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Steve, Good suggestion and I already had done that. More or less useless. He just suggested I submit a claim for Foreign Travel expenses which I had already explained to him I had done and it was denied it claiming it wasn't an emergency. I did find an appeal form that states it is . It gives you the option of filling out the form or calling the CS number on the ID card (which would just take me back to the claims processor) or just send in more documentation via snail mail. My next course of action is to send the attached three letters, one from me, one from my Pulmonologist and one from my MS Neurologist. If that doesn't work I'll start escalating up the managerial chain. Thanks for the response and suggestion. Mark aetnadocletters.pdf Markaetna.docx

Hank, thanks for the detailed reply. Very helpful info and guidance. We have a supplement rather than the Advantage plans. I'm guessing tripmate will also deny the claim since the primary, aetna supplement, denied it. This little ER side trip is looking to be, overall, a 10k+ hit. Sucks. Coding aside. I vehemently disagree with the claims processor ignoring the local ER docs decision. I've asked my local Pulmonologist to write a statement about my damaged lungs and the risk to me with covid and pneumonia. I plan on appealing as far as I can. Truly thought this part of the claim was a slam dunk and that the problem would be solely with the trip interruption expenses. Mark

We did have TripMate as well and we have submitted the claims to them too. Based on what I've read, TripMate is notorious for claims denials so I'm not expecting much but we'll see. Turns out that Aetna denied my claim because they determined it wasn't an emergency. So, I have history of accute covid (4 months in hospital in 2020 with two of those being in a coma), permanent lung damage (70% capacity), the local doctor insisted I be admitted and the diagnosis was covid and pneumonia and I was put on paxlovid and antibiotics but some claim processor at Aetna decides it wasn't an emergency. Great. Oh, and was told by the claims processor there is no appeal even though I am looking directly at an appeal form. Unbelievable.

My wife and I were just on a Viking River cruise. Halfway through, I got sick and we had to leave the cruise to get me to an ER in Germany where I was admitted with Covid and pneumonia. Spent a total of three days and was discharged with a preliminary bill, paid by me, of $5,500. Submitted the claim to Aetna which just denied the claim because of "No procedure billing code" available. What in the world? German hospital, paid and submitted by me. Where exactly would this American insurance billing code come from? We did provide the hospital records so they know exactly what was provided and it was extremely straight forward. Anyone with experience on the best way to handle this? Also interested in anyone's experience with TripMate which is supposed to cover trip interruption. We never made it back to finish the cruise because of fear of spreading it or getting re-infected. Have a statement from my long time Neuro to return to the states ASAP. Submitted all receipts for lodging, meals, airline tickets, transport and medical including the letter from my Neuro. Should note this. Viking did not have any covid tests, or masks and would not have required us to shelter in place or quarantine and would have welcomed us back knowing full well I was a probable covid carrier and capable of infecting others. At least one other person was known to have gotten covid and there was an awful lot of coughing and sneezing going on. Just saying. But they were great on helping my wife find an ER, arrange cabs, hotel rooms and packing. So there is that too.

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