What Happens If an American Goes to the Hospital in Europe?

If you’re an American traveling in Europe and suddenly need medical care, you might panic. What if you break a leg in Paris? Get sick in Rome? Have a heart flutter in Berlin? You’re not alone. Every year, tens of thousands of Americans find themselves in European hospitals-not by choice, but by accident. And the experience is nothing like back home.

You won’t get a bill right away

In the U.S., hospitals send bills within days. In most of Europe, you won’t see a bill until weeks later-if at all. That’s because many European countries have public healthcare systems. When you walk into a hospital in Spain, Germany, or Sweden, staff don’t ask for your insurance card first. They ask if you’re feeling okay. Treatment comes first. Billing comes later, if it comes at all.

For Americans with travel insurance that includes emergency medical coverage, you’ll usually pay out of pocket at the time of service and then file for reimbursement. But if you’re uninsured or underinsured, you might be surprised: many European hospitals will treat you anyway. They don’t turn people away for lack of payment. That’s not how their system works.

Emergency care is fast and free in most cases

Call 112 anywhere in the European Union and you’ll get an ambulance within minutes. That number works in every country-from Iceland to Greece. Emergency rooms in Europe are well-staffed and equipped. You’ll be seen quickly, even if you don’t speak the language. Most hospitals in tourist-heavy areas have English-speaking staff.

In 2024, a study from the European Commission found that 94% of emergency cases in EU hospitals were treated within 30 minutes of arrival. Compare that to the U.S., where ER wait times average over two hours in big cities. In Europe, the priority is your condition-not your payment method.

Your U.S. insurance might not cover everything

Most American health plans, including Medicare and Medicaid, don’t cover care outside the U.S. Even private insurers like Blue Cross or UnitedHealthcare often limit international coverage. Some plans only pay for emergencies. Others won’t cover follow-up care, prescriptions, or rehabilitation.

That’s why travel insurance matters. A good policy should cover:

• Emergency hospitalization
• Medical evacuation back to the U.S.
• Repatriation of remains (yes, it’s grim, but it’s included)
• 24/7 assistance hotlines

Companies like Allianz, World Nomads, and GeoBlue offer plans specifically for Americans traveling abroad. They’ll even coordinate with European hospitals directly. That means less paperwork for you.

You might pay less-way less

Here’s the kicker: many treatments cost a fraction of what they do in the U.S.

A knee replacement in the U.S. averages $31,000. In Hungary, it’s $8,000. A CT scan in the U.S. runs $1,200. In Poland, it’s $180. Even a simple appendectomy in Germany costs about $4,000-less than a third of the U.S. price.

And it’s not just about cost. Quality is high. European hospitals meet strict EU standards. Surgeons train for years. Many are fluent in English. In fact, countries like Germany, Spain, and the Czech Republic have become top destinations for medical tourism-not because they’re cheap, but because they’re reliable.

Language barriers? Not a dealbreaker

You don’t need to speak French, German, or Italian to get care. Most hospitals in cities like Barcelona, Prague, or Vienna have multilingual staff. Many use translation apps or phone services during emergencies. In rural areas, it’s trickier-but even then, nurses and doctors often know basic medical English.

Bring a phrase card or use Google Translate. Write down your symptoms in the local language: “I have chest pain,” “My leg won’t move,” “I’m dizzy.” Hospitals keep these on hand. They’ve seen it all.

Prescriptions are different

In the U.S., you can walk into a pharmacy and get almost anything off the shelf. In Europe, many medications require a prescription-even over-the-counter ones like antibiotics or strong painkillers.

If you need a refill while abroad, you’ll need to see a local doctor first. They’ll write a new prescription based on your condition-not your U.S. one. Don’t assume your American prescription will be honored. And don’t try to bring U.S. meds into Europe. Customs can seize them, especially controlled substances.

Pro tip: Pack a letter from your doctor listing your medications, dosages, and why you need them. That helps European doctors understand your history.

Discharge is different

When you’re ready to leave the hospital in Europe, you won’t get a stack of paperwork. You won’t be handed a 10-page discharge summary with billing codes and follow-up appointments. Instead, you’ll get a simple note in English (or your language) with key instructions: rest, avoid heavy lifting, take this pill twice a day.

Hospitals assume you’ll follow up with your own doctor back home. They don’t handle long-term care coordination like U.S. hospitals do. That means you need to take charge. Schedule a check-up with your primary care physician within a week of returning.

What if you need long-term care?

If your condition requires weeks of rehab or ongoing treatment, things get complicated. European public hospitals won’t take you in for long-term stays unless you’re a resident. Tourists are treated for acute issues only.

That’s why medical evacuation insurance is critical. If you’re stuck needing rehab after surgery, your travel insurer will arrange a flight home. They’ll even coordinate with your U.S. hospital to ensure a smooth transfer. Without it, you could be stuck paying for private nursing care abroad-costing thousands a day.

What about documentation?

European hospitals don’t issue bills in the same way U.S. ones do. You’ll get a receipt or invoice, but it won’t have the same insurance codes. That can make reimbursement harder.

Ask for:

• A detailed itemized receipt
• A doctor’s diagnosis letter
• Lab results in English
• Discharge summary with treatment dates

Keep all of this in a folder. Scan them. Email copies to yourself. You’ll need them when filing your insurance claim.

Don’t assume you’re covered

Many Americans think their credit card travel insurance is enough. It’s not. Most card benefits cap at $5,000 and exclude things like medical evacuation. Some only cover you if you bought the ticket with that card.

Don’t gamble. Buy standalone travel medical insurance. It’s cheap-often under $100 for a two-week trip. And it’s the difference between walking out of a hospital with peace of mind and facing a $50,000 bill months later.

Bottom line: You’ll be treated, but you need to be prepared

Europe’s healthcare system isn’t perfect. Wait times for non-emergencies can be long. Private clinics cost more. But for emergencies, it’s fast, safe, and affordable. Americans who go to the hospital in Europe often come out surprised-not by the cost, but by how well they were cared for.

What you need: travel insurance, a plan for emergencies, and a clear head. Don’t panic. Don’t assume. Do the prep work before you leave. Then, if something happens, you’ll be ready.