complicated - payments between the various health insurance systems of the Spanish regions within Spain, payments between various health insurance systems of the EU countries and so on. We've never had anyone here who actually has insight from Spanish hospitals themselves and their policy (if any) on how they bill foreign tourists. There are, apparently, huge unpaid sums for one reason or another.

PS: We all know how the EHIC system is supposed to work on the individual level. We know little about how it works on the macro level. Another recent article in English says that: the United Kingdom tops the list of bad [health care bill of foreign tourists] debts by nationality, followed by Germany, France, and Italy. The non-EU destinations with the highest number of non-paying tourists are the USA and Argentina. Brexit does not matter because as far as I understand it the UK opted to somehow stay or become a member of the system (GHIC card). Main point, however: somebody else has to pay for your medical care in Spain if it is not you or your insurance.

chinacat said:

The first thing in your post that caught my attention was that a passing motorist had taken you to a local clinic.
That in itself is admirable.
I can easily imagine that that would not necessarily happen in certain parts of this kingdom.

As a citizen of a ‘minority‘ country, in a larger union, I found much in common with the Basque people I met on the camino.
And I received a warm welcome.
I would agree that the Basque are good people.


On another note, our lovely hospitalera, whose name is hiding just beyond recall, (last albergue, on the left, on the way out of Rabé) drove us back to Burgos University Hospital, where my daughter was x-rayed and given instructions for her hamstring injury in the A&E (ER) department. The usual problems with the unintelligibility of public announcement systems were magnified by our lack of fluent Spanish but we were never forgotten. Someone always appeared to guide us and it all felt as familiar as our local hospital. We asked about payment but were assured there was nothing to pay.
But we were in the EU then
We are still covered for a lot of medical treatment in the EU, due to reciprocal arrangements, I believe.

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Coverage for UK residents when visiting EU countries post our withdrawal from EU hasn’t changed as it was negotiated as part of Withdrawal Agreement.

As someone who once worked for an insurance company - I agree - read the policy. You are only covered for the specific events covered, and only to the extent covered, and only in accordance with the specific wording and only if you make a claim in accordance with the policy requirements.

For some reason people think insurance policies cover everything not excluded. It is really the other way round. Make no assumptions.

I have a travel insurance policy specifically for someone over 70 years of age. it is gratifying to see that I am covered for medical costs associated with any pregnancy going wrong.

Something I did not know until today - the things I don't know about Spain! - the Health Service of Galicia regularly publishes in their Official Gazette a list of those patients that had been treated in hospitals or health centres in Galicia with unpaid bills who could not be tracked. These patients are requested to pay their outstanding debt to the bank account listed in the announcement. Sometimes the list contains names, sometimes only passport/ID card numbers, and always the number of the invoice and the sum to be paid. The names look mostly like Spanish names but there are also others. Occasionally an insurer is listed that cannot be tracked, for example on the list of unpaid bills for medical services provided in August and September 2021 in the Área Sanitaria de Ferrol:

https://www.xunta.gal/dog/Publicados/2022/20220225/AnuncioG0003-110222-0004_gl.html

Kathar1na said:

The comment made me giggle, actually. But ok we all don't really know how health care costs are financed in Spain, me included - and I am of course aware of discussions about the pros and cons of a universal health care system in other countries that don't have such a system. Needless to say that "universal" does not mean that everyone in the universe is covered but only those who are formally and legally enrolled in the system, which is usually only the inhabitants of a country (note: that's inhabitants and not nationals of the country in question).

Anyway ... a recent article sheds some new light on this topic. If you get never charged for your hospital stay or other medical treatment as a foreign tourist in Spain, it is obviously not your fault that you don't get a bill, and we will rarely know whether this was intentional or not. But see this recent article on the Spanish Antena3 website:

Spain's healthcare system accumulates millions of euros in uncollected medical bills from defaulting tourists: Many international tourists leave without paying their bills at hospitals and health centres in Spain.​

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In most cases, if they are EU tourists, they arrive with a European Health Insurance Card. If they are from a country outside the European Union, they should arrive in Spain with travel health insurance. However, this is not always the case and many of those who need medical attention end up leaving the hospital without paying the bill. ​

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By country, the UK is at the top of the list of tourists who do not pay their Spanish health care bills. Outside the EU, the country that pays the least bills is the United States, followed by Argentina.​

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Translated with www.DeepL.com/Translator (free version)​

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I don't know all the ins and outs of the Spanish health insurance system, but I arrived yesterday to take up a post as a teaching assistant. My employer is the local education department and when I went to look around the school this morning, they had a medical insurance card waiting for me.

Kanga said:

As someone with a travel insurance policy specifically for someone over 70 years of age it is gratifying to see that I am covered for medical costs associated with any pregnancy going wrong.

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TravellingMan2022 said:

Coverage for UK residents when visiting EU countries post our withdrawal from EU hasn’t changed as it was negotiated as part of Withdrawal Agreement.

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Yes, I thought so …
But it does have some limits … always did have …

chinacat said:

Yes, I thought so …
But it does have some limits … always did have …

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Yes, and those limits vary from country to country. It also doesn't cover UK citizens resident in another country (eg if you live in Spain you can't use GHIC for treatment in Spain).

Molly Cassidy said:

Yes, and those limits vary from country to country. It also doesn't cover UK citizens resident in another country (eg if you live in Spain you can't use GHIC for treatment in Spain).

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Good luck in your new job!

chinacat said:

Good luck in your new job!

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Thank you. I think I'm going to improve my Spanish a lot!

Kathar1na said:

I quoted the article as an example for the view from "the other side" and not from the individual traveller's side. The whole system of repayment of health care costs is complicated - payments between the various health insurance systems of the Spanish regions within Spain, payments between health insurance systems of the various EU countries and so on. We've never had anyone here who actually has insight from Spanish hospitals themselves and their policy (if any) on how they bill foreign tourists. There are, apparently, huge unpaid sums for one reason or another.

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Thank you! I read an article once talking about respective countries billing other countries for provision of medical service forif it happen,!

Molly Cassidy said:

Yes, and those limits vary from country to country. It also doesn't cover UK citizens resident in another country (eg if you live in Spain you can't use GHIC for treatment in Spain).

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yea it’s all covered here.

Walton said:

In my experience, these companies love selling policies and taking your money. They love adding lots of fine print and usually always look for ways to avoid payment of claims even if the claim is legitimate.

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Corned Beef said:

It won't be "legitimate", if the claims don't meet the terms written and agreed to.

For those in Common Law jurisdictions, there is an underlying understanding that there is "freedom to contract" and that relies on each party being fully aware of their rights and obligations within the "4 corners of the page" i.e. what's on the document and no more. It goes back to a decision in L’Estrange v Graucob from 1934.

Some of the decisions that underlies contract law can make your head spin but it all comes back to whether you've had the opportunity to read the agreement beforehand. Apple for example have a huge agreement which no one reads and allows them to do all sorts of stuff with your private data.

No one reads [insurance] contracts - but they should.

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Just to explain my comment about insurance companies looking for ways to avoid payment of claims.

Our car was damaged in a hailstorm. The insurance company wanted to inspect the car and an appointment was made. I was running five minutes late due to traffic and on arriving home I noticed the insurance guy was hidden behind the said car on his knees using a tyre depth guage checking the depth of the tyre tread. Yes- he was checking because there is a clause in the fine print about the car being roadworthy. Sure - worn tyres caused the hail damage ... not! Anyway, I said let's go to the police station and see if the tyres are legal - the "caught out" insurance guy said they were fine.

By way of another example, In Australia at the moment, there is quite a kerfuffel because an insurance company declined to pay out for a farmers house that was damaged in a fire because the farmer concerned sold chook eggs at the farm gate using an honesty box and boxes of chook eggs. Apparently, selling spare chook eggs at the farm gate is "running a business" and there is something in the fine print about that. Needless to say, this has turned into a mighty row with lawyers and various government agencies now involved.

Corned beef says "you should read the fine print" and yep - if you have a claim there are some insurance companies that will trawl through the fine print looking for a reason to avoid payout.

Corned beef is also correct in that before buying insurance, you have the opportunity of discussion with the company. For example, in 2017 before I bought travel insurance to walk the Portuguese, I sent a cardiac surgeons report regarding my ticker to the insurance company to see if I would be covered if something cardiac wise, either directly or indirectly happened to me. They agreed to cover me - in writing, so I knew if I had a heart attack should I walk too quickly uphill or worse, unexpectedly see a naked person in an albergue, then knowing one is covered is peace of mind.

Pre-existing medical conditions is always a trap and something that should be really looked at because there would be very few of us on this forum that are devoid of a medical issue or two.

Buen Camino

trevorcc said:

Australian

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Yes, that’s a good idea. Haha. I’m Canadian. At the same time, Spain hospital asked for id with address and that’s where the bill went. I note your comment. I should be more complete. Thank you

Re: the pre-existing condition and insurance. When I called the credit card company’s insurance broker people before one of my caminos, to buy extended coverage, we had a conversation about pre-existing conditions and coverage. I was 3 years post-condition and they could have denied any claim on the basis of their requiring 5 years post-condition, if I hadn’t specified this in advance. They sent me paperwork to complete to duly record my pre-existing condition (which was long healed at 3 years) and then that they would cover me for anything unrelated to that condition.

Another clause that some insurance companies can mess you up on, again in the small print, is that if you make a claim in the middle of your trip, they expect you to go home. So if you break your leg a week after you made a claim for xrays and examination for something else, they might refuse that second claim.

Read the policy carefully.

CWBuff said:

I went to a hospital in Burgos mainly to be sure that my freakin blisters on the bottom of both feet (hence I could not really see them and assess for myself) were not infected. They were not but the nice nurses still cleaned them all up and put some sterile stuff ang gauzes on them (was told to stay off the feet for 3 days...but yeah... not happened...1.5 that I did)
anyways - they processed me through ER and I nicely paid E150 on the spot
Working with my Travel Insurance (Travelex) to get reimbursed (hopefully should be no issues)

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To follow-up on my own message I did get fully reimbursed for the above hospital bill as well as the bill from the Farmacia where the following day I bought some other pertinent supplies (extra bandages, gauzes, COMPID etc.)