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What to Do When You Have an Accident in the USA as an Expat

There’s a lot to be said about the American healthcare system. Regardless of how you feel about healthcare in the states, almost everyone can agree that the system is confusing. InterNations member Holly has some advice on how to deal with the healthcare costs following an accident.

The US healthcare system is not easy to navigate. Even those born and raised in the states are often confused about how much treatment costs, what insurance actually covers and how to get affordable treatment.

For an expat, these details can be even more complicated. A number of things make obtaining health insurance difficult. Maybe your work’s health insurance doesn’t kick in for a couple more months. Perhaps you’re waiting for a Social Security number to get on your partner’s health insurance. Regardless of the reason for the lack of insurance, you’ll want to be prepared in case an accident happens and you need medical treatment.

The good news is that the quality of treatment is often excellent and a hospital won’t refuse someone who doesn’t have health insurance. The downside is that the cost of being treated can be absolutely devastating. Nearly two million people file for bankruptcy due to medical bills each year, and in some cases the person even had health insurance yet still couldn’t afford treatment. Medical costs are the leading reason for bankruptcy.

This is frightening news, yet there are ways to mitigate the costs and not go totally broke if you have an accident. Here’s what to do if the worst happens.

Travel Insurance

Getting extensive health insurance from an American insurer is a difficult and expensive process, as it’s often unaffordable. However, it is possible to get travel insurance to cover any emergencies. Travel insurance is intended for travelers, so there’s often a limit on how long you can have the insurance. However, it’s great to have when you’re getting started in the U.S.

Finding a Low-Cost Clinic

If you don’t have travel insurance at the time of an accident, you’ll be on the hook for the cost of whatever treatment you need. Assuming you aren’t facing an emergency that requires immediate help, you should shop around to find a low-cost medical clinic that can help you. A number of free and low-cost clinics around the United States are designed to help those who need help most. They’re often run by nonprofits, so resources can be limited and the waits can be long. You can do a search to see if any of these clinics are near you.

Negotiate Prices

One of the biggest problems with the American healthcare system is the lack of price transparency. Even the people treating you won’t know how much you’ll be charged until after everything is settled. You might end up with a shock after receiving the bill, as sometimes the most basic treatments run thousands of dollars.

As terrible a surprise as one of these expensive bills are, not everyone knows that medical bills are negotiable. It sounds perverse to allow haggling over medical expenses as if they’re a used car, but the practice is a reality.

“All medical bills are negotiable,” Sharon Hollander, author of Medical Billing Horror Stories, told Forbes. “At the very least, you may be able to work out a payment plan or land a lower fee if you can pay on the spot.”

After receiving your bill, follow up, keep good notes and find the right person in billing to talk to. This due diligence could save you thousands of dollars. 

Find a Lawyer

There’s nothing as American as taking someone to court. If you’re injured, particularly in an accident that was someone else’s fault, then hiring a lawyer can go a long way in ensuring that you receive the money you need for medical treatment. A good lawyer can help you obtain compensation for a variety of different accidents.

The legal costs can be high, but some accident lawyers only charge fees based on the amount of money you’re awarded. This is something of a last resort that only applies to certain situations, yet it’s an option that shouldn’t be overlooked.


If you’ve done everything you possibly can to bring your medical costs down, it’s time to start paying off your bill. If the bill is beyond your means, you might want to consider taking out a loan from a bank to help settle the bill. Depending on your residency status in the U.S., you might need to find a U.S. citizen acting as a co-signer to obtain the loan.

The healthcare system in the U.S. is tricky to navigate whether you’re a long-time resident or going to the hospital for the very first time. Be sure to do all that you can to keep medical costs down until you obtain health insurance.


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