Obviously a complicated question, so very general answers –
1) American private insurance does *not* usually extend to overseas treatment. If you are traveling overseas as an American you may want to purchase separate “Travel Medical Insurance” which handles these types of scenarios.
2) Yes, they will be billing in accordance with the policies of the provider/nation they receive treatment in.
3) Nations that have public healthcare will often cover/negotiate on behalf of their citizen if they receive treatment in the States. Again, they might not cover everything 100% and travel medical insurance is something people should look into.
I had an asthma attack in Munich after my sunscreen exploded in my bag and destroyed my nebulizer. Took a cab to the ER, got a breathing treatment and blood test, and visit from the doctor. Paid a whopping 147 euros. Almost had enough cash in my wallet but used my card instead. Didn’t bother trying to run it through insurance.
The US has a lot to learn.
Usually you would take out travel medical insurance for that reason.
I ended up with a $20k hospital bill in Chile, I had to pay it. Yes I had an invoice. Luckily my insurance eventually covered it but it took almost a year to get reimbursed.
A buddy of mine got bad food poisoning in Cuba… ended up in the hospital. He had to pay on the spot as well… free healthcare is for citizens only.
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