# More on US hospital scams and insurance refusing to pay Canadians for medical bills



## carverman (Nov 8, 2010)

The scamming by US hospitals and Canadian travel insurance companies is still very much in the news.'

June 22/2015 Travel insurance policy taken out with: Royal and Sun Alliance 
An Ontario man who winters in Arizona was shocked recently after receiving a $*26,000 bill for a three-day hospital stay* in the U.S. despite having travel insurance.



> According to Ing, the insurance company gave the hospital the go-ahead to run multiple tests. Ing was also held for three days at the hospital before being released with a clean bill of health.





> According to the company's coverage policy, however, a* claim can be denied if an individual has consulted with a specialist* -- something Ing did last year when his doctor suggested a procedure that would help stabilize his heartbeat.



http://toronto.ctvnews.ca/ontario-man-who-travelled-to-u-s-stuck-with-26k-hospital-bill-1.2434995


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## kcowan (Jul 1, 2010)

I was in the hospital in Mexico for complications from a spider bite: cellulitis and phlebitis. Manulife contacted my GP to see if I had ever been diagnosed with either of those before. Fortunately I had not. Upon discharge, they refunded my credit card charge for 20000 pesos with a cheque, leaving me with the 1% cashback from Chase.


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## carverman (Nov 8, 2010)

kcowan said:


> I was in the hospital in Mexico for complications from a spider bite: cellulitis and phlebitis. Manulife contacted my GP to see if I had ever been diagnosed with either of those before. Fortunately I had not. Upon discharge, they refunded my credit card charge for 20000 pesos with a cheque, leaving me with the 1% cashback from Chase.


Well that's a good story, but it is quite clear now that if you have to travel to the US, and for some reason have to visit their "for profit" hospitals, you will need to find out if any
pre-existing condition has (not) been treated by your doctor/specialist in the last 6 months..

otherwise be prepared to pay the hospital bill on your own. 

I'm sure you can refuse treatment for minor issues, but lets say you are involved in an auto accident while there, you may not have a choice of where they take you.

Once these for profit hospitals have you, they will keep you as long as possible for observation and extra tests.

Sock it to the tourists..they got health insurance...sure


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## sags (May 15, 2010)

Selling travel insurance, with the intention of refusing all claims must be quite a lucrative little business.

There should be a law that the insurers have to do their investigation BEFORE they accept the policy.


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## fraser (May 15, 2010)

This past Feb. my spouse broke a vertebrae while we were in Kuala Lumpur. She arrived at the hospital at noon. By 12:30 she had been admitted. Xrays and a consult by 2:30PM. Specialist recommended an MRI. Radiologist was brought in (it was a Saturday) and the MRI was done just before 4PM-wait time of 1 1/2 hours for the MRI. Results and consult at 4:30. Back at the hotel by 5:30PM.

Paid the bill. Received 3 copies of the bill and the consultants report. Also so the full set of Xrays and a CD of the scan results. The price included a prescription. We went to the pharmacy and it was waiting for us in a bag with our name on it. 

Oh, and the cost? Exactly $732 Canadian dollars.

We have to submit the bill to Alberta Health before our insurer will pay the balance. We just heard from AHS...they took 9 weeks to respond after we filled out the forms. No money, no account. Just a note saying that we will get a cheque in three weeks with the accounting. So that will be 12 weeks by the time any cash shows up and before we can submit to our insurer?

We expect little from AHS but cannot help but wonder what the cost of this would be in a hospital in Alberta-either internal or external patient billable amounts...let alone the long wait for MRIs.

The folks at the hotel told us this particular hospital tends to more expensive. It caters to foreigners and does massive amount of medical tourism. They said it has the latest and greatest gear, with highly qualified personnel. Spouse is an RN and well versed in hospital proceducres/etiquette. She was blown away by the care she received and the promptness with which it was provided.


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## uptoolate (Oct 9, 2011)

carverman said:


> you will need to find out if any pre-existing condition has (not) been treated by your doctor/specialist in the last 6 months..
> Once these for profit hospitals have you, they will keep you as long as possible for observation and extra tests. Sock it to the tourists.they got health insurance.


I'm sure this is why I have only seen a doctor twice in the last 30 years. Once was for a broken ankle. No records!

And don't think they just stick it to tourists. Anyone with insurance will do. This is one of the things that is lost on most Americans - even those with great healthcare insurance often get poor care. Unnecessary tests can be dangerous to your health.


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## Beaver101 (Nov 14, 2011)

fraser said:


> This past Feb. my spouse broke a vertebrae while we were in Kuala Lumpur. She arrived at the hospital at noon. ...
> 
> Spouse is an RN and well versed in hospital proceducres/etiquette. She was blown away by the care she received and the promptness with which it was provided.


 ... rather ironic that Canada (and its neighboring cousin) supposedly having the most advanced healthcare systems or medical technology is going progressively backwards in terms of accessibility, long waits, and ever-increasing costs. Where did we go wrong with our systems?


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## carverman (Nov 8, 2010)

Beaver101 said:


> ... rather ironic that Canada (and its neighboring cousin) supposedly having the most advanced healthcare systems or medical technology is going progressively backwards in terms of accessibility, long waits, and ever-increasing costs. Where did we go wrong with our systems?


In Canada, the hospitals are over budget in their spending and have to cut back by firing staff. They are not allowed to charge patients under provincial health care rules..at least not for the general health issues. 

In Ontario some hospitals were taking foreign visitors as tourism health care for profit, but this impacted the residents,
and OHIP told them to cease and desist. 

In the US, pretty much all the hospitals are privately funded, and even with technology, it costs a fortune to undergo tests or to have a lengthy stay.
The guy in question who went into a hospital in AZ assumed he was covered by his insurance policy, but they found a way to renege on the $26,000 bill
because it was a $26,000 bill in US dollars which would be about $30K Cdn. The insurance companies are in there for a profit, not to pay out exorbitant
amounts of money per claim. 

Possibly if the charges were more reasonable..say under $1000 US, the insurance company would have paid up..but they are in business to make a profit themselves, and if they start paying out more in claims than what they take in premiums..well you do the math.

Technology increases the cost of the healthcare in the US, fortunately we don't see that in Canada, because if we had to pay for any hospital visits, most of us would be broke too.


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## Guban (Jul 5, 2011)

carverman said:


> In Ontario some hospitals were taking foreign visitors as tourism health care for profit, but this impacted the residents,
> and OHIP told them to cease and desist.


Did they cease? I've always wondered how pro athletes get their MRI's so quickly. Are there privately run clinics with all of the newest fanciest medical equipment lying around? They are injured in the game, and the damage is reported in the news the next day.


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## Beaver101 (Nov 14, 2011)

carverman said:


> ...
> 
> Technology increases the cost of the healthcare in the US, fortunately we don't see that in Canada, because *if we had to pay for any hospital visits, most of us would be broke too.*


 ... see the cost mentioned in fraser's post, 



> Oh, and the cost? Exactly $732 Canadian dollars. for an MRI, etc. $732


doesn't it seems like some "body" is gouging at our end, never mind about the private firms in US.


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## Beaver101 (Nov 14, 2011)

Guban said:


> Did they cease? I've always wondered how pro athletes get their MRI's so quickly. *Are there privately run clinics with all of the newest fanciest medical equipment lying around?* They are injured in the game, and the damage is reported in the news the next day.


 ... you bet there are. Recall a few winters back, priority given to healthy elitists getting the HIN1 flu-shots at club-med-clinics.


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## carverman (Nov 8, 2010)

Guban said:


> Did they cease? I've always wondered how pro athletes get their MRI's so quickly. Are there privately run clinics with all of the newest fanciest medical equipment lying around? They are injured in the game, and the damage is reported in the news the next day.


I don't think it was the pro athletes as they would be covered. My understanding was that the hospitals in question were soliciting foreigners to come to Canada
to get their operations done for a fee. 

http://www.cbc.ca/radio/day6/episod...patients-raises-questions-of-ethics-1.3001554


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## MRT (Apr 8, 2013)

Guban said:


> Did they cease? I've always wondered how pro athletes get their MRI's so quickly. Are there privately run clinics with all of the newest fanciest medical equipment lying around? They are injured in the game, and the damage is reported in the news the next day.


Allegedly, pro teams and atletes pay for tests, use of equipment, etc. during "off-time" when it would not otherwise be used anyway, so they are not actually leap-frogging over other patients.

Whether this is true or not, I can't say.


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