Most Americans’ nightmares are likely made up of what would happen if they got really sick. And that dread continues at the thought of getting sick or injured when you’re abroad. Well, it’s no secret that our for-profit healthcare system is considered extremely out of touch with what the purpose is: to provide public health. But, because of this predicament, many Americans are surprised about how affordable healthcare is when traveling to other countries. Even out of pocket pay of what it costs to see a doctor abroad is often met with a sigh of relief. Because… America could never.
So earlier this year, I found myself having to go to a walk-in clinic in Iceland. This is a country that runs on universal healthcare, and I don’t have Icelandic residency. So none of those benefits applied to me the day I walked into a walk-in clinic in Reykjavik with an ear infection I couldn’t ignore anymore. I didn’t expect free care and knew that I would have to pay. What I didn’t know were the costs. But, honestly, because of my experience with having to seek care abroad, I wasn’t nervous either.
Three Straight Weeks of Travel, My Ear Gave Out
This was early May, and Iceland was the third stop in a stretch of back-to-back travel that had already run three weeks straight. The week before, I’d spent most of my days in the water, swimming and snorkeling. Having the time of my life. And during all of that galavanting, I noticed that I just couldn’t get the water to drain out of my left ear all the way.
Now I had a 24-hour break at home where I tried to handle it myself first, drugstore remedies, ear pulling. I didn’t have time to see a doctor before this trip; I had one day to unpack from the last one and repack for Iceland. The night before my flight, I kept messing with my ear trying to fix it, and it only got worse. By the time I boarded, I couldn’t hear out of it. On the flight, I knew my request to the host would be asking to see a pharmacist. It wasn’t painful yet, and I thought a simple over-the-counter recommendation could help. But I did know it was time to ask for some because I’m past the age where I convince myself a problem like that heals on its own. It doesn’t. It gets worse.
So as soon as I landed, after a trip that ate most of a day, I told my host: not urgent, but I need a pharmacist. We went to one and they told me to visit the walk-in clinic before this turns into something worse.
What It Costs to See a Doctor Abroad, Itemized
At the door, the clinic told me upfront that because Iceland runs on universal healthcare and I’m not a resident, I’d be paying full price. Non-residents in Iceland pay unsubsidized rates for care; the system that covers Icelanders after six months of residency doesn’t cover a tourist on day one.
That didn’t scare me. I’ve lived abroad before, and “you’ll have to pay” in another country’s healthcare system has never meant the same thing as it would here the U.S. I actually made a game out of guessing the cost it would be while driving over. A walk-in visit in Mexico had run me about $30. In France, closer to €40 (~$44). Iceland is remote and expensive across the board, so I set my expectations higher, somewhere between $80 and $200.
So here’s what it actually cost me. The visit fee: $169.15, charged at the counter before I saw anyone. I took a ticket and sat in the waiting room.
I don’t speak Icelandic, but most people in Reykjavik speak English, so there wasn’t a language barrier to deal with. I was told they couldn’t predict how long the wait would be, “Maybe 45 minutes to an hour,” the woman helping me guessed. It ran closer to an hour and a half. I hadn’t planned on that, so I hadn’t brought a portable charger or earphones. So I sat most of the time looking blankly because I had to turn off my phone to preserve the battery so I could call for a ride back to the hotel. The waiting period was awkward and uncomfortable. I was also the only Black person; in fact, the only person of color, in that waiting room. Not a shock, given the country. Just part of the experience.
When my number was called, I moved to a second, smaller room, more like a holding area right outside the doctors’ offices, for another five or ten minutes. That clinic had roughly ten treatment rooms, and there were about ten of us in that second room, each one on deck for our own doctor.
The doctor who saw me was friendly and fast. I started explaining what happened and he cut me off before I finished: this is common here, he said, because a big part of daily life in Iceland is spending time in pools. About 79 percent of Icelandic adults visit public pools regularly, and children are required to learn swimming in schools. In fact, it’s such a part of daily life that Iceland’s pool culture earned UNESCO recognition last year.
The doctor told me to lie down, confirmed it was swimmer’s ear, warned me it might get sore before it got better. He wrote a prescription to help with the pain from the swelling. Start to finish, the visit with the actual doctor took five to ten minutes.
The prescription, filled at the pharmacy in the same building cost $33.91. The cab back to my hotel cost $19.87.
So in all, the total cost of the urgent care visit was $222.93.
Surprise! I Got Reimbursed
Even if that was the end of the story, many Americans would think I got off easy having to only pay a little more than $200 for medical service in another country. But, I have travel insurance. So I was confident after reading my policy that it would be fully reimbursed.
But, to my surprise, my own domestic health care had protections for a situation like this. So I sent the receipts to my primary health insurance first. They only covered part of the fee, though. $145.20 of the total. (I’m not sure why.) So, I sent the claim for the remaining $77.73 to my travel insurance with the same documentation, and they covered the rest. Every dollar of the $222.93 eventually came back to me. The health care came the very next day. The travel insurance was in my bank less than two weeks after that. I was feeling both surprised and happy at that efficiency.
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