Medical Limit and Medical Evacuation - How much is enough?

[Firehunter]

Trying to decide between Travel Guard Gold and Travel Insured Worldwide Trip Protector. These are the areas I am most concerned with:

 

Medical Limit

TGG = $25,000 primary

TIWTP = $100,000 secondary

 

Medical Evacuation

TGG = $500,000

TIWTP = $1,000,000 secondary

 

I can't even guess how much costs would be if something happened and if TGG's lower coverages are reasonable and would be enough to cover costs. Does anyone know?

 

My inclination is to go with the high coverages, since the plan only costs $13 more. Not sure how I feel about it being secondary coverage though...

[GeezerCouple]

Check with the insurer OR a broker like Steve at TripInsuranceStore.com

 

For some (maybe all??) TravelInsured policies, for $25, one can have the medical become primary.

 

There may be other tweaks that make one policy better than the other for the purposes you need/want.

 

Do you have ANY other medical insurance that would cover you during the trip?

$25k doesn't seem like much for something serious.

 

GeezerCouple

[sail7seas]

If your regular health insurance does not pay outside U.S., $25,000 would not go that far if you have a serious accident or illness.

 

For $13 more, my choice would be higher medical coverage.

[FlightMedic555]

Evacuation from the furthest region by air ambulance (Asia) can approach $500,000. From the Caribbean back to the US up to about $100,000 and about $200,000 potentially from Europe.

[greatam]

Trying to decide between Travel Guard Gold and Travel Insured Worldwide Trip Protector. These are the areas I am most concerned with:

 

Medical Limit

TGG = $25,000 primary

TIWTP = $100,000 secondary

 

Medical Evacuation

TGG = $500,000

TIWTP = $1,000,000 secondary

 

I can't even guess how much costs would be if something happened and if TGG's lower coverages are reasonable and would be enough to cover costs. Does anyone know?

 

My inclination is to go with the high coverages, since the plan only costs $13 more. Not sure how I feel about it being secondary coverage though...

 

Take a look at the Travelex plans. Other than the bare bones basic policy, MINIMUM of $50,000 medical and $500,000 evac. AND this is PRIMARY insurance. You can also add more to the medical for just a few dollars (about $45 for $100,000 medical).

 

And one other really great thing about Travelex. They are owned by Travelex, the CURRENCY EXCHANGE people. Travelex currency exchange is worldwide and often have offices in very small cities and airports. Their insurance division can offer assistance much more easily due to the tie in with the currency exchange. Translators, heads up about local conditions (natural disasters, terrorist threats, even coups in the making) and referrals to hospitals and doctors just because they actually have people on the ground worldwide working in the currency exchange business. I swear by Travelex. Have used them for years. I travel for business internationally a lot and even though I have a yearly international medical policy and MedJet assist, I still buy the Travelex policy every trip. The help they provided me in Cambodia when I got so sick was just priceless.

[Hlitner]

WOW! Where to start. Regarding Medical...if you have no other coverage we think that $100,000 is a reasonable coverage amount. Some of the cruise lines sell Insurance Policies with as little as $10,000 of Medical and we think this should be outlawed!

 

As to Med Evac, this is actually a fascinating topic. We have an annual Travel Med policy that gives us $500,000...but they can do this because the payouts of this type of insurance are few and far between. Most policies (Medjet Assist is an exception) leave Medical Evacuation decisions up to the whims of the local physician and insurance company...with the patient (and family) not having a lot of discretion. For the typical cruiser who is going the Caribbean, Alaska, Mexican Riviera, Central America...etc...we think it would be rare for Med Evac to exceed $100,000 in cost. But if you are going to more remote locations like Africa, South Pacific, South Asia, etc.. then we would want at least $250,000. I once challenged somebody from the industry to give me a singe instance, in the previous 12 months, where a Med Evac company had paid out over $250,000 in costs...and he quickly blew us off. My challenge still stands...because we do not think it happens. And keep in mind that evac does not always mean evacuation to home. For example, if you get sick in Luxor, Egypt they might only evacuate you to Cairo or perhaps to a hospital in Western Europe. So before you get too hung up on the limits, read all the fine print.

 

Hank

[Firehunter]

Thank you for all the helpful information. I checked our health insurance and it does cover emergency medical illness and medical evacuation. We pay a $500 deductible and then 25% of the costs, so that with your the information provided here will help in making a decision on which travel insurance to go with.

[donaldsc]

Thank you for all the helpful information. I checked our health insurance and it does cover emergency medical illness and medical evacuation. We pay a $500 deductible and then 25% of the costs, so that with your the information provided here will help in making a decision on which travel insurance to go with.

 

I would not go w that policy. 25% of a $100,000 evacuation is $25,000/ Not likely to be that much but I would not want to take the chance.

 

BTW - when we did our small board Antarctica cruise, we were required to show that we had one million in evacuation coverage.

 

DON

Edited August 30, 2014 by donaldsc

[Algebralovr]

My understanding is that with secondary coverage, you submit to your regular insurance, then any additional costs are covered by the travel insurance company. So if you have a $3000 deductible on your regular insurance, then you submit the EOB that shows the regular insurance didn't pay that first $3000 and the travel insurance will reimburse it to you.

[Hlitner]

My understanding is that with secondary coverage, you submit to your regular insurance, then any additional costs are covered by the travel insurance company. So if you have a $3000 deductible on your regular insurance, then you submit the EOB that shows the regular insurance didn't pay that first $3000 and the travel insurance will reimburse it to you.

 

Maybe yes, and maybe no! You have the concept correct but there are a few monkey wrenches. The Travel Medical policy may have its own deductible...so you have to read the policy. And then there is a huge issue in the Medical Insurance Industry we used to the "UCR" or Usual and Customary Rate. What this means, in plain English, is that many policies will only pay what they (the insurance company) considers the appropriate price for specific procedures. So if a hospital in Germany bills you $50,000 for a certain services, it is possible the insurance company would say, "we will only cover $30,000 of that because we consider the remainder to be excess above the UCR!" This can leave the patient holding the bag. So it is important to look at how the policy is worded.

 

Hank

[greatam]

My understanding is that with secondary coverage, you submit to your regular insurance, then any additional costs are covered by the travel insurance company. So if you have a $3000 deductible on your regular insurance, then you submit the EOB that shows the regular insurance didn't pay that first $3000 and the travel insurance will reimburse it to you.

 

Secondary medical may be slightly cheaper but you have two things going against you:

 

1. Your own insurance premium may rise and if your medical issue is something that can be construed as a chronic illness, you have just waved the red flag for pre existing conditons. Sure, with Obamacare, you can't be kicked off the policy. BUT the price can go sky high.

 

2. You have to file two sets of paperwork. Wait for the first to be denied, THEN file with your travel insurance. And all the while, you are out of pocket whatever was denied by your own insurance company.

 

If you are leaving the USA, I think secondary medical is a real rip. JMHO

[Hlitner]

Secondary medical may be slightly cheaper but you have two things going against you:

 

1. Your own insurance premium may rise and if your medical issue is something that can be construed as a chronic illness, you have just waved the red flag for pre existing conditons. Sure, with Obamacare, you can't be kicked off the policy. BUT the price can go sky high.

 

2. You have to file two sets of paperwork. Wait for the first to be denied, THEN file with your travel insurance. And all the while, you are out of pocket whatever was denied by your own insurance company.

 

If you are leaving the USA, I think secondary medical is a real rip. JMHO

 

There are two points of view with secondary coverage. Most medical insurance premiums are no longer impacted by prior history and a majority of folks in the US with insurance are covered under Group Policies. So in these cases it can be argued that paying extra for primary coverage is simply paying for something you already have. And for those of us on Medicare, with no coverage outside the US, a secondary policy actually becomes primary :).

 

Hank

[sail7seas]

There are two points of view with secondary coverage. Most medical insurance premiums are no longer impacted by prior history and a majority of folks in the US with insurance are covered under Group Policies. So in these cases it can be argued that paying extra for primary coverage is simply paying for something you already have. And for those of us on Medicare, with no coverage outside the US, a secondary policy actually becomes primary :).

 

Hank

 

 

 

Is that true about coverage becoming primary if you have Medicare and additionally have MedEx Part B policy?

 

[Hlitner]

Is that true about coverage becoming primary if you have Medicare and additionally have MedEx Part B policy?

 

 

Better be careful here since we do not want to mislead anyone. You are possibly confusing Medicare Part B with a Supplemental Medicare Policy..so I am going to be a bit long winded (for the sake of others). Medicare has "Part A" which is the hospital coverage and has no specific premiums. They also have "Part B" which is essentially physician (and some other services) coverage. Part B is optional and does have a monthly premium (often deducted from one's Social Security Payment). Neither Part A or Part B will pay any claims outside the USA (and its territories) with 2 notable exceptions which are (on a ship within 6 hours of a US Port, or if in Canada when transiting to Alaska).

 

Now we get to Medicare Supplemental Policies (we think this might be what you mean) which are completely optional and obtained by folks either privately or through employers, retirement plans, or groups. These Supplemental Policies take quite a few different forms (all set forth by Medicare regulations) including various coverage options, Advantage Plans, etc. Now (and this is very important) some of these supplemental plans do extend limited benefits when traveling outside the USA...but a majority of these plans do not provide any coverage outside the USA.

 

So, you really need to carefully read the fine print of your supplemental policy to see if it will extend coverage outside the USA (if in doubt...call the plan and ask where you can find the details in writing).

 

Now we get to your question. If your supplemental policy does offer some international coverage then it will be Primary (if you buy a secondary travel med policy) and would have to first process your claim before the secondary payor would get involved. But, if your supplemental policy (or Advantage Plan) does not offer any coverage outside the USA, the "secondary" plan you buy would essentially become primary (by default) when you are traveling. Some of these secondary plans can be a bit anal and will demand that your regular Medicare Supplemental Policy process the claim (which will be rejected) before they will process and pay. Other travel plans will be a bit bothersome although they will still want to know the details of your supplemental policy. And by the way, the popular industry term used when trying to resolve which insurance company pays (and how much) is called "Third Party Liability" and it is a major part of claims processing at every insurance company.

 

Hank

P.S. I know this is more then Sail7seas wants to read, but it is important to lay all this out for the masses :)

Edited September 4, 2014 by Hlitner