An Australian insurance company is warning travellers about sky-high medical bills in the United States after a Sydney woman was forced to pay NZ$2634 and was hassled for months by a Hawaiian hospital after simply breaking a nail.
Rachael Minaway, 32, and a friend had just arrived in Honolulu and hadn't even checked into their hotel when she accidentally got her finger caught while slamming shut the glovebox of her rented car, breaking her acrylic nail.
"We had a late check-in, so we headed straight for the beach, and we were so excited to run out of the car and get into the water," Ms Minaway told news.com.au.
"We were packing away the GPS in the glovebox, and I was being too quick and smashed my fingernail between the dashboard and the glovebox, and it cracked.
"I didn't think it was a big deal at all, it's happened to all of us before."
But after a while Ms Minaway's finger started to go numb and she and her friend figured they should get it checked at the closest medical centre.
"We typed in 'medical centre' in the GPS and I guess in Hawaii they call hospitals 'medical centres' because it directed us to the closest emergency room," she said.
"At that point my hand was really hurting, and we thought, OK, they'll just tell us what to do. "We just wanted to get back to our trip. And I was wasting my friend's time for a fingernail, it was so silly."
At the hospital, a doctor said it would be best to remove Ms Minaway's fingernail, which she agreed to if she could get a local anaesthetic.
"It was so painful, I did not want to feel him ripping it off," she said.
"But we were taking photos and laughing through it, I honestly did not expect it to be a big deal."
After the consultation was over — the whole thing took about 30 minutes — Ms Minaway checked out at reception and was presented with a huge bill of about NZ$1300.
"I had to pay it on the spot," she said. "I told them we'd only just landed, I hadn't even checked in my luggage at the hotel. But they wouldn't let us leave without paying it."
Ms Minaway settled the bill and after getting to the hotel, she sent photos of the paperwork to her insurer 1Cover and made a successful claim.
But for months after returning home to Sydney, Ms Minaway said she was inundated with new bills from the hospital — which tallied up to a massive $2634, all for a broken nail.
"I was getting multiple invoices for months," she said.
"I remember emailing them after the first one and saying, 'No, sorry, I've already paid for this', but the invoices were for different things. They kept finding new things to bill me for. After a few months I regretted giving them my real address.
"It was pretty upsetting. I was six months pregnant at that point, and I kept thinking, imagine if didn't have insurance and actually had to pay for all this myself."
Ms Minaway's insurer 1Cover was able to cover her for all her charges.
But the avid traveller, who shares her travel adventures on Instagram, said she "couldn't believe" what an expensive ordeal had come of simply accidentally closing a glovebox on her finger.
"I'd heard about how in America they don't have Medicare like us, but I never expected (the cost) to be this outrageous for something this tiny," she said.
The Unites States is the third-most visited overseas destination for Australian travellers, and it's the source of the most expensive medical claims for travel insurers.
It can cost $280,000 for an air ambulance from the US back to Australia, an average of $140,000 for one week's stay in an American intensive care unit and $20,000 for injured travellers who are in a stretcher or can't walk to be repatriated back to Australia.
1Cover has received claims for American medical costs of up to $1 million, the company says.
But medical bills for minor injuries, like Ms Minaway's broken fingernail, are also unusually high in the US — and hospitals and medical centres were notoriously pushy about getting paid, 1Cover's travel safety expert Richard Warburton said.
"Recently, we had another customer who faced costs of $2600 for a splinter she removed in the US. She was harassed continuously for this tiny injury once she got back to Australia," he said.
"A recent customer of ours saw the doctor for an uncomplicated case of tonsillitis. She was billed $10,000, and they didn't even take out the tonsils.
"Another patient had some nausea and vomiting over 24 hours. She was completely fine but was charged NZ$29,000.
"Sometimes the hospital will contact their travel insurer demanding payment for a customer. But sometimes they'll contact the customer directly, and this is scary and intimidating."
Mr Warburton said where possible, travellers should contact their travel insurer at the time they saw a doctor or visited a hospital so they could be advised appropriately and the insurer could talk directly with the medical provider if needed.
He said a hospital or billing department might make an upfront charge, but they were likely to push for follow-up charges.
Providing travel insurance details with the hospital or billing department means they can keep liaising with the insurer and lay off pestering the patient.
Ms Minaway said she would never risk travelling without insurance, especially now she travels with her young daughter.
"I feel so sorry for those people who go over there (to the US) and wind up with massive medical bills," she said.
"You have no idea what's going to happen."