No insurance is taken by the hospital, lab or doctors on the island. You pay the bill and send it in to your insurance carrier when you get home and you will get most of your money refunded unless you are on Medicare. I posted my experience above and when I got home sent all of the bills in to Medicare and was told in no uncertain terms that no citizen on Medicare is covered outside of the United States. That's our medical system. We now take private insurance for each out of the states trip we take and it is very reasonable.