Carol, Tony's BCBS supplemental plan re-embursed us about 90% of his pneumonia French-side hospital charges. Yes, they must be paid up front. He was there 7 days, and I paid on a daily basis. They now have a wonderful FREE service of a liason person, who helps coordinate your UD insurance with the hospital, and official translation (all bills must be in English to be re-embursed). She also arranged Tony's release to SkyMed when we flew back to the States.