Portugal: paid out of pocket, no insurance. A trip to the ER to refill a prescription (it's what our landlord told us to do) took about twenty minutes and cost under $30. Filling that prescription cost less than the copay in the U.S.

Thailand: paid out of pocket, no insurance. A trip to the ER for digestive issues took under an hour and the visit plus antibiotics cost under $200. This was at Bumrungrad, one of the best hospitals in Thailand.

I'll double-check, but I'm pretty confident my wife's care in the UK was under the NHS. Nepal was also her, I think it was out of pocket, but I'll check.

I checked with my wife:

Nepal: she had some form of insurance. She doesn't know how much it cost, but presumably not much (she was volunteering for a non-profit) and her out-of-pocket costs were zero for a multi-day stay at a hospital.

UK: she doesn't remember having insurance, but thinks she must have (she was a student at the time). She used the NHS, again with no out-of-pocket expenses.