payment of unexpected medical expenses from India

[sunilg14]

Hi,
My father is visiting from India. We had travel insurance from IMGlobal but it was not going to cover pre-existing conditions for people over 70 (he is 73). He had an onset of asthma for which the doctor stated is a pre-existing condition and also made a diagnosis of slight pneumonia because of the condition. Since insurance is not going to cover it for sure, we thought instead of filing for a claim we will cancel and use the remaining money to pay for bills.
After a week, the pneumonia worsened and he had to be taken to the ER and then admitted to the hospital and treated for about 7 days. The hospital bill alone is around $52K and it does not include pharmacy, CT Scan and ER bills. The hospital agreed to reduce the bill to about $26K and I am assuming ER, pharmacy all put together will likely be about $35K.

1> My father has signed all the documents, but I have given my address and contact as the care giver. Does that make me liable?

2> I hate to ask this but my father is retired and he lives off the money we send him. So if he returned to India without paying, will the hospital collections pursue him in India? They have his address from his passport/visa. There are many threads which discusses similar situation but none has posted the aftermath. What can they go after or do they write off at some point? Will he have trouble visiting again?


Any practical inputs are greatly appreciated.

Regards

[inadmissible]

Pursuing unpaid medical bills within the United States is difficult enough because HIPAA prevents covered entities from sharing material details about the unpaid bills to professional collection agencies

Pursuing any debt abroad is particularly expensive, but even more so in countries that don't grant comity to US judgements. See http://www.pepperlaw.com/publication...ia-2016-01-06/

If your father has no assets in India to collect against, it would be a waste of money to go after him for his unpaid bills. Yes, the hospital will likely write it off. That is one reason why medical costs here are so high in the first place, because many bills go unpaid, and those who do pay the bills have to cover the expenses of those without the ability to pay

Since your dad is lawfully present, he should get himself an Affordable Care Act compliant policy that covers pre-existing conditions. You'll have better peace of mind and possibly better access to ongoing care and medication (which hospitals don't have to provide to people who can't pay), as opposed to just emergency care (which hospitals are obligated to provide regardless of the ability to pay)

[sunilg14]

Pursuing unpaid medical bills within the United States is difficult enough because HIPAA prevents covered entities from sharing material details about the unpaid bills to professional collection agencies

Pursuing any debt abroad is particularly expensive, but even more so in countries that don't grant comity to US judgements. See http://www.pepperlaw.com/publication...ia-2016-01-06/

If your father has no assets in India to collect against, it would be a waste of money to go after him for his unpaid bills. Yes, the hospital will likely write it off. That is one reason why medical costs here are so high in the first place, because many bills go unpaid, and those who do pay the bills have to cover the expenses of those without the ability to pay

Since your dad is lawfully present, he should get himself an Affordable Care Act compliant policy that covers pre-existing conditions. You'll have better peace of mind and possibly better access to ongoing care and medication (which hospitals don't have to provide to people who can't pay), as opposed to just emergency care (which hospitals are obligated to provide regardless of the ability to pay)

Hi,
Thanks for the response. I am working with the hospital to find available options. Does the Affordable Care Act allow non-citizens on visitor visa to buy insurance? Can you point to any site which offers Affordable Care Act complaint policies?

Regards,

[insubuy]

Visitors are clearly NOT eligible for Affordable Care Act plans. Even those (US citizens, green card holders etc.) who are eligible can only enroll during open enrollment from Nov to Jan. Visitors come and go at any time.

Visitors can only purchase visitors insurance.

[inadmissible]

People in lawful immigration status are eligible to participate in marketplace health insurance. A tourist would not be eligible for subsidies however https://www.healthcare.gov/immigrant...ration-status/

Gaining lawful presence makes one eligible for Special Enrollment outside the open-enrollment window

[insubuy]

I don't think so. In the link you specified, there is nowhere tourists are mentioned.

Tourists are welcome to try that during the open enrollment period. I wish them best of luck. (By the way, many people have already tried and could not get through.)

[sunilg14]

If your father has no assets in India to collect against, it would be a waste of money to go after him for his unpaid bills. Yes, the hospital will likely write it off. That is one reason why medical costs here are so high in the first place, because many bills go unpaid, and those who do pay the bills have to cover the expenses of those without the ability to pay

Hi,
My father still owns a house in India but the hospital don't know that. Given the bills to repay are high enough, would they be motivated to pursue a legal case in India or against me? I have talked to couple of medical workers and they say this is a common situation they see from time to time from even people living in US who simply cannot pay their bills and are written off. And they say its unlikely they would initiate legal action overseas.

We still intend to pay any reasonable costs within our limits if they are agreeable to a monthly payment plan but one person in the billing department I talked to said the hospitals will want to recover the cost within 18 months max. If that is the case, we simply cannot afford it. I still have not received a finalized bill yet.

I appreciate any feedback in this regard.

Regards

[inadmissible]

Insubuy, in the link I provided, it says

"Immigrants with the following statuses qualify to use the Marketplace: Individual with Non-immigrant Status, includes worker visas (such as H1, H-2A, H-2B), student visas, U-visa, T-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau"

In the link https://www.healthcare.gov/immigrant...nt-immigrants/ it says

"Lawfully present immigrants are eligible for coverage through the Health Insurance Marketplace. The term “lawfully present” includes immigrants who have: Valid non-immigrant visas"

I myself don't have a dog in this fight - I don't sell non ACA compliant health insurance plans in competition with ACA compliant health insurance plans. That said, I don't know of any B visa holders who have obtained ACA coverage. Actually, I don't know any B visa holders at all

[insubuy]

inadmissibe,

Will you please stop arguing about something you are not qualified to do?

You are just reading what you want to read and interpreting the way you would like to. It does not always work like that.

People on B2 visas are not eligible for ACA plan. Period. Anyone that does not believe that can waste their time on their own. Good luck.

[manju.kori]

Hello Sunilg14,
I am in the same situation as yours now, could you please let us know what happened later about those medical bills?

I bought comprehensive travel insurance from IMGlobal too, my father-in-law was admitted to ER for breathing issues. Hospital did many tests including CT scan, even though we were asking them just provide nebulization. All tests were negative and later he was discharged with Handheld Inhaler, which he did not use it later during his entire stay, now he has already retuned to india.
Total bill is about 18K, insurance is asking us to pay entire amount, bills are named to my father-in-law, I am really worried about it.

I have NOT signed or provided my SSN to hospital or to insurance company, only my address and phone number were given in the insurance application.

How do I go about this? can ignore these bills? I am on H1B btw.

Please suggest.

Thanks

[namitrs]

Hello Sunilg,

Can you please share your experience and how you tackled it? I am planning to bring my mother in May and she has pre-existing condition (Cancer), so trying to see what would be the options in case something happens while she is here

thanks

[ambrish426]

Conclusion

Hi,
Thanks for the response. I am working with the hospital to find available options. Does the Affordable Care Act allow non-citizens on visitor visa to buy insurance? Can you point to any site which offers Affordable Care Act complaint policies?

Regards,

Hi Sunilg,

Can you share your experience about how did you manage to close this situation?

[GCEB32020]

Summary and conclusion

Dear all,

Could one of you please advise me on how this was handled. I am going through the same issue for my father and we have ~$90K+ bills sent to Visitors insurance as claims. Still waiting for the final amount after claims but know for a fact visitors insurance is usually very tricky and i need to be prepared for the worst which is make most of the payments.

I am of the opinion, as a son i am not directly obliged to make the payments for bill on my father's name in USA as he was admitted in ER to begin with and was in ICU for a week but i don't want to ignore this for moral grounds and also the fact, i want to be reasonable here.

Obviously, all bills are on my father's name coming to my address. He is retired and i support him so he cannot pay the bills. At this time, i am waiting to know the final amount that my father is liable for. I plan to negotiate "fiercely" to see if i can get maximum discount - say 80% or more. Some options are see if you can make lumpsum payments of say $20K to max $25K at one shot and be done with or set up payment plans for 18months with no interest for an agreed final payment etc. If any one has any thoughts, do let me know.

[GCEB32020]

For my dad, I did not use insubuy as I was not aware of this forum before. For my mom, I bought insurance through insubuy.

I am keeping my fingers crossed and my insurance is seven corners.