[em-bee]

the big point you are missing is the denial of paying for treatment after it has been applied.

in germany (and probably most other european countries) you can be denied treatment if it is deemed unimportant and it is known that insurance does not cover it. you will never be put in a situation where treatment is applied but then the insurance doesn't pay leaving you with the bill unless you were made aware that the treatment is optional or you specifically chose a treatment that you could not be sure would be paid. payment for any treatment that is not optional can not be denied. if there is uncertainty you can also ask your insurer in advance, and they must give you a binding response whether the proposed treatment will be paid or not.

most importantly the doctors must inform the patient in advance if the treatment is insured or not. if they don't tell them that something is not insured then they can't demand payment from the patient.

you will never face a surprise bill.

[torified]

Because you mentioned Germany and surprise bills...

My partner suffered a medical episode while we were traveling in Germany. Bystanders called an ambulance which turned up and checked her out and asked her to be taken to hospital for more tests.

She/we elected to not go with them.

To our surprise, about 6 months later after we returned home (to Australia), we received a letter in the mail (in German) that said we owed something like $500 for the ambulance, I forget the exact number.

How does that line up with "you will never face a surprise bill" in Germany? Or is it because we are foreigners?

We never paid but I sometimes wonder if something would happen should we return to Germany.

[em-bee]

it's most likely because you didn't have insurance at all. if you had travel insurance you should have forwarded that to them. (but see below about calling an ambulance that is not needed)

if you don't have insurance you have to pay for everything of course. the surprise in your case comes from the unusual situation that the people who called the ambulance didn't know that you had no insurance, or more likely and you weren't even aware of how your situation is going to be handled.

it's unlikely that anything will happen if you return since the ones issuing the bill would not be notified in any way that you entered the country.

it is also possible that you could have disputed the payment since you didn't call the ambulance yourself (and i assume didn't ask anyone to call them). on the other hand if you had insurance you should have gone to the hospital because apparently insurance doesn't pay if an ambulance is called but not used. so actually, you didn't receive a surprise medical bill, but a bill for calling a service that was not needed (and potentially inconveniencing someone else who might have needed the ambulance, but now had to wait).

however, if you didn't ask anyone to call the ambulance then the bill is inappropriate because the law here is that if you call an ambulance but you don't need it, you pay, but if someone else calls the ambulance without you asking them, and it turns out to be unnecessary, then nobody pays.

since i lived in china i also don't have insurance in europe, so when we were visiting and needed treatment for a burn we had to shop around different hospitals to find out which one charged the least. costs for an ER visit ranged from 80€ to 250€ if i remember, and later we found a special hospital that was funded by a charity for the uninsured were we could go for after care for free. that works because the number of people without insurance is extremely small. mostly foreigners who somehow fell through the gap.

[torified]

Interesting.

We didn't ask for anyone to call the ambulance, although personally I am happy that it was called and she was checked out.

[em-bee]

indeed. while i was reading up on this i kept wondering if there is no way to call a doctor without calling an ambulance. i know there are private doctors that you can call (i recently saw a report about a doctor who said that he gets called specifically because his patients do not want to be taken to a hospital (and don't need to)), but when you call emergency services then an ambulance seems to be the only option.

[torified]

Here in Australia we have a line you can call, I think it was started during covid.

No idea how useful it'd be for non-covid calls though. Probably not very.