Hospital transport - urgent question

[Polina]

My parents are currently on Coral Princess, coming from Panama, and ending tomorrow in Los Angeles. Well, my father fractured his hip yetsterday and we are working out ways to get him transported to a hospital. He does have travel insurance and they are working with us. However, they say the policy is to transport to the nearest hospital, not the hospital of choice. Once he stabilizes, he could transfer. My parents live in San Diego, it's only a couple of hours away from LA and we really want thim to be taken to his hospital, be treated by his doctors, and be close to his family. Any tips on how to make it happen? My father has Medicare as primary insurance and Medical as secondary, by the way. The travel insurance is saying they may not get involved at all, after all, because it is happening within the US. If you have any ideas for me, I would really appreciate some suggestions at this point.

 

Thank you!

Polina

[cruiseco]

My parents are currently on Coral Princess, coming from Panama, and ending tomorrow in Los Angeles. Well, my father fractured his hip yetsterday and we are working out ways to get him transported to a hospital. He does have travel insurance and they are working with us. However, they say the policy is to transport to the nearest hospital, not the hospital of choice. Once he stabilizes, he could transfer. My parents live in San Diego, it's only a couple of hours away from LA and we really want thim to be taken to his hospital, be treated by his doctors, and be close to his family. Any tips on how to make it happen? My father has Medicare as primary insurance and Medical as secondary, by the way. The travel insurance is saying they may not get involved at all, after all, because it is happening within the US. If you have any ideas for me, I would really appreciate some suggestions at this point.

 

Thank you!

Polina

 

I think you'll find that eventually the insurer will agree to transport him to a hospital near home as it's in their long term interest to do so. They're just understandable reluctant to promise anything upfront. They probably just want to hear from the ship's doctor as they're loading your father in the ambulance that as of that minute driving 100 miles to San Diego won't cause any additional harm. If the doctor says that he can''t be safely transported that distance they'll take him to a local hospital until it's safe to move him. It's the doctor's call and he/she might not be an orthopedic specialist although any doctor on a Princess ship has probably seen his/her share of broken hips.

 

The term of the insurance is normally home to home. So if he's sent to a hospital in LA any medical services he receives is on the insurer's dime -- he's not home yet. If his insurance is primary they're going to receive a claim for the hospital bill for every day he's in that hospital. If it's secondary they're still picking up the tab for any co-pays or deductibles he's racking up. And at some point they're still probably going to have to load him in an ambulance to take him home. It should be much more cost-effective for them to drive him to the hospital near home, declare the trip finished, and cut their losses.

 

What insurer by the way?

[Polina]

So far the doctor says the policy is to go to nearest hospital, he is not keen on transporting to San Diego. But if I'm understanding correctly, the doctor can give a green light for longer transport last minute?

 

The medical insurance is secondary. The company is Travel Insured International. The last person I spoke to made it sound like as soon as my dad disembarks, they are washing their hands off and are not responsible for any other cost, but it does not sound right to me. He was going to speak to his supervisor and call me back. I better call them again and put more pressure. What a headache!

 

Thank you for your response!

 

I think you'll find that eventually the insurer will agree to transport him to a hospital near home as it's in their long term interest to do so. They're just understandable reluctant to promise anything upfront. They probably just want to hear from the ship's doctor as they're loading your father in the ambulance that as of that minute driving 100 miles to San Diego won't cause any additional harm. If the doctor says that he can''t be safely transported that distance they'll take him to a local hospital until it's safe to move him. It's the doctor's call and he/she might not be an orthopedic specialist although any doctor on a Princess ship has probably seen his/her share of broken hips.

 

The term of the insurance is normally home to home. So if he's sent to a hospital in LA any medical services he receives is on the insurer's dime -- he's not home yet. If his insurance is primary they're going to receive a claim for the hospital bill for every day he's in that hospital. If it's secondary they're still picking up the tab for any co-pays or deductibles he's racking up. And at some point they're still probably going to have to load him in an ambulance to take him home. It should be much more cost-effective for them to drive him to the hospital near home, declare the trip finished, and cut their losses.

 

What insurer by the way?

[cruiseco]

So far the doctor says the policy is to go to nearest hospital, he is not keen on transporting to San Diego. But if I'm understanding correctly, the doctor can give a green light for longer transport last minute?

 

The medical insurance is secondary. The company is Travel Insured International. The last person I spoke to made it sound like as soon as my dad disembarks, they are washing their hands off and are not responsible for any other cost, but it does not sound right to me. He was going to speak to his supervisor and call me back. I better call them again and put more pressure. What a headache!

 

Thank you for your response!

 

It's amazing how some of these phone reps don't know their own plans. All of the Travel Insured plans I'm aware of have the following which precludes them "washing their hands of the matter" the minute he gets off the ship:

 

"EXTENDED COVERAGE. All coverage under the policy will be extended, if: (a) Your entire Trip is covered by the policy; and (b) Your return is delayed by covered reasons specified under Trip Cancellation and Interruption or Travel Delay. If coverage is extended for the above reasons, coverage will end on the earlier of: (a) the date You reach Your return destination; or (b) seven (7) days after the date the Trip was scheduled to be completed. "

 

There's also this:

 

"PERIOD OF COVERAGE: The “effective date” of Your travel protection policy begins at 12:01 a.m. following the date You enroll and pay the required plan cost. The Trip Cancellation benefit begins on the effective date. The Trip Delay benefit is in force while You are en route to and from Your Trip. All other benefits begin on 12:01 a.m. on the later of Your Scheduled Departure Date or the effective date of Your travel protection policy, as described above. Benefits end for all Insureds when You cancel Your Trip, when You return home, or when You complete the term of Your Trip."

 

By the way, breaking your hip is a covered reason under the trip cancellation benefit. And I'd sure consider filing a trip interruption claim for the value of the days he's spent in the ship's infirmary instead of enjoying his cruise.

 

As far as who decides where it is medically necessary to transport him, the usual process is a joint call between the doctor on the scene and a doctor at the insurer's assistance office. They usually go with what the on-scene doctor decides but the doctor at the assistance company can overrule. I'm guessing he's in bed on the ship and maybe getting some pain meds. No reason that can't continue in an ambulance as far as I can see. But I"m not a doctor.

[klfrodo]

Cruiseco,

I don't know you from Adam, however, I'd like to say thank-you for taking time out of your life to help others the way you do. This post is one small example.

[sail7seas]

Cruiseco,

I don't know you from Adam, however, I'd like to say thank-you for taking time out of your life to help others the way you do. This post is one small example.

 

 

I totally agree and also thank you.

Your information is so helpful and much appreciated.

I never fail to read your posts as I know I will learn something.

 

[Polina]

Cruiseco,

I don't know you from Adam, however, I'd like to say thank-you for taking time out of your life to help others the way you do. This post is one small example.

 

Yes, THANK YOU!

 

I've been putting pressure on the insurance company. Last they tell me is that my Dad has to go to local hospital for evaluation and if they clear him, then they will transport him home to San Diego. I'm trying my best to stay on top of it.

 

And I would have never even thought to file a claim for the days spent in the infermery, but you are absolutely right! Thank you again for your help!

 

Polina

[cruiseco]

 

I've been putting pressure on the insurance company. Last they tell me is that my Dad has to go to local hospital for evaluation and if they clear him, then they will transport him home to San Diego. I'm trying my best to stay on top of it.

 

Polina

 

You're welcome. As frustrating as it is, I don't think that that plan is totally unreasonable. You probably know full well that the 405/5 corridor can be like a war zone at times and you want to be sure that a sudden stop or swerve to avoid some idiot driver isn't going to cause irreparable additional harm. If they want to do an MRI or something and have him evaluated by a specialist before shipping him off I'd be tempted to err on the side of over-caution.

[dread_pirate]

If your father does have to remain in LA to be stabilized, check your mother's travel insurance as well. Her policy may cover her expenses to remain with him.

[6rugrats]

My father has Medicare as primary insurance and Medical[Medi-Cal] as secondary, by the way. The travel insurance is saying they may not get involved at all, after all, because it is happening within the US.

 

When you say the "medical insurance is secondary" which medical insurance are you talking about. The travel insurance policy, or Medicare? If your dad is covered by Medicare and then Medi-Cal, and he is accepted by such as anyone providing treatment, he won't have any copays will he, for treatment in the US?