My regular health insurance covers care received abroad. We are traveling to Georgia next month (the country, not the U.S. state), and I bought travel insurance for the first time for that trip. My medical insurance would have covered me in Georgia, but I wanted the medevac/repatriation insurance. Medical care is waaaay cheaper in Georgia than in the U.S., but they don’t have the same availability of anything sophisticated if needed. I don’t expect to need anything sophisticated, but on the off chance I do, I don’t want it to bankrupt me.
I was surprised how cheap it was to buy emergency medical and medevac-only coverage: $30-some for the trip (we get trip interruption, lost baggage, etc. coverage through our credit card, so I didn’t see the need to duplicate).
The small handful of times I have paid out of pocket for medical care outside the U.S., the whole service provided was cheaper than my copay for a routine appointment at home. Throat infection with name-brand antibiotics in Mexico? I think around $40 for exam and drugs at a very clean private clinic. The same in Spain, when I was a student and should have been covered on the national plan but hadn’t yet received my health card? Exam was free, though I had to wander around with a high fever explaining what was wrong with me, and several clinics didn’t know what to do with me because although I told them I was willing to pay a doctor out of pocket, they had no idea how to process my payment. (Finally an ER doctor took pity on me and examined me for free and gave me an antibiotic prescription - this was 1988, so I don’t remember how much it cost, but no more than a few dollars - well, pesetas at the time.) A similar thing happened in England when my bum foot was acting up - the local GP saw me for free because she didn’t want to figure out how to take my money, and a 99p tube of ointment fixed me right up.
One of my co-workers has a Panamanian wife, and on a visit to her family, he ended up in the ER with food poisoning. A day in the ER in Panama cost him less than his ER copay at home - he didn’t even bother submitting a claim.
It boggles me how many people are scared of being treated for routine medical issues abroad. The biggest problem I ever had with that was figuring out how to get someone to take my money.
(ETA: the one exception was 1989 in Leningrad, when I got an impacted wisdom tooth. The dentist poked at it and said, “yeah, that’s a wisdom tooth. Wash it with warm tea three times a day and take aspirin for the pain.” But in that situation, the problem was late-perestroika lack of medical supplies - what I really needed was antibiotics, but those were a black-market item, and I was not about to have an impacted wisdom tooth extracted in a country where one couldn’t rely on sterile instruments. Insurance wouldn’t have fixed most of that situation, anyway.)