Air/Medical evac

[tinykygal]

I feel more confident traveling when we purchase trip insurance.

However, we had a nice discussion with another couple on our recent cruise regarding air evacuation.

I understand that coverage is reimbursement on approved expenses.

I was shocked when I learned that a recent medical emergency of a cruise passenger was $60,000 UP FRONT.

 

Not everyone has that money readily available.  They would not evacuate until money was wired.

 

Anyone have firsthand knowledge of similar situations and do you mind sharing?

Secondly, how do you prepare for such a thing? 

It suddenly has me second guessing our travel.

 

Thank you.

[Flatbush Flyer]

2 minutes ago, tinykygal said:

I feel more confident traveling when we purchase trip insurance.

However, we had a nice discussion with another couple on our recent cruise regarding air evacuation.

I understand that coverage is reimbursement on approved expenses.

I was shocked when I learned that a recent medical emergency of a cruise passenger was $60,000 UP FRONT.

 

Not everyone has that money readily available.  They would not evacuate until money was wired.

 

Anyone have firsthand knowledge of similar situations and do you mind sharing?

Secondly, how do you prepare for such a thing? 

It suddenly has me second guessing our travel.

 

Thank you.

First of all, let's be clear as to what is "medical evacuation" (medevac).

 

It is NOT that medically necessary Coast Guard transportation from the ship to a shoreside emergency facility. With rare exception, that is a public service at no cost to the patient.

 

Rather, medevac is that patient transportation from the initial land based emergency facility to the appropriate acute care facility (or to home in some cases) as ordered by the treating MD (often with required concurrence of the insurer if reimbursement is sought/expected). 

 

And since that medevac may require special handling and accompanying medical personnel, you can expect a significant bill - often paid upfront.

 

There was a recent thread here on CC regarding credit card limits related somewhat to this topic. And, at the very least, anyone who travels without credit card(s) (preferably with, at least, five figure limits) and medical insurance with adequate medevac coverage is taking a significant risk.

[Shmoo here]

17 minutes ago, tinykygal said:

I feel more confident traveling when we purchase trip insurance.

However, we had a nice discussion with another couple on our recent cruise regarding air evacuation.

I understand that coverage is reimbursement on approved expenses.

I was shocked when I learned that a recent medical emergency of a cruise passenger was $60,000 UP FRONT.

 

Not everyone has that money readily available.  They would not evacuate until money was wired.

 

Anyone have firsthand knowledge of similar situations and do you mind sharing?

Secondly, how do you prepare for such a thing? 

It suddenly has me second guessing our travel.

 

Thank you.

Typically, any medical procedures are paid up front (both on the ship and in hospitals in foreign countries), and then you submit to your (travel) insurance for reimbursement once back home.  I believe there are policies that will cover you out of country just like your regular insurance (payment after services), but I don't know which ones they are.

 

We have a high limit on our credit cards, so that would be what we would use.

[Flatbush Flyer]

5 minutes ago, Shmoo here said:

Typically, any medical procedures are paid up front (both on the ship and in hospitals in foreign countries), and then you submit to your (travel) insurance for reimbursement once back home.  I believe there are policies that will cover you out of country just like your regular insurance (payment after services), but I don't know which ones they are.

 

We have a high limit on our credit cards, so that would be what we would use.

IMO, international travel (particularly to third world countries) should not be undertaken without total available credit of at least $50k.

[lenquixote66]

51 minutes ago, tinykygal said:

I feel more confident traveling when we purchase trip insurance.

However, we had a nice discussion with another couple on our recent cruise regarding air evacuation.

I understand that coverage is reimbursement on approved expenses.

I was shocked when I learned that a recent medical emergency of a cruise passenger was $60,000 UP FRONT.

 

Not everyone has that money readily available.  They would not evacuate until money was wired.

 

Anyone have firsthand knowledge of similar situations and do you mind sharing?

Secondly, how do you prepare for such a thing? 

It suddenly has me second guessing our travel.

 

Thank you.

A few years ago neighbors of ours were on a Caribbean cruise.The husband had a heart attack and was airlifted to the nearest port that had a hospital capable of treating him.

His wife was told that they required Ten thousand American dollars before they would treat him.

[navybankerteacher]

Intelligent people will insure themselves against risks which they could not cover out of pocket.  If you own a house, you will most likely insure it so you would not be homeless if there were a fire.  If you own a valuable car, you will likely have collision insurance (subject to whatever deductible you would be happy to pay out of pocket to save a bit on the premium), and if you travel you should be aware of the awesome expenses (probably $50,000 and up) involved in flying you home if you should suffer serious illness/injury.  While the costs being insured against are huge, the likelihood of incurring them is so slight that the cost of insurance to cover a $100,000 repatriation is far less than the collision insurance you might have on a $20,000 car.

[Shmoo here]

1 hour ago, Flatbush Flyer said:

IMO, international travel (particularly to third world countries) should not be undertaken without total available credit of at least $50k.

Yep.  No problem.

[Host Kat]

2 hours ago, tinykygal said:

... Secondly, how do you prepare for such a thing? 

It suddenly has me second guessing our travel....

 

Howdy @tinykygal !

 

At this time Cruise Critic has a special forum for questions regarding cruise insurance hosted by Steve Dasseos of the TripInsuranceStore.com. I feel sure he will be able to help you find out how to prepare.

Take a look: Q&A: Cruise Insurance w/ Steve Dasseos of the TripInsuranceStore.com

 

[Elaine5715]

7 hours ago, navybankerteacher said:

Intelligent people will insure themselves against risks which they could not cover out of pocket.  If you own a house, you will most likely insure it so you would not be homeless if there were a fire.  If you own a valuable car, you will likely have collision insurance (subject to whatever deductible you would be happy to pay out of pocket to save a bit on the premium), and if you travel you should be aware of the awesome expenses (probably $50,000 and up) involved in flying you home if you should suffer serious illness/injury.  While the costs being insured against are huge, the likelihood of incurring them is so slight that the cost of insurance to cover a $100,000 repatriation is far less than the collision insurance you might have on a $20,000 car.

I don't think you would be shocked to hear how many people drop house insurance once they secure their mortgage or only purchase a few days of car insurance just to get plates.

[clo]

44 minutes ago, Elaine5715 said:

I don't think you would be shocked to hear how many people drop house insurance once they secure their mortgage or only purchase a few days of car insurance just to get plates.

You've mentioned things I'd never heard/thought about. And it makes me nuts. Thanks.

[Cruzaholic41]

10 hours ago, Flatbush Flyer said:

It is NOT that medically necessary Coast Guard transportation from the ship to a shoreside emergency facility. With rare exception, that is a public service at no cost to the patient.

There is zero exception. USCG does not charge. 

[Flatbush Flyer]

30 minutes ago, Cruzaholic41 said:

There is zero exception. USCG does not charge. 

Actually, the U.S. is not the only country with a Coast Guard. And among some third world countries there can be that rare occasion when the government will attempt to recoup its costs for "field rescue."

Edited November 18, 2019 by Flatbush Flyer

[sparks1093]

With all of the insurance products out there it isn't that difficult to find a provider that will guarantee the payment to the medevac company so the passenger doesn't have to pay up front (and the same applies for medical). 

[sparks1093]

15 hours ago, Flatbush Flyer said:

IMO, international travel (particularly to third world countries) should not be undertaken without total available credit of at least $50k.

If that were a hard and fast requirement I suspect that the travel industry would fold. 

[flamomo]

I too feel it necessary to be covered by insurance of some sort in the event to serious illness or injury, as well as minor ailment that can be taken care of in the ship's medical center.

Not only do I sign up for the cruise line's insurance, since age is not a factor in the cost, and which I have used a few times in the past to get 100% reimbursement for visits to the medical center, but I also purchase a membership in MedJetAssist, which can provide air evacuation from pretty much anywhere in the world. The annual membership fee is around $400 with a bit  of a discount if purchased thru AARP. If one does need their services, the membership fee covers 100% of the person's costs for medical evacuation, whether by medically equipped and staffed jet or commercial flight (with a medical escort accompaniment).

It might be worth your looking into.

I renew my membership every year because I cruise 3-4 times a year and it covers me  whether I am across the country (at least 150 miles away from home) or across the world. I find it a comforting feeling.

[navybankerteacher]

7 hours ago, Elaine5715 said:

I don't think you would be shocked to hear how many people drop house insurance once they secure their mortgage or only purchase a few days of car insurance just to get plates.

I would not be at all shocked —you will note that I prefaced the post to which you responded : “Intelligent people will insure themselves...” ;  and I suppose it must be acknowledged that responsible people are at least as rare as intelligent people. 

[tinykygal]

16 hours ago, navybankerteacher said:

Intelligent people will insure themselves against risks which they could not cover out of pocket.  If you own a house, you will most likely insure it so you would not be homeless if there were a fire.  If you own a valuable car, you will likely have collision insurance (subject to whatever deductible you would be happy to pay out of pocket to save a bit on the premium), and if you travel you should be aware of the awesome expenses (probably $50,000 and up) involved in flying you home if you should suffer serious illness/injury.  While the costs being insured against are huge, the likelihood of incurring them is so slight that the cost of insurance to cover a $100,000 repatriation is far less than the collision insurance you might have on a $20,000 car.

We are insured when we travel.

I just had not given thought to 'pay up front'.

I understand it and thank you.

[tinykygal]

2 hours ago, sparks1093 said:

With all of the insurance products out there it isn't that difficult to find a provider that will guarantee the payment to the medevac company so the passenger doesn't have to pay up front (and the same applies for medical). 

I will check into this.

Thank you.

[Heidi13]

3 hours ago, sparks1093 said:

With all of the insurance products out there it isn't that difficult to find a provider that will guarantee the payment to the medevac company so the passenger doesn't have to pay up front (and the same applies for medical). 

Most of the travel insurance policies we have available include medivac costs paid directly; however, they also have very specific requirements of how to schedule. Unfortunately, many do not follow the claims procedure and have claims denied.

[Cruiser_1977]

I am still employed full time with insurance through work. Am I in the minority that all of this stuff is covered by my health insurance?

[chipmaster]

Insurance is exactly that, there to cover when things happen.   

 

Unintended things like illness and emergency procedures in far-way lands can get very expensive and depending on the place may require payment before treatment.   There you either got cash/cash-transfer or most places do expect credit, better have enough on the CC for these.    If you got good insurance then you like can get some if not all of it covered except the deductible if it is indeed a medical coverage / accident etc.   But claims can take months or longer if they were't pre-approved.   

 

And of course all those with personal health insurance think carefully before you vote this coming election as choice could be gone!

[Flatbush Flyer]

3 minutes ago, JennyB1977 said:

I am still employed full time with insurance through work. Am I in the minority that all of this stuff is covered by my health insurance?

You may want to re-read your policy T&Cs.

 

While your employer's policy may cover emergency medical treatment while outside of the US, including emergency ambulance services, "medical evacuation" (that secondary transfer from a landbased emergency facility [where you were taken by helicopter from the ship] to an acute care facility abroad or back home to the U.S. is most often NOT covered.

 

In addition, the treating medical facilities abroad may/may not be considered out-of-network (larger copay?). And, of course, that international coverage is most often limited to "emergency" care (as is most additional international coverage). 

 

Though it may not apply to you, folks with Medicare really need to look at the T&Cs of whatever supplementary medical insurance they may have. I am very fortunate to have what many consider to be the gold standard of employer paid health insurance - CalPERS' "PERS Care." Thus, my Medicare supplement immediately converts to the regular policy coverage the minute I step foot out of the U.S.. Nonetheless, while emergency ambulance services are included, that secondary Medevac is not. This is one reason why separate Medevac policies are gaining in popularity for constant travelers with significant regular health coverage.

 

BTW, as I posted earlier, don't confuse Medevac with "field rescue," i.e., emergency transfer by helicopter from the ship (ordered by the ship's MD) to the initial emergency facility. Worldwide, Coast Guards (or some equivalent government entity with responsibility for "search and rescue [SAR]" events) provide that service at no charge to the patient. But, as aforementioned, there can be those extremely rare occasions- primarily in third world countries with limited rescue resources on hand - where reimbursement for reliance on a "contractor" for immediate response may engender a service charge. So, when looking carefully at the specifics of medevac related insurance, it is a comforting thought when the stated coverage includes "field rescue."

[Flatbush Flyer]

5 hours ago, sparks1093 said:

If that were a hard and fast requirement I suspect that the travel industry would fold. 

Never suggested that adequate insurance/credit should be required by travel providers (though it already is in certain circumstances [e.g., done an African Safari lately?].

Rather, I am suggesting that it is shortsighted and irresponsible not to have adequate resources to reduce risk.

[Cruiser_1977]

@Flatbush Flyer I appreciate the heads up! I have spoken to my healthcare provider. "Under your plan benefits for emergency services is covered at $100 copay then paid at 100% of eligible expenses." Then I asked an example. "okay so for example I have a heart attack and am transported to a mexican hospital and then from there need to be moved in network. All I'm out of pocket is $100?" Response - "Yes, that is correct!"

[new_cruiser]

When I broke my wrist in Thailand, I had to pay upfront for medical care (surgery plus 3 days hospital stay for IV antibiotics because it was an open fracture). I had primary coverage from my Medicare Advantage plan and secondary coverage from travel insurance, but I had to pay the hospital and file a claim for reimbursement. The initial charge was around $12,000 but some of that was refunded as the final bill came to about $11,000. 

 

Medicare plans aren't required to provide international emergency coverage - some do and some don't so as Flatbush Flyer says, you have to check with your plan. Mine (Kaiser Permante) does. I filed a claim when I got home and they sent a check covering all but the $500 hospital co-pay that I'd had to have paid if the injury was treated by them. I'd submitted all the documentation from the Thai hospital with the claim and insurance paid pretty promptly - within a few weeks.

 

It's not just the immediate medical evacuation (i.e. from where you were injured to where you are treated) that travel insurance covers. It is also extra costs to travel home afterward: e.g.; new flights, sometimes increased travel costs (someone on a trip I was on had a knee replacement fail and their travel insurance paid for first class flights home to accommodate the injury), paying for someone to accompany you if medically necessary. None of these are covered by any medical insurance plan I've seen. 

 

In my case, I called United from the hospital to let them know I wouldn't be able to make my original flight and later called to rebook my flights. They nicely waived change fees and fare increases for the new flights. So my travel insurance provider got off pretty lightly.