Well, there are going to be lazy hospitals… and bad insurance programs that really don’t want to pay and do everything they can to get out of it. Just like there are in the US.
Heck. Look at the web page of this “Medical Audit Professionals”.
“We work for your profit”
“Our goal is to provide you with services, and tools that preserve the company and individual assets while helping to improve profitability”
“Our company is comprised of a team of experts in the financial medical cost containment and insurance business industry”
Whose side are they on, I wonder. Oh yes I know all insurers are looking out for their profits and and for fraud and the like. But is there any counterbalance? Where is the sales and marketing side to point out to a common boss that looking like assholes when push comes to shove isn’t necessarily a good idea? I think a common thread of all of these “fintech”-like “insurers” is that they’re tech/marketing shells over third party services with fairly thin resources. It sounds good but is that really want you wanted?
And then there is just the factor of “I am in pain NOW and I ended up HERE and didn’t have a choice in the matter because I was unconscious/wigged out/etc”. One insurer may do and have as you say. Another one might well do a shoddy job of it. And how do you know before signing up?
I don’t know. My wife had a really bad accident in Scotland. There was no time to call ahead, or to wait for a MAP. You went to the ER and the bill was going to be whatever the hell it was going to be. The last thing you’re thinking about is whether your insurer is going to pay for this. I called UHC after the fact, got an RN in 5 minutes, and found there was zero question of who was paying and that RN ended up fighting with NHS because NHS refused to let her leave out of fear of a blood clot in her lung even though UHC knew that and had arranged special pressurized medjet to get her out - when the cheapest thing to do was let NHS deal with it. It was dead clear whose side she was on. The only real thing that was hard was her asking “so where do you want to go” and she didn’t offer much advice. But I suppose that, when your choices are Mount Sinai, NYU-Langone, and NYP/Weill Cornell, did it really truly matter?
(As an aside. These are things people don’t normally think about - where WOULD you go if you needed something serious? I certainly never had. Now, we know we prefer NYP/Cornell system though we wish we’d picked HSS.)
In the end, stupidly, I DID have to pay NHS and get reimbursed, which sucked. But I think it was because NHS wasn’t going to let UHC pay. I forget. But it may well have been UHC policy, too.
(Once I was back, of course, I had to deal with all the US standard bullcrap of getting surprise out of network docs and bad billing and all that, but that’s just the standard US experience, and not what we’re talking about here. Though in Weill Cornell’s defense, they handed us to their one trauma-specialist plastic surgeon, clearly their best person, he even ran a lab doing research on new tech for dealing with trauma injuries - not a common thing in that field, sadly. And it wasn’t his fault that our UHC policy had a terrible method for rating payment for out of network docs.)
I guess all this is a lot easier than your situation though. NHS is going to charge whatever it’s going to charge, and there’s no real questions in anyone’s mind about whether they should cover or what the bill would be or choice of doctor. And yes, I pay through the nose for that policy. Well, my employer does, same diff.
But one core takeaway is yes, you really want a high-limit credit card or you’re taking your chances. If this had happened in UAE with a hospital demanding payment up front, with a policy demanding you pay and get reimbursed (and I’m sure some do)? And those of you digital nomads looking for bargain policies… it’s ok if you want to take that chance, but beware that you may well be getting what you pay for. Safety Wing depending on a third party means you’re not really dealing with the people making the serious decisions until maybe far too late. Whereas that UHC RN was clearly able to speak for and commit all of the resources of UHC right then and there, she owned the case until we got home and my wife was safely ensconced in a bed and she made sure of it. There never was a real question. I go abroad now knowing exactly where I stand. I suppose this sounds like an ad for UHC. It’s not meant to be, it’s meant to be an example of what “right” looks like, in contrast to this person’s experience.
I understand getting high limit offshore cards can be a problem. I think you can find banks that will do it if you can secure it with cash. But that isn’t an option for everyone. Call it a downside of the nomad lifestyle - you’re cutting ties, and that has consequences as well as benefits. For folks from some countries, maybe those benefits are somewhere between not-great and non-existent, of course, and it’s easy. But for others, those consequences may not be obvious. Especially those of us from the first world. We make lots of assumptions about our health based on “we’re healthy” and our country’s resources, and it’s super easy to ignore those tail risks because that’s what humans often do… it’s maybe worth thinking through what assumptions we’re unconsciously making and what we might be giving up and how we really feel about that.
