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 implausible 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 awake at night, not to mention the anxiety of Googling my symptoms. I’d tried every medication I could find, but nothing could ease the pounding in my skull.

Back at our Airbnb, my husband advised me to book a telemedicine appointment through our international health insurance. (As an American family living in France for a year, we were required to sign up for this service as part of our visa application.) A few minutes later, I described my symptoms to a Spanish doctor over chat using Google Translate. When he learned 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 medical offices, but the remote area offered 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. As we pulled into the hospital parking lot and walked to the front desk, I was struck by how similar it was to American hospitals. My husband, who speaks fluent Spanish, took the lead in checking us in, but the receptionist switched to English when she realized I didn’t speak Spanish.

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

I prepared myself by thinking back to my past experiences in American hospitals: the emergency room visit for chest pain that cost me $2,500 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 into a room that looked like every American hospital room I had ever been in—except that the posters on the wall 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 scan, which was performed on a state-of-the-art machine by two efficient technicians.

Shortly after, the doctor returned to tell me the results: no brain injury. He suspected that my headaches were aggravated 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 worsened or did not go away.

As I settled my bill at the front desk, I prepared myself to pay the full price, 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 amount for my emergency room visit was €729. After paying, she gave 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 to get reimbursed.

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 is accompanied by 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 where you go. The average bill can easily exceed $2,000 without insurance. Even with insurance, the costs can be astronomical for the average American family. If intensive care is needed or surgery is performed, these costs could climb to $20,000 or more.

It is therefore not surprising that recent polls It has been found that 40% of Americans have health care debt, even though over 90% of the US population has health insurance.

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

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 sheet with details such as your address and phone number.

THE Centers for Disease Control and Prevention recommends contacting the nearest U.S. embassy or consulate for assistance locating medical services, as well as registering for the State Department’s vaccination program. Smart Traveler Enrollment Program (STEP) before you go 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 International Association for Medical Assistance to Travellers. health professionals directory around the world.

Accidents and emergencies can happen anywhere, anytime, and you should always have a plan of action ready to implement. And whatever you do, don’t delay seeking care if you think the problem is serious. The result could be catastrophic.