Tale of Med Evac and Insurance Companies

[Shorex]

When I purchase travel insurance, I have certain criteria that must be met. One is that the medical coverage is primary. It surprises me that anyone is surprised by their travel policy being either primary or secondary. I don't "assume", I know. It's right there in writing in the policy you select.

 

Another factor that I hope frequent travelers add to their layers of protection is a membership in MedJet Assist. MedJet is a service, not an insurer. They will transport a hospitalized member from a hospital anywhere in the world to their hospital of choice anywhere in the world. I have read in other threads of people who say, well, my travel policy provides for emergency evacuation for up to $500,000 (pick an amount). However, focus on that word "emergency". For a stabilized patient in a hospital in Japan or Brazil or wherever with a reasonable standard of care, there is no "emergency". So no coverage to get the patient back to the states.

 

For a woman who broke her leg and had other damage from a fall on a cruise, her travel insurance would pay for the cost of orthopedic surgery in Japan but not for evacuation to the states for surgery at home. Why? The hospital in Japan met a reasonable standard of care. No emergency. She and her husband had to pay upfront for Medjet evacuation in a Lear jet with a crew that included an EMT and nurse. Had they been members of Medjet, there would have been no additional cost.

 

I'm not trying to sell you on Medjet, there are other, similar services. Just have something. Just know what you have and what you don't have and what your risk exposure is.

[buggins0402]

When I purchase travel insurance, I have certain criteria that must be met. One is that the medical coverage is primary. It surprises me that anyone is surprised by their travel policy being either primary or secondary. I don't "assume", I know. It's right there in writing in the policy you select.

 

In some cases Secondary is better, particularly for those of us that have a HSA/high deductible health care policy for our at home health insurance.

 

https://tripinsurancestore.com/blog/best-travel-insurance-hsa-plan/

 

There is no one size fits all...especially for those of us that have one spouse in Medicare and one in an HDHP.

[mauimary]

Hank... thank you for sharing the addition clarification of Geo Blue coverage on Hawaiian Cruises from a US Port. Your response was exactly as we were told twice by GeoBlue. We totally get it that they offer no coverage while in the Islands.

Mary

 

 

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[klfrodo]

Hank, I would appreciate and value your opinion on a website I found that discusses Medicare and the options within Medicare.

The site is http://www.medicareonvideo.com

I am not affiliated with this guy but as a 61YO retired person, I'm doing some recon on the Medicare front lines.

I understand he's a sales guy and that's what I'm asking from you. I'm not looking for an endorsement from you. Just an opinion of the information presented.

 

Thanks.

[Hlitner]

Hank, I would appreciate and value your opinion on a website I found that discusses Medicare and the options within Medicare.

The site is www.medicareonvideo.com

I am not affiliated with this guy but as a 61YO retired person, I'm doing some recon on the Medicare front lines.

I understand he's a sales guy and that's what I'm asking from you. I'm not looking for an endorsement from you. Just an opinion of the information presented.

 

Thanks.

 

I assume you are aware its just a site to promote one particular insurance agent/agency. But I did play their game and put my zip code into their quote place. And then it wants personal info so that they can contact me directly (and heaven knows how many others will be sold our information). And contrary to what that initial page might lead one to believe, there are Medicare supplemental plans that do have networks. For example Aetna's Medicare PPO has network providers. In our part of the country Geisinger Gold (popular with many) has a very restricted network.

 

I guess there is no harm in playing their game, listening to what they have to say, and then evaluating that info in conjunction with other info that is available. One very nice thing about Medicare supplemental coverage is that you can change your provider during the annual open enrollment period (once a year). So if you find you do not like your plan and later discover a better option you do have the chance to change :).

 

Many folks have their own favorite physician (s). We have long suggested that simply asking your doctors office which plans they find the best might get you some very interesting answers. Just keep in mind that not all plans are the same although they must all meet the minimum federal rules. Some plans have larger networks, other plans might toss in some extra benefits, etc. As a simple example our plan picks up the tab for my YMCA membership. One popular plan in my area is not a good plan for me because we routinely travel and like having a large national network (which increases the odds you can stay "in network" even when traveling).

 

Just keep in mind that you do not need to pay a broker or anyone else for info. They should get their money from the plans who pay them a fee to bring in new business. I would also tell you not to waste too much time since you are still a young person (61). By the time you reach 65, there will likely be many changes in plans and coverage.

 

If you haven't already done this you might consider reading some articles from publications that are somewhat neutral on their writing. For example you could read this:

https://health.usnews.com/health-news/best-medicare-plans/articles/how-us-news-picks-the-best-medicare-plans

 

Hank

[notjaded]

After some more thought on the GeoBlue topic I decided to give them a call to resolve some questions in my own mind (we are very dependent on their policy when we travel). I raised the question about cruises between a US port and Hawaii (we periodically take this type of cruise) and coverage. As I suspected, GeoBlue would cover a valid claim for medical treatment received on the ship....while in International waters. So if something happened between Seattle and Honolulu, GeoBlue would generally pay the onboard medical claim (assuming the claim meets all their other requirements). But once that ship gets to Hawaii, the policy would not pay for claims on those islands since GeoBlue does not cover domestic claims (inside the USA and its territories). Once the ship departed Hawaii for other places (such as NZ) the GeoBlue policy would again be in force. I should also add that the policy holder would first need to pay their own medical bills (while onboard) and later seek reimbursement from their insurance. This is a compelling reason for travelers to have at least one major credit card with a high limit...or have the ability to get their limit raised when necessary.

 

Another question I just had to ask was why GeoBlue requires other insurance (for their Annual Trekker Policy) even if that is only Medicare. The answer I received was simply that other insurance means the policyholder is likely receiving medical care for prior existing conditions. Upon more thought this is a brilliant concept :). Consider a person who might we aware they have a major medical problem...but who has no other insurance. Perhaps that person would simply book an International trip for the primary purpose of seeking treatment in a foreign country which they expect to be covered by their GeoBlue policy.

 

And finally, the GeoBlue rep did confirm they cannot offer their policies in NY (a recent development), MD and Washington State. Since each of our States has their own insurance regulators and rules we do not find this surprising. Cruisers in those States who find this disappointing might want to lobby their own State Insurance folks on the issue and ask "why?" Good luck in getting a response but it never hurts to try.

 

Hank

 

 

I’m a bit surprised by your last paragraph suggestion to lobby states who don’t license GeoBlue. I may be naive, but the cause is likely GeoBlue’s unwillingness to conform to these state’s requirements. Why? One would have to ask GeoBlue.

[erdoran]

Hank, I have another question for you. Why was Chase such a big problem getting them to pay, and why was the airfare an issue? It seems like there was no question about pre-existing conditions. Were they trying to avoid paying a legit claim, and what were their excuses? Thanks.

[Hlitner]

Hank, I have another question for you. Why was Chase such a big problem getting them to pay, and why was the airfare an issue? It seems like there was no question about pre-existing conditions. Were they trying to avoid paying a legit claim, and what were their excuses? Thanks.

 

It is all very complicated and hard to explain here. But the air was booked through Princess EZAIR and was a round trip Bus Class deal with flights from JFK to Singapore and returning from Vancouver to PHL. We never used that return air. It took several weeks to get Princess to tell us in writing the value of the unused air. Once that was submitted to Chase they wanted additional written assurance from the airline (AA) that the unused airfare was not refundable or that the airline would not issue a voucher. After many days of calls to AA we finally found out how to get to the proper office where they could not even help unless we had the actual ticket numbers. So back to Princess to get ticket numbers and then back to AA for some kind of letter. AA then wanted to know why we did not use the air and when we told them it was a medical issue they wanted evidence of the medical issue. So I sent them a few pages of Medical docs. AA then sent a cryptic e-mail saying the air was not refundable but we had a year to use our "credit." But there was no value and the phone number AA gave us to get info had no clue. After several more e-mails back and forth AA said they really had no way to tell us how much credit we had or how we could even access it....and that would all have to come from Princess. So back to Princess with this info where they also had no clue. Princess did try to work with us and AA but apparently they were also frustrated. But meanwhile, there was no way that Chase would pay for that air given that the e-mails from AA did say there was some kind of unknown credit that nobody knew how to use (including AA).

 

Now, I am just giving you the short version of this single issue (out of many). I do not blame Chase since they were correct in wanting something in writing regarding the air. I might blame AA, but with AA you cannot even find a human to blame for anything :(. As to Princess, they have always been very cooperative in helping us work through the issues and for that we are grateful.

 

We do not feel screwed by anyone, but at times have felt like a ping pong ball bouncing back and forth between Chase, Princess and AA.

 

Aren't you glad you asked?

 

Hank

Edited September 30, 2018 by Hlitner

[erdoran]

Yes, I am, and that was quite helpful. thanks for sharing it. BTW if you are elite status on AA they have a special phone # to call for customer service...as much as you travel you may be, it’s worth looking into. you can google for the phone #s for the different statuses.

 

That runaround is awful; I personally always book my own air because I want to be in control of my airline & itinerary.

[Hlitner]

Yes, I am, and that was quite helpful. thanks for sharing it. BTW if you are elite status on AA they have a special phone # to call for customer service...as much as you travel you may be, it’s worth looking into. you can google for the phone #s for the different statuses.

 

That runaround is awful; I personally always book my own air because I want to be in control of my airline & itinerary.

 

We have no Elite status with AA because it is one of our least favorite airlines which we try to avoid whenever possible. While I do agree with you about booking our own air, in this situation we did book our own air through the Princess site using EZAIR. The reason was that the lowest cost Business Class, booked by normal means, would have cost us over $4000 more then the deal we got through Princess EZAIR. In the past few years it seems like the air contracts have been very favorable when it comes to one-way International Business Class.

 

Our issues with AA are just the nature of most US Airlines where customer service is relegated to somewhere below the dumpster. We actually did finally get to some very helpful AA people who expressed frustration with their own companies computer systems. The reality is that Corporate Bulk Air (alls through the cracks when it comes to the availability of information.

 

We have a similar situation with an upcoming HAL cruise (they use the same air folks as Princess). Business Class on Virgin will cost about $2800 if booked through the cruise line's air folks. Those same exact flights would cost about $5800 if we booked it on our own. While I would prefer to do my own bookings it is hard to justify paying another $6000 for the same two tickets.

 

Hank

[emptyhouse]

Wow, how lucky for me to stumble on this post. Thanks for taking the time to inform us all Hlitner.  H and I have started to take a number of cruises a year and I was literally JUST investigating the medical evacuation options.  We also have a CSR card. It reimbursed a small amount recently when I broke a toe and could not go on a planned trip.  We also carry a $100,000 policy thru Amex which covers medical costs incurred at least 150 miles from home.  Years ago they picked up an ER bill without a hitch.  H is also on Medicare with a supplemental policy covering 50K international - lifetime limit.

We also stopped buying trip insurance on an individual trip basis.  It's infuriating that you have to cover the 'whole' trip - including hotels which you could cancel, airfare which can be refunded or credited and the like.

The info given here on the GeoBlue tracker policy is super helpful.  I'd been looking into them as well as MediJet.  I seem to remember that MediJet had a hidden 'gotcha' in that you needed to be hospitalized for at least 3 days before they would consider picking up the cost of transporting you back home.  

I'm going to go ahead and purchase the GeoBlue Tracker annual policy.  It is cheap peace of mind.

[GeezerCouple]

12 minutes ago, emptyhouse said:

Wow, how lucky for me to stumble on this post. Thanks for taking the time to inform us all Hlitner.  H and I have started to take a number of cruises a year and I was literally JUST investigating the medical evacuation options.  We also have a CSR card. It reimbursed a small amount recently when I broke a toe and could not go on a planned trip.  We also carry a $100,000 policy thru Amex which covers medical costs incurred at least 150 miles from home.  Years ago they picked up an ER bill without a hitch.  H is also on Medicare with a supplemental policy covering 50K international - lifetime limit.

We also stopped buying trip insurance on an individual trip basis.  It's infuriating that you have to cover the 'whole' trip - including hotels which you could cancel, airfare which can be refunded or credited and the like.

The info given here on the GeoBlue tracker policy is super helpful.  I'd been looking into them as well as MediJet.  I seem to remember that MediJet had a hidden 'gotcha' in that you needed to be hospitalized for at least 3 days before they would consider picking up the cost of transporting you back home.  

I'm going to go ahead and purchase the GeoBlue Tracker annual policy.  It is cheap peace of mind.

 

You might want to check with an insurance broker (we use Trip Insurance Store) who can clarify the terms of MJA, but our understanding is that there is no 3-day minimum.  However, it is correct that one must be an *inpatient* (not ER, not Observation, etc.) before their services kick in (and at least 150 miles from home, etc.).

 

Now, it is possible that from the time one starts that effort, especially if one is in a remote area and/or phone communication is difficult, it might take some time to get all of the arrangements finalized.

 

But you are mentioning Amex, and last we checked with them (which was, admittedly, not very recent), they didn't any longer have any reasonable travel insurance.  And I don't think it would cover pre-existing conditions, which might be a non-starter for us.  However, I will call them again to discuss, so thanks for mentioning that!

 

Good luck with whichever policies you have, and hope you don't need them!

 

GC

[emptyhouse]

The Amex policy is a long time holdover from when they offered it under the Costco Amex Business card.  I signed up for a new Amex just so I could continue that coverage.  It's been running us $18/month and regretfully, it is no longer available.

[GeezerCouple]

11 minutes ago, emptyhouse said:

The Amex policy is a long time holdover from when they offered it under the Costco Amex Business card.  I signed up for a new Amex just so I could continue that coverage.  It's been running us $18/month and regretfully, it is no longer available.

 

Ah, thanks for that update.

 

GC

[Ep010835]

On 1/17/2019 at 4:38 PM, emptyhouse said:

It's infuriating that you have to cover the 'whole' trip - including hotels which you could cancel, 

 

I don’t think your assumption is correct. In your “insurable cost calculation” Include ONLY non-reimuursable (pre-paid) costs. 

 

In the case of hotels, do not include hotels for which you have only made a reservation and for which payment will be made when you arrive. If however, you take advantage of the pre-paid discount many hotels offer, include those. These are the reservations on which you lose your pre-payment if you cancel for any reason. 

If our raw air/cruise costs are below the policy limit leaving some room to reach the top of the limit, I’ll pre-pay all the hotels I can to save some $ on hotel costs. 

[GeezerCouple]

12 minutes ago, Ep010835 said:

 

I don’t think your assumption is correct. In your “insurable cost calculation” Include ONLY non-reimuursable (pre-paid) costs. 

 

In the case of hotels, do not include hotels for which you have only made a reservation and for which payment will be made when you arrive. If however, you take advantage of the pre-paid discount many hotels offer, include those. These are the reservations on which you lose your pre-payment if you cancel for any reason. 

If our raw air/cruise costs are below the policy limit leaving some room to reach the top of the limit, I’ll pre-pay all the hotels I can to save some $ on hotel costs. 

 

We do much the same.

 

In addition, we'll often book fully refundable hotels.  We usually do this early on anyway, for flexibility, if we find a better hotel, or change itinerary a bit, etc.

But once we've departed... we may well see if there are lower non-refundable rates, and change the reservation.  By then, we are pretty sure of our actual itinerary/choice of hotel, plus we won't need to add in new charges for the insurance premium.  This has worked out quite well many times.

 

We used to do this even when travel insurance wasn't a concern (we were foolish back then, and lucky!).  Once we were *sure* where we were going, and on exactly which nights, we'd do a bit of juggling of reservations, and get as many "cheaper, non-refundable" reservations as possible.

 

GC

[Stonewolf Cruiser]

Thanks for detailing your experience.  A medical emergency is my biggest fear in overseas travel.  Two years ago, I started getting annual coverage with GeoBlue and Medjet Assist.  Trip cancellation coverage isn't a big priority with me, but hopefully, my Chase Sapphire card will help in that area, if needed.

 

Take care and best wishes on your future cruises.

[fstuff1]

i plan to take many solo cruises this year.

i'm male, age 48, live in USA.

 

GeoBlue 'Trekker Essential' annual plan is $100:

https://www.geobluetravelinsurance.com/products/multi-trip/trekker-quote-results.cfm

• $50,000 medical / $250,000 evacuation
• $2,500 RX/ $0 AD&D
• $50 Deductible (waived when using a GeoBlue provider)

 

worth it over the other evac only plans on Insuremytrip.com?

ie: Arch RoamRight Preferred evac only plan is $23 per cruise

 

Edited January 24, 2019 by fstuff1

[Hlitner]

21 hours ago, fstuff1 said:

i plan to take many solo cruises this year.

i'm male, age 48, live in USA.

 

GeoBlue 'Trekker Essential' annual plan is $100:

https://www.geobluetravelinsurance.com/products/multi-trip/trekker-quote-results.cfm

• $50,000 medical / $250,000 evacuation
• $2,500 RX/ $0 AD&D
• $50 Deductible (waived when using a GeoBlue provider)

 

worth it over the other evac only plans on Insuremytrip.com?

ie: Arch RoamRight Preferred evac only plan is $23 per cruise

 

Be careful not to compare apples to oranges.  GeoBlue is a comprehensive major medical policy with a high limit ($250,000) and a low deductible ($50).  The evacuation coverage is just icing on that medical cake! It appears that you are comparing that to another plan that only offers medical evacuation.  If you do need medical insurance, then an evacuation-only policy will not meet that need.   The question you must answer is whether, or not, you need to protection of medical insurance.  Some cruisers already have pretty decent medical insurance through their regular med policy, but many medical policies do not give much coverage when outside the country or their own network.

 

[fstuff1]

15 minutes ago, Hlitner said:

Be careful not to compare apples to oranges.  GeoBlue is a comprehensive major medical policy with a high limit ($250,000) and a low deductible ($50).  The evacuation coverage is just icing on that medical cake! It appears that you are comparing that to another plan that only offers medical evacuation.  If you do need medical insurance, then an evacuation-only policy will not meet that need.   The question you must answer is whether, or not, you need to protection of medical insurance.  Some cruisers already have pretty decent medical insurance through their regular med policy, but many medical policies do not give much coverage when outside the country or their own network.

 

 

wait.. the plan says $50k for medical and $250k for evac.

i think im comparing apples to apples to other evac only plan???

 

and i have medical from my company. but have no clue on how my company's plan works outside the USA :o

 

Edited January 25, 2019 by fstuff1

[Hlitner]

35 minutes ago, fstuff1 said:

 

wait.. the plan says $50k for medical and $250k for evac.

i think im comparing apples to apples to other evac only plan???

 

and i have medical from my company. but have no clue on how my company's plan works outside the USA 😮

 

In your situation I would first want to learn about the coverage you have from your company plan.  The only way to be sure is to call your medical insurer and ask the question and then ask for the International Coverage info in writing.  You did say "evac only" plan when you talked about Arch Roamright (I know nothing about this company) but now you say it has 50k of Medical which means it is NOT evac only .  All these terms are confusing (even to experts) but have real meaning if you ever need to use these policies.  And consider that high amounts on evac plans almost lose their meaning beyond $100,000 (most evacs cost far less) but a serious medical problem can quickly break the bank.

 

Much of the devil is truly in the details.  Most foreign coverage policies will tell you they pay something akin to what they call the "Usual and Customary Rate" and they will reimburse you after the fact.  This can mean you have to spend 10s of thousands of your own dollars out of pocket and later seek reimbursement.  How long it takes to get that reimbursement can be a serious problem for some folks, so the reputation of the insurance company matters as does whoever they use to actually process the claims (this is often sub-contracted).  One strong point for GeoBlue is that they are an arm of Blue Cross/Blue Shield and actually process (and also case manage) their own claims.  There are other insurance companies that do the same.  But then there are those that sub-out just about everything (for better or worse).   Medical and Travel insurance is truly a minefield.  Most folks pay little attention to any of these details until they actually have a major claim (hopefully this never happens to you).  I was traveling for over forty years before we ever had a serious issue....and it was nice to make a phone call from Japan to the USA (nighttime in the USA) and actually have somebody answer the phone :).

 

Hank

[Walfam]

22 hours ago, fstuff1 said:

. . . and i have medical from my company. but have no clue on how my company's plan works outside the USA 😮

 

You might want to call your company's plan and ask how it works outside the USA.  That could be really important info.