Being an Ex-Pat Brit working here in Florida in a job that follows all you Brits that come here and need medical treatment and then leave unpaid bills behind.

If you are going to travel to Florida you need to know a few things just in case the need arises for medical treatment. Before you buy ANY travel insurance make sure it covers your needs. Pre existing conditions are the biggest single reason that I have claims rejected, this may be because some of you think that you will not be covered if you tell the insurers that you have a pre existing condition (previous heart problems is a biggie) where in actual fact most insurers will cover them and may only increase the premium or excess to take account of any pre existing conditions. Sometimes they may cover you for other events but exclude the pre exist condition.

You must also consider that if you need to visit an Urgent Care Facility (sort of between a GP surgery and an Emergency Room) or to a hospital Emergency Room the medical service provider will make YOU not your insurers legally responsible for any medical debts. Although the hospital I work for will deal with your insurance company, it is done as a courtesy to you, their customer. US and Florida State laws protect the medical facility from bad debt and when you attend the facilities you, in fact, "Sign your life away" and no matter what, you are responsible NOT THE INSURANCE COMPANY.

WHERE TO BUY INSURANCE:

Avoid buying Insurance from your Travel Agent, Teletext, and the Internet (they can sell you the cheapest and often worst coverage policy and you won't know until you make the claim.) UNLESS YOU KNOW THE UNDERWRITERS ARE A KNOWN AND REPUTABLE INSURANCE COMPANY. you can buy very good insurance from the Post Office, insure & Go, Moneysupermarket.com, Tesco, Barclays Bank etc and you do not need to be an account holder.

Check your policy details and ask questions.

One of the UK's largest insurers have a clause that states if you are over the drink driving alcohol limit (EVEN IF YOU ARE NOT DRIVING) any accident (trip/fall etc) is considered SELF INFLICTED INJURY and will not be covered (ask the lady in Middlsex who had 3 cocktails and tripped and hit her head and ended up paying us $19,000.00+ out of her own pocket).

If you are not sure ASK the insurance company NOT the seller of the policy. (many insurance companies will have their policy "wording" available on-line so you can see before you buy).

If you need medical treatment, first consider if it is REALLY an emergency - if so go to the hospital or call 911 for an ambulance. If it is a minor condition (Sore throat, ear pain, cuts & bruise) you are better off going to an Urgent Care facility - Florida Hospital CentraCare, Solantic, and some CVS & Walgreens Pharmacies now have "In-Store Clinics" - these are often much cheaper than hospital ER's and often a lot quicker!

If you forget your Prescription Medicine's.

Try to find a (Heart or Diabetic etc) Doctor's office that will see you and give you a prescription, only use the ER only if you cannot find someone else (a local Doctor's office or Urgent care facility) the Hospital will put you through a full medical before they will even consider writing you a new prescription and some insurers will not cover this as it is your negligence and/or pre existing condition). Attending the ER for blood pressure meds could end up costing YOU around £500.00! - Also other tip - before flying keep 3-4 days meds in your carry-on bag, should your aircraft be delayed or diverted, your bags may not!

DEBT COLLECTORS.

Medical providers will use debt collectors after sometimes a very short time, this is not unusual and does not necessarily mean that you are having legal action taken against you. - If you are contacted by a Debt Collection Agency the best you can do is contact the debt collector - NOT THE MEDICAL PROVIDER, as debt collection laws mean that the debt collector is now in charge of your debt - the hospital should refer you to the debt collector and if you ignore them, then they have the law on their side and you could find out the hard way that you should have TELEPHONED them - E-mail often is considered unsafe as the debt collector cannot be assured that you are the person entitled to receive the Protected Health Information in your medical bill (same with fax) by telephone the debt collector will ask you if you are the debtor if you say you are, and you are not then it is you who has committed an offence and the debt collector has complied with the law. Also if you are over 18 YOU must deal with your debt not your Dad, Mum or anyone else that may have paid for the holiday or insurance policy.

In any case, you sign a consent form at the medical providers office and the bottom line is that YOU owe the money NOT your insurers. Any legal action will be taken against you not your insurance company. I have had many stubborn customer that "knows better" then call back 6 months later because they have been refused a mortgage/credit card or Car HP.

SOLICITORS.

If your insurance company deny your claim and you disagree with their decision (or do not pay fast enough) do NOT engage a Solicitor, there are other and better ways to complain against your insurers such as the Financial Services Authority's Ombudsman Service and this consumer protection service is free to a consumer - why waste £85 - £100 per hour on a Solicitor when you get a better service from the FSA for FREE? But remember this or any other legal action you may take, does not releive you from your responsibility to the medical provider and you should pay them straight away and then "fight" your insurance company for reimbursement.

AFTER A CLAIM IS MADE.

It is your responsibility to make sure that the insurers have actually paid the bill - some insurers tell you this and then the debt collectors start calling - Insurers have the legal responsibility to prove they have paid, not the medical provider or their agents to prove that your bill has not been paid.

You must fill in your claim forms and comply with requests from your insurers for medical records from your own GP (this is the only way a pre existing condition can be ruled out) and your insurers cannot process the claim if you have not complied. Any cost for your GP may be your responsibility also, so if you don't pay your GP then you WILL have to pay the hospital! I don't need to tell you what is the cheeper bill!

RE-ENTRY TO USA.

Many ask - will this affect their return on their next visit to the USA - Officially you must make this enquiry to the Dept. of Homeland Security (at the US Embassy in London or any US Consulate). I have heard that yes it can affect entry to the USA - If you have holiday property here or are planning to immigrate here the immigration officers WILL do a credit check (unpaid medical bills are reported to Experian, Trans-Union & Equifax the 3 major credit reporting agencies) although I believe that it is rare for any "2 week tourist" to be refused entry on the grounds of bad debt (I think it may differ the bigger the debt).

Remember;

A medical bill in the US can ber huge! A personal friend of mine from Hertfordshire had a twisted bowl and was hospitalized twice in 4 weeks here having 2 surgeries and her medical bill for the hospital alone was $158,000.00+ [£80,000.00]

Doctor's here bill separately and that means you may have multiple bills, just being treated at the emergency room and released (without overnight stay in hospital may result in

A bill from the Ambulance/Paramedic service.
A Hospital bill.
The Emergency Room Doctor's Bill.
The Radiologist's (if you need x-rays etc).
The Pathologist (if you have blood tests etc).
A Pediatrician (if it is your child that needs treatment).

Overnight stay in the hospital can cost upwards of £600.00 per night, just for the stay (called "hotel charges") WITHOUT ANY MEDICAL TREATMENT!

etc etc etc ......

Motor vehicle accident are another subject and is complicated (as if the above is not!!!).

One final tip - If you smoke, or like a tipple, DON'T BUY DUTY FREE ON THE AIRCRAFT on your way to Florida (other sates may differ) Duty Free does not mean Profit Free! The Airlines know how much you pay in the UK and make it cheeper but not as cheep as buying it in Florida (e.g. 200 Marlboro cigarettes bought in Walgreens drugstore on any street corner here costs $23.00 approx £12 - £13 while the airline will charge about £26 - £30).
IMPORTANT - Ways to avoid delay or denial of your claim.

Should you need to receive medical treatment TELEPHONE YOUR INSURERS HELPLINE NUMBER at the earliest possible moment. If a minor illness or condition (cut, bruises, minor infection, insect bites etc) call before you go for treatment, often your insurers will tell you where to go (MANY Walgreens and CVS Pharmacies -similar to Boots) now have in-store clinics that can deal with prescribing antibiotics etc as they have pre-arranged with certain medical facilities to assist. If an Emergency situation then call as soon as you are fit to do so. DO NOT WAIT UNTIL YOU GET HOME, under your policy conditions this may be enough to make any claim void.

If you get a call or bill in the mail, call the person who sent it (Debt Collector. or Medical Billing company) who work for the hospital/facility - the hospital don't want to deal with billing problems they pay these agencies to collect the money for them. If you insist in sending payment to the hospital after receiving a debt collectors notice, you may find yourself facing further collection activity as to the debt collector it seems that you are ignoring them and avoiding your responsibilities.

Remember here in Florida, the medical service providers have the law on their side - you had the service and YOU are responsible not your insurers. Medical billing companies will deal with insurance companies (as I do in most cases) but it is done as a courtesy to you and we have no legal right to pursue an insurer, we must pursue you, the customer. It is up to you to chase and make sure your insurers pay and pay promptly otherwise the facility will obtain payment from you and it is then up to you to recover any payment from your insurers

Hope the info helps and you never know we may speak soon!