What happens to your partner if you are Medical evacuated off the ship?

[Hlitner]

We have had some personal experience with medical issues on cruises and in foreign lands and I want to talk about an issue raised by Flatbush Flyer in another post.  No matter what insurance you might have, there is a good chance that you will need to cover the cost of medical before you even leave a foreign hospital.  Even Geoblue (we have had their insurance for many years) may be of little help in most hospitals.  They do have agreements with some hospitals and physicians around the world but the odds do not favor that you would be in one of those facilities.  When a serious medical emergency happens on a ship or in a foreign country you are generally going to have little control over where you are taken for initial care.  When DW needed emergency care while we were in Asia, the physician on the Golden Princess contacted the Princess agent in Osaka who made all the arrangements.  We did not even know where we were going until we left the ship (in Osaka) and were on our way to the hospital.  Even though DW was treated at the major teaching hospital in Osaka, it turned out that Geoblue had no arrangements with that hospital.  I had to settle the entire hospital bill before we could leave the hospital (we were taken to the accounting department before we could leave).  Fortunately I have several credit cards with high credit limits so this was not a problem.  It was many weeks until we were reimbursed (by Geoblue) since I first had to file a complex claim (my submission was about 50 pages long and included copies of CT Scans, surgical reports, etc.).

 

I will add that we live in Puerto Vallarta for part of the year.  In that city we have at least 5 hospitals (both public and private) and if you need to go to the hospital the norm is that they want your credit card (which they hold) as soon as you go through the doors.  If one racks up a major hospital bill (a recent COVID case in Puerto Vallarta cost the patient over $150,000) one needs access to financial resources.  Geoblue does have some network providers in Puerto Vallarta which means not having to lay out lots of money up front.  But most travel insurance policies do not have such arrangements so cruisers generally need the ability to handle emergency medical bills until they can file a claim and get reimbursed.  In Mexico they expect you to have a credit card with an adequate credit limit, but many travelers do not have a very high credit limit.  Add to this the problems with language barriers and dealing with medical emergencies can be a very trying experience.

 

Hank

 

[Elaine5715]

18 hours ago, Hlitner said:

We have had some personal experience with medical issues on cruises and in foreign lands and I want to talk about an issue raised by Flatbush Flyer in another post.  No matter what insurance you might have, there is a good chance that you will need to cover the cost of medical before you even leave a foreign hospital.  Even Geoblue (we have had their insurance for many years) may be of little help in most hospitals.  They do have agreements with some hospitals and physicians around the world but the odds do not favor that you would be in one of those facilities.  When a serious medical emergency happens on a ship or in a foreign country you are generally going to have little control over where you are taken for initial care.  When DW needed emergency care while we were in Asia, the physician on the Golden Princess contacted the Princess agent in Osaka who made all the arrangements.  We did not even know where we were going until we left the ship (in Osaka) and were on our way to the hospital.  Even though DW was treated at the major teaching hospital in Osaka, it turned out that Geoblue had no arrangements with that hospital.  I had to settle the entire hospital bill before we could leave the hospital (we were taken to the accounting department before we could leave).  Fortunately I have several credit cards with high credit limits so this was not a problem.  It was many weeks until we were reimbursed (by Geoblue) since I first had to file a complex claim (my submission was about 50 pages long and included copies of CT Scans, surgical reports, etc.).

 

I will add that we live in Puerto Vallarta for part of the year.  In that city we have at least 5 hospitals (both public and private) and if you need to go to the hospital the norm is that they want your credit card (which they hold) as soon as you go through the doors.  If one racks up a major hospital bill (a recent COVID case in Puerto Vallarta cost the patient over $150,000) one needs access to financial resources.  Geoblue does have some network providers in Puerto Vallarta which means not having to lay out lots of money up front.  But most travel insurance policies do not have such arrangements so cruisers generally need the ability to handle emergency medical bills until they can file a claim and get reimbursed.  In Mexico they expect you to have a credit card with an adequate credit limit, but many travelers do not have a very high credit limit.  Add to this the problems with language barriers and dealing with medical emergencies can be a very trying experience.

 

Hank

 

Great information.  There are way too many US citizens whose experience with payment to medical professionals is done weeks or months after a encounter 

[Philob]

My uncle passed during a land trip in China, the hospital would not release him to the mortician until the bill was settled. Cash only, no credit cards, no wire transfers. My cousin was running around in the US trying to get his passport renewed and expedited visa for China. Naturally my Aunt was totally freaking out the whole time. Eventually the hospital was persuaded to take a wire transfer, but the mortician pulled the same cash only thing on her the day she was supposed to fly out with my uncle.

[Underwatr]

Echoing many of the comments here.

 

DW required emergency medical attention when QM2 was at anchor off St. Lucia. We were tendered to a waiting ambulance at the wharf. There was really no assumption that either of us were going to stay on the ship - she was being discharged from the ship and so was I.

The ambulance drivers asked whether we wanted to go to Castries' public or private hospital and recommended the private hospital. It was good advice. The hospital had state of the art diagnostic imaging equipment and good doctors (the chief doctor at the hospital was the attending for my wife) although the doctors were trained in the US the nurses appeared to be locally trained and weren't as skilled as I would have hoped.

 

I had travel insurance and our regular health insurance (not Medicare) was in effect outside of the US as well. I needed to present a credit card in the ER for her to be seen and again for her to be admitted. The hospital offered a sort of hotel room onsite for me to stay in for a reasonable rate. Although my insurance coverage wasn't via the ship the Cunard/Princess special care staff was in contact with me on a daily basis as well as the special care office at my travel insurance company.

 

Most travel insurance is secondary so they won't pay until they get evidence such as an EOB that my regular insurance didn't pay for something. Well wouldn't you know my medical insurer lost the claim for several weeks. Eventually they did pay, but they paid 100% of the overseas charge rather than the 80% that was defined in the policy. Maybe it was in apology for taking so long to process the claim.

 

The fine print of the policy matters. DW's medical evacuation coverage and my trip interuption coverage got both of us home, but our car was still parked at the pier in Brooklyn. The policy defined the trip - and our insurance coverage - to end when we returned home, so the $150 or so in train tickets and cab fare for me to retrieve my car were denied. I tried to argue that I was simply rejoining my planned trip at the point of ship disembarkation (which nominally would have been covered) but crossing my home threshold invalidated that. I wonder whether it would have been covered under a slightly different scenario - but of course my wife needed home care at that instant.

 

Good travel insurance is more than just the medical coverage. I was quickly reimbursed for non-medical out-of-pocket expenses such as my travel home (hers was paid for upfront), lodging in St. Lucia, food and phone calls as well as the unused portion of our cruise cost. Due to the issue with the health insurance claim reimbursement for those expenses took longer, but on the other hand I ended up not having to wait for a portion of the money to come from the trip insurance.

[Hlitner]

On 12/12/2020 at 6:29 PM, Elaine5715 said:

Great information.  There are way too many US citizens whose experience with payment to medical professionals is done weeks or months after a encounter 

Most of us only know the system with which we have at home.  When you have a medical emergency in a foreign country it is a very scary experience.  Depending on where you are there might be a tremendous language barrier, the hospitals/physicians could care less about your insurance, and accessing high quality of care can be a challenge when you have no clue and are completely dependent on strangers to make decisions.  If a person is evacuated off a ship without their partner or if they have no partner then they are completely alone with folks that may not even speak their language.  Meanwhile, medical decisions must be made and you may have very little control.  Having a partner or advocate on the scene can be invaluable but is not always possible. 

 

When we had our own medical emergency (wife had an accident in Viet Nam) a lifetime of experience in the healthcare sector was my own best friend.  But few folks have my kind of experience (unless they have worked in the healthcare sector and done a lot of travel) and having a medical emergency in a foreign land with a language barrier, different healthcare standards, no ability to consult with experts, etc.  can be a very frightening experience with a bad outcome.  After our own medical emergency experience I actually thought about writing an article or even a book on the subject...but nobody wants to read that kind of thing which we all find so depressing and scary that we avoid the topic.

 

What to do?  1.  Have decent medical insurance (that covers you anywhere).  2.  Have a cell phone that works just about everywhere (this becomes invaluable).  3.  Give some thought about how you would handle a medical emergency if you are the healthy advocate.  4.  Make pre trip arrangements so you have access to cash or a lot of credit...if needed.   And then like most travelers pray that you never need to deal with a serious medical emergency on a ship or in a foreign country.

 

I should add that while there is help on a cruise ship, that all disappears once you are off the ship.  At that point you are generally at the mercy of the local ship agent who may be a godsend...or could also be near useless.  So, it is possible that you end up along in a country where communicating is difficult, under tremendous stress, and totally lost (in your thoughts).  And if a person is evacuated off a ship without a partner/advocate....and is alone and ill that is a much worse scenario.  Nobody likes to hear this stuff, and the truth is that in most cases you (and a partner if you have one at your side) are your own best advocates.  Knowing how to think straight under pressure, when to use lots of charm, when to look helpless, and when to be assertive are all valuable skills.   DW and I traveled extensively for decades before we finally had our own emergency (you always think it only happens to others) that became a major part of our lives for many months.  But we survived, all turned out good, we lost very little money (that is because of good planning), and a few months later we were back to traveling.

 

Hank