# emergency operation without insurance



## takmahug (Sep 18, 2016)

Hello everyone,

my wife and I have a big issue.
we live in Spain and On a vacation to Germany my wife had a placenta previa and had to give birth by emergency c section to our little daughter.
my wife is fine and had been released from hospital after 3 days. 
our baby is still in the hospital and will have to stay there for approximately at least four weeks.

we have a spanish private health insurance which should cover 12k€ in case of an emergency abroad.
the insurer refuses to pay anything because they say that the insurance is not valid for pregnant women after the 150th day of pregnancy.

some facts 
I am a German citizen, my wife is a non eu citizen with an article 10 residence permit in Spain. our child is a German citizen.

what can we do now? we don´t have the money to pay the 40k€ bill. should we seek payment from Germany or is there a way to make sanitas pay?

any information is appreciated

Best Regards

Takmahug


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## Nononymous (Jul 12, 2011)

I think you need professional advice, in a hurry.

It seems fairly clear that your Spanish private insurance will not cover you, according to the terms you describe (and would in any case have only paid 12 of 40k euro).

I have no idea what you would do with Spanish public health insurance - perhaps ask in the Spain forum?

In terms of German insurance, I think the fact that you (and the baby) are German citizens will not be helpful to you - if you are not German residents, without German health insurance, then you cannot be covered - you are no different from a tourist with non-German citizenship.

On edit: I am by no means an expert on this. Talk to an insurance professional to see if there's some way to obtain public insurance coverage for a baby born in Germany to a non-resident German citizen father.


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## *Sunshine* (Mar 13, 2016)

Do you only have Spanish private insurance? Or do you also have public Spanish health Insurance? Public Spanish health insurance will cover emergency treatment at the same rates it would in Spain. 

Whether or not the private insurance would have to cover anything will be based on Spanish law.

German public insurance is not an option since you're not resident in Germany. 

If the private insurance will not cover you, you can tell the hospital that you're a Selbstzahler and negotiate a payment plan.


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## Nononymous (Jul 12, 2011)

This either won't work or isn't legal, but maybe worth exploring. You hear sometimes of people moving to Germany then somehow failing to sign up for health insurance right away then being hit with a large bill when they do because the insurance coverage is retroactive to the date the residency begins. 

So perhaps if the family were "moving" to Germany and the German-citizen father made all the various bureaucratic moves for this to happen, they could obtain public insurance from the time of arrival. But the cost of this might be staying in Germany for a while longer, or being investigate for fraud. Just an idea, and probably not a good one.


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## *Sunshine* (Mar 13, 2016)

Nononymous said:


> This either won't work or isn't legal, but maybe worth exploring. You hear sometimes of people moving to Germany then somehow failing to sign up for health insurance right away then being hit with a large bill when they do because the insurance coverage is retroactive to the date the residency begins.
> 
> So perhaps if the family were "moving" to Germany and the German-citizen father made all the various bureaucratic moves for this to happen, they could obtain public insurance from the time of arrival. But the cost of this might be staying in Germany for a while longer, or being investigate for fraud. Just an idea, and probably not a good one.


I actually thought of that, but it wouldn't make much of a difference. They'd only be eligible for public health insurance in Germany if they had public health insurance in the EU prior to moving here or for 2 years in the past 5. 


In Germany opting for private insurance means opting out of the public system. Since insurance is there to protect against potential risks, it's too late once something has happened.


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## takmahug (Sep 18, 2016)

thank you guys so much for the replies.

i need a good plan now and even if it is in a grey area it´s fine.
we only have private insurance in Spain, no public one.

my wife and my baby were registered as selbstzahler and the hospital put the name of my mother on the papers because she brought her to the hospital. my mother didn´t sign anything though so she can´t be liable for the bill right?

if it would benefit us, we could register in Germany. what would be the dead line for this?my wife has been staying here since July 7.
I had had public health insurance here in Germany until I moved abroad in 2011, so I am not sure if I could get in again.

Thank you guys again and any reply is appreciated


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## Nononymous (Jul 12, 2011)

Talk to a professional, is all I can say. Find a trustworthy insurance broker.


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## James3214 (Jun 25, 2009)

Sorry to hear your story 'takmahug' but it's not the first time I have heard something like this happen. That's why travel insurance is always worth it especially if you aren't legally entitled to it as a EU citizen. But there again the insurance premum for your wife would of been quite high as well.
I understand hospitals, etc are legally obliged to recover their money and I doubt you will get any retrospective insurance if you already have a 40K bill. 
As already mentioned, the only thing I can also say is seek some legal advice. You might be able to negotiate with the hospital or debt collecter about the cost but seek legal advice first. I think I did hear that there also might be a public fund for these sort of cases, but I might be wrong.
I hope you can sort something out.


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## Nononymous (Jul 12, 2011)

Look on the bright side, if you'd taken your vacation in the US without proper travel insurance, you'd probably owe 400k instead of 40k. Relatively speaking, Germany is a bargain.


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