Medical question.

[JIMDSB2]

Just wondering,

If you are on a cruise is the ships infirmary considered Domestic or International.

The reason for the question is that we were on a Serenade cruise out of Barcelona, and while onboard, even before we left port I got a Kidney stone attack. Luckily after a few hours it subsided and never returned, BUT, if I needed attention, my medical insurance states that it is not good internationally.

Would the same be true if we left Floridas, Port Canaveral which is what we are going to be doing in October??

 

Thanks

[sail7seas]

The ship when docked in a U.S. port COULD be considered domestic but there are distinct guidelines. The ship docked in Barcelona is International to most U.S. insurance plans. Many of us write travel medical policies for that reason. DH and I never insure the price of our cruise for cancellation of interruption but we always have medical coverage that pays outside U.S. and evacuation/repatriation coverage. The high losses don't come from the usual cost of cruises; the high cost would be uninsured medical or evacuation/repatriation.

 

[sparks1093]

Just wondering,

If you are on a cruise is the ships infirmary considered Domestic or International.

The reason for the question is that we were on a Serenade cruise out of Barcelona, and while onboard, even before we left port I got a Kidney stone attack. Luckily after a few hours it subsided and never returned, BUT, if I needed attention, my medical insurance states that it is not good internationally.

Would the same be true if we left Floridas, Port Canaveral which is what we are going to be doing in October??

 

Thanks

 

I would think that on a foreign flagged vessel it would be considered to be international. That's why I get a package travel insurance policy, I don't want to hassle with my own medical insurance.

[attilamom1217]

Check with your medical insurance as to your coverage while on a cruise. My medical insurance covers cruises as 'in network' because I don't have an option as to which Doctor to use. Many medical insurance companies do not cover international or allow out of network coverage.

 

i suggest you buy third party travel insurance. Personally we get Travel Guard. They can be your primary or secondary insurance - depending on what your purchase. If you get sick on board, save your receipts. When you get back, contact the travel insurance company and they will tell you what you need to do. If they are secondary insurance, you will need to file first with your regular insurance company. When they deny coverage, you will need to send the denial along with your receipts and whatever forms you need to fill out and send them to the travel insurance company.

[smeyer418]

I would think that on a foreign flagged vessel it would be considered to be international. That's why I get a package travel insurance policy, I don't want to hassle with my own medical insurance.

 

 

It depends there is no set answer it depends on the insurance policy. Medicare guidelines would cover.

 

Will Medicare pay for medically-necessary health care

services I get on a cruise ship?

Medicare may cover medically-necessary health care services you get on a cruise ship

in these situations:

• The doctor is allowed under certain laws to provide medical services on the cruise

ship.

• The ship is in a U.S. port or no more than 6 hours away from a U.S. port when you get the services, regardless of whether it’s an emergency.

Medicare doesn’t cover health care services you get when the ship is more than 6 hours away from a U.S. port.

[sail7seas]

It depends there is no set answer it depends on the insurance policy. Medicare guidelines would cover.

 

Will Medicare pay for medically-necessary health care

services I get on a cruise ship?

Medicare may cover medically-necessary health care services you get on a cruise ship

in these situations:

• The doctor is allowed under certain laws to provide medical services on the cruise

ship.

• The ship is in a U.S. port or no more than 6 hours away from a U.S. port when you get the services, regardless of whether it’s an emergency.

Medicare doesn’t cover health care services you get when the ship is more than 6 hours away from a U.S. port.

 

 

Each time I read these Medicare coverage exceptions, I always wonder if Medicare would cover all treatment if that treatment started while the ship was less than 6 hours from a U.S. port but continued for more hours after it left the 6 hour distance limit? If the ship left Miami headed for Nassau and treatment started 4 hours out of port but continued until the ship reached Nassau where the cruiser was medically disembarked?

 

[smeyer418]

Each time I read these Medicare coverage exceptions, I always wonder if Medicare would cover all treatment if that treatment started while the ship was less than 6 hours from a U.S. port but continued for more hours after it left the 6 hour distance limit? If the ship left Miami headed for Nassau and treatment started 4 hours out of port but continued until the ship reached Nassau where the cruiser was medically disembarked?

 

here is the generic coverage info

 

http://www.medicare.gov/Pubs/pdf/11037.pdf

 

there is a number there to call.

[sail7seas]

Thanks.......

 

think I'll wait for the 'short answer'. :D

 

I'm not up to reading government'ese' right now. :o

 

[Dayenu]

International. And they don't take insurance, you pay out-of-pocket, get the paperwork from them, and send to your insurance in hopes for being reimbursed. Somebody in my family went through it.

 

I don't know if the NCL ship that only circles HI is different.

[GrannyJ]

On our last cruise, my boyfriend received medical care from the ship's doctor. We did have a travel insurance policy that would have covered what Medicare and his Medicare Supplement wouldn't have paid, but luckily his Medicare Supplement policy covered all of it (except for $2.75, which I never did find out what that was for). It would have involved jumping through several hoops, though. First Medicare would have had to deny it, then his supplement would have had to deny it and THEN the policy would have paid.

 

I was surprised at how reasonable the charges were from the ship's medical department, though. He had three visits to the infirmary over four days involving oral antibiotics, IV antibiotics, blood tests, a chest x-ray, and several hours on IV fluids. The bill came to only a little over $500. Imagine if he had received this care (which was proficient and compassionate) in a land-based hospital emergency room; I can't imagine it would be less than $2000 there.

 

I was very impressed with the ship's medical department and the personnel.

[Keith1010]

My best advice is don't ask here. Check with your insurance company.

 

Keith

[xxoocruiser]

So that there's no surprises regarding insurance in the event a medical need arises , I always purchase Travel Insurance that includes Medical and Medical Evacuation Benefits.

[JIMDSB2]

Thanks for all replies. I guess the short answer is buy the extra insurance and have a good cruise, but I do not understand yet, if I am at Port Canaveral I am domestic, but if I am a few miles at sea, I am international. Is that right??

[xxoocruiser]

Thanks for all replies. I guess the short answer is buy the extra insurance and have a good cruise, but I do not understand yet, if I am at Port Canaveral I am domestic, but if I am a few miles at sea, I am international. Is that right??

 

Theoretically that may be correct. However it really depends on your medical insurance provider. So as was previously stated you need to be checking with your insurance provider and not with those on the CC forums for how it specifically pertains to your policy.

[sail7seas]

Medical/evacuation coverage is very low premium. The insurance costs go up considerably when you insure for cancellation/interruption. We never insure the trip itself. Presumably we can afford that or we would not have booked the cruise. We do not wish to expose ourselves to possibly huge medical bills.

 

[Hlitner]

Once the ship leaves a US Port it is no longer "domestic" for medical insurance purposes. Each insurance company has its own definition...for example..Medicare will provide coverage if the ship is within 6 hours of the US port. If your policy does not extend coverage outside the US you are well-advised to buy some kind of trip insurance or travel medical policy.

 

I should add that it gets even worse if you get really sick on a ship (like a bad kidney stone attack). In that case the ship's physician will probably have you taken off the ship at the next port and transported to a hospital. If that port is outside the US then you are responsible for all the medical costs plus the cost of getting back home.

 

Hank

[Dayenu]

Thanks for all replies. I guess the short answer is buy the extra insurance and have a good cruise, but I do not understand yet, if I am at Port Canaveral I am domestic, but if I am a few miles at sea, I am international. Is that right??

 

It's not about geography, it's about the doctor who works on the ship in any port or at sea - that doctor is not a US doctor, so no US insurances are accepted.

[Krazy Kruizers]

I did have to see the doctor a couple of years ago on a HAL cruise. He was American on that cruise. So it could vary.

I already knew in advance that they would not accept Medicare or Security Blue. The doctor's bill was added onto our shipboard account. I got a detailed list which I could turn into Security Blue.

[Hlitner]

It's not about geography, it's about the doctor who works on the ship in any port or at sea - that doctor is not a US doctor, so no US insurances are accepted.

 

I think you are confusing some issues. It is unlikely that any cruise ship (or physician working on any cruise ship) will accept insurance. But if the patient has coverage, the patient can pay the doctor bill and then seek reimbursement from their insurance. In fact, we just did this for a $130 medical bill DW received on the HA Westerdam. The medical charge was automatically added to our onboard account. After we returned home we submitted a claim to our primary insurance company (a PPO) who actually accepted the claim...but then paid zero since it had not exceeded our out of network deductible. We then submitted that info to our HTH-Gold Travel Medical Insurance carrier and they ultimately sent us a check for $80 (the $130 charge minus the policies $50 deductible). In this process nobody cared about the actual physician (except DW) or where he was licensed. Both insurance companies simply accepted a copy of the invoice we got from HA. And by the way, HA does generally use US or Canadian physicians whereas most other lines use physicians from just about anywhere other then the US or Canada. We have been on ships with physicians from South Africa, Italy, France, Greece, and even Norway.

 

But the big point I tried to make is that if you have a serious medical emergency on a cruise ship, it is likely you will be put off the ship at the next port after which everything is your problem. We actually knew a passenger that tried to stay on the ship (while on a Med cruise) but the physician said no and they tossed the passenger off the ship in Italy (he was transported to a hospital in Livorno). Some cruise ship passengers think they have an option to get medical treatment on the ship...but the real power and control is with the ship's physician. And when they get a real sick or injured passenger they cannot get rid of them fast enough :)

 

Hank

[sail7seas]

It's not about geography, it's about the doctor who works on the ship in any port or at sea - that doctor is not a US doctor, so no US insurances are accepted.

 

 

HAL has Canadian and U.S. doctors who treat guests. There likely is Filipino doctor for crew. Certainly, as needed, one interchanges with the other if care is needed and whichever is available is called upon.

 

 

 

 

[cruiseryyc]

HAL has Canadian and U.S. doctors who treat guests. There likely is Filipino doctor for crew. Certainly, as needed, one interchanges with the other if care is needed and whichever is available is called upon.

 

 

 

Why would they have a different doctor for the crew?? I highly doubt that they carry two physicians with one strictly for crew.

[CPT Trips]

Why would they have a different doctor for the crew?? I highly doubt that they carry two physicians with one strictly for crew.

 

I was thinking the same thing. NCL has one physician per ship . . . The jumbos may be an exception, I never traveled the big 'uns, so I won't say.

 

ETA - searched the web and found this . . . http://book.hollandamerica.com/pdfs/media/factsheets/OnboardMedicalServices_FactSheet.pdf

Yep, two physicians . . . perhaps their demographic demands it.

[sail7seas]

Why would they have a different doctor for the crew?? I highly doubt that they carry two physicians with one strictly for crew.

 

 

HAL carries two MD's.

A cruise ship cannot sail without MD. HAL has two MD's aboard.

 

One is designated for crew and one for guests but certainly there is crossover when needed.

 

You may doubt it but you can verify if you feel the need. :)

 

[Krazy Kruizers]

Why would they have a different doctor for the crew?? I highly doubt that they carry two physicians with one strictly for crew.

 

 

HAL certainly does have 2 doctors on board all their ships.

There is a doctor for the passengers who has a very limited time when you can see him/her. Usually one hour in the morning and one hour late in the afternoon.

There is also a doctor for the ship's staff and crew.

I had an accident a few years ago and the doctor for the passengers wasn't available. So they called the crew doctor who took the x-rays of my leg and knee.

[Shmoo here]

HAL certainly does have 2 doctors on board all their ships.

 

There is a doctor for the passengers who has a very limited time when you can see him/her. Usually one hour in the morning and one hour late in the afternoon.

 

There is also a doctor for the ship's staff and crew.

 

I had an accident a few years ago and the doctor for the passengers wasn't available. So they called the crew doctor who took the x-rays of my leg and knee.

 

 

Just because I'm interested - does the crew doctor also have limited hours? What does the passenger doctor do when not "working"?