I Ended Up in the Emergency Room While on Vacation in Spain. Here’s What Shocked Me Most.

My family had just arrived in a coastal village on the east coast of Spain, where I was sitting on a white sand beach, admiring the implausibly blue water. The scene was straight out of a Mediterranean dream, and yet I was panicked.

My head had been throbbing ever since I hit my head on the bottom of a metal safe in a hotel a few days earlier. The pain and pressure kept me up at night, not to mention the anxiety caused by googling my symptoms. I had tried every medication I could find, but nothing could relieve the throbbing in my skull.

Back at our Airbnb, my husband urged me to book a telehealth appointment through our international health insurance. (As an American family living in France for a year, we had to purchase it as part of our visa application.) A few minutes later, I described my symptoms to a Spanish doctor over a chat using Google Translate. After learning how long the pain had been going on, he advised me to see a doctor to rule out brain injury.

I frantically searched for nearby doctor’s offices, but the remote area had limited options and I didn’t even know how or where to get an appointment. So we decided to go to the nearest emergency room.

Leaving our son with his grandparents, my husband drove us to a small town about 35 minutes inland. When we pulled into the hospital parking lot and walked toward the front desk, I was struck by the resemblance to American hospitals. My husband, who speaks fluent Spanish, took the lead during our check-in, but the receptionist switched to English when she realized I didn’t speak Spanish.

The receptionist asked for proof of our public health coverage, but I explained that I had private health coverage for international travel – essentially expat insurance. She apologized, explaining that I would have to pay out of pocket for the emergency room visit and then seek reimbursement from our insurance company since I had not obtained pre-approval for the hospital visit.

I prepared myself by thinking back to my past experiences in American hospitals: the $2,500 emergency room visit for chest pain a few months later. The breast biopsy, where I had to pay nearly $3,000 for the privilege of finding out if the lump in my breast was cancerous or not. Of course, all of these costs were on top of the $12,000 insurance premium my family paid each year.

Luckily, I didn’t have to wait long to find out how much we’d be paying. The receptionist explained that there was a €200 flat rate for emergency room visits, showing me a poster next to her desk that detailed the hospital’s costs. She noted that if I needed additional tests or procedures, the total could increase. I let out a breath and handed over my passport as an assurance that I would pay at the end of my visit.

Inside the hospital, things went as planned. We sat in a sterile room on uncomfortable plastic chairs with dozens of other uncomfortable-looking people. I spoke briefly with a hospital employee (in English), who assessed the severity of my situation and added me to the queue. I waited nearly two hours before my name was called, and a young doctor led me to a room that looked like every American hospital room I had ever been in—except that the posters on the walls were in Catalan.

He took my vitals, asked me about my symptoms (in English, with a little translation from my husband for clarity), and told me he was going to order a CT scan just to be safe. We waited another hour for the exam, which was performed using a state-of-the-art machine by two efficient technicians.

Shortly after, the doctor came back to tell me the results: no brain damage. He suspected that my headaches were made worse by the anxiety and tension I had developed following the injury, and he gave me a prescription for a common Spanish painkiller. He asked me to come back if my symptoms got worse or didn’t go away.

As I checked out at the front desk, I braced myself for the grand total, knowing from bitter experience that a CT scan can cost thousands of dollars in the United States. I was pleasantly surprised when the receptionist told me that the final tally for my ER visit was $729. After paying, she handed me a disk with a copy of my CT scan for my records. She also gave me the documents I needed to provide to my insurance company for reimbursement.

As I walked back to our car, I was overwhelmed with relief, both because I didn’t have a brain injury and because we didn’t have to pay thousands of dollars to confirm that I was going to be okay. While an unexpected $729 bill is certainly a hardship for most people (including me!), I was comforted to know that it would be reimbursed and that it wasn’t as much as it might have been in the States.

I also felt sadness and frustration thinking about the extreme shortcomings of our healthcare system in the United States. Even a simple visit to the doctor comes with the worry of not knowing how much you will have to pay to get the care you need. Too often, Americans must choose between prioritizing their health or their financial stability.

The cost of an emergency room visit can vary greatly depending on location; the average bill can easily exceed $2,000 without insurance. Even with insurance, the numbers can be astronomical for the average American family. If intensive care is needed or surgery is performed, those costs could skyrocket to $20,000 or more.

It’s no surprise, then, that recent polls have found that 40% of Americans have health care debt, even though more than 90% of the U.S. population has health insurance.

How to Prepare for an Emergency Before Going Abroad (and What to Do If One Happens to You)

If you, like me, are an American who is concerned about hospital costs, it’s a good idea to do some research about your destination before heading abroad. Find out what type of establishments are available there, whether travel insurance is recommended there and how to contact emergency services if necessary.

Additionally, Johns Hopkins Medicine advises that you know your blood type before traveling abroad, carry documentation of any pre-existing conditions and medications, and fill out your passport information card with details such as your address and phone number.

The Centers for Disease Control and Prevention recommends contacting your nearest U.S. embassy or consulate for help locating medical services, as well as enrolling in the State Department’s Smart Traveler Enrollment Program (STEP) before traveling abroad. Consuls can also help you transfer funds from loved ones back home if you need them to pay for medical services.

You can also consult the directory of health professionals around the world established by the International Travel Medical Association.

Accidents and emergencies can happen anywhere and at any time, and you should always have a plan of action ready. And whatever you do, don’t delay care if you think the problem is serious. The result could be catastrophic.This article was originally published on HuffPost.