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YOKOSUKA NAVAL BASE, Japan — Make sure your friends and family have international health insurance when they come visit you in Japan, Okinawa or South Korea.

Without it, they could be in for a world of hurt — both physically and financially, as many regional hospitals want cash up front and base hospitals provide care only if it’s an absolute emergency, hospital officials said Monday.

“When they buy their plane tickets online to visit a servicemember or civilian, no one is thinking about what would happen if they are injured or have a health problem,” said Lt. Bradley Johnson, the head of Tricare operations at U.S. Naval Hospital Yokosuka. “We need people to think about this before they come here.”

Base hospitals in Japan, Okinawa and South Korea are not required to accept patients who don’t have Tricare insurance or who are not sponsored under status of forces agreements.

Exceptions are made only in an emergency.

“In that case, we would stabilize the patient and then make arrangements for transfer to an off-base facility or for medical evacuation to the States, which is extremely expensive,” said U.S. Naval Hospital Okinawa spokesman Brian Davis. “Therefore, travelers should purchase health care insurance that will cover them in the event that medical problems come up while traveling to Okinawa.”

In South Korea, unless a patient is enrolled in Tricare Prime and referred by the 18th MEDCOM, they will pay the cost share upfront at local hospitals, said Capt. James Fabia, the 18th MEDCOM spokesman.

“121st Combat Support Hospital and 18th MEDCOM treatment facilities will treat non-Tricare and non-SOFA sponsored patients on an emergency basis only to stabilize them,” Fabia said. “We bill their insurance company for all the care provided.”

The situation is similar in Japan, Johnson said. If the situation is not an emergency, guests will be given a list of local hospitals with English-speaking staff.

Even if a guest has stateside health insurance, they will likely have to pay the amount in full and file a claim with their insurance agency themselves, Johnson said.

“Japanese hospitals may hand you the whole bill upfront and expect you to pay right then, like getting your car fixed,” Johnson said. “That’s different from what happens in the States and a lot of people may not expect that.”

It’s not just a matter of money — insurance also is a diplomatic issue because guests who don’t pay their bills in full can inadvertently hurt the U.S. relationship with Japan, Johnson said.

“We don’t want Japanese hospitals to turn our people away because of a bad experience,” Johnson said.

Asking visitors to buy international traveler’s insurance is an easy fix, as plans typically cost between $100-$200 and cover services that many U.S. insurance companies neglect in foreign countries — like 24-hour care and extended evacuations, Johnson said.

International traveler’s insurance plans can range from a few days to an entire year, depending on the visitor’s vacation plans, he added.

“You don’t ever realize that it could happen over here,” Johnson said. “We just want people to be better prepared for it.”

Cindy Fisher contributed to this report.

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