Will You Choose Destinations Based on Medical Facilities?

[getting older slowly]

will-you-choose-destinations-based-on-medical-facilities

 

NO.....

 

I did know a person, whom chose were they lived to be close to a hospital, and also with travel, only went to main cities......  But each is their own on this.....

 

Never do anything with the smallest risk....   I remember telling about an outback trip I did by myself... and at one point was over 200km from the nearest person ( and then only a handful ) .... they were shocked...  what it something happens........

[ilikeanswers]

4 hours ago, iancal said:

The challenge might not be the country's medical facilities but rather how far you might be from them in the case of a medical emergency.

 

We have spent a number of winters in Southern Thailand. One of our hosts, a Swiss expat, explained the medical realities of living where he did in the event of an emergency.

 

Sometimes time is critical.   He resolved himself to be history if he was ever in need of urgent care.  By the time he was transferred to a proper facility he would be deceased.  That would not be the case if was living in a major center like Bangkok.   

 

This may well hold true no matter if you are at home, depending where you live, or you were travelling.

 

That is very true. Just travelling around Australia a supposedly developed first world nation and you can still easily find yourself too far from medical care🤕. 

[ldubs]

On 2/28/2021 at 3:38 PM, Hlitner said:

Not at all true.  In fact, we are living in Puerto Vallarta for 10 weeks (our normal winter home) and had no problem obtaining excellent health insurance that specifically INCLUDES coverage for COVID.  That is the good news.  The bad news is that one will usually pay more money for such a policy.  We actually have a Geoblue policy with $1 million of medical coverage.   When we shopped for a policy back in December there were several good options.

 

Hank

 

I think that a travel insurance policy might have exclusions that would not be usual for a traditional health insurance policy.  I would be surprised if any health insurance coverage excluded COVID.  Not talking about travel policies.   But to the question of do mainstream travel insurance exclude COVID -- That I don't know.  

[Hlitner]

41 minutes ago, ldubs said:

 

I think that a travel insurance policy might have exclusions that would not be usual for a traditional health insurance policy.  I would be surprised if any health insurance coverage excluded COVID.  Not talking about travel policies.   But to the question of do mainstream travel insurance exclude COVID -- That I don't know.  

Then you would be very surprised :(.  Many traditional health care policies do not even cover care rendered outside the home country while others have limitations (which may exclude Pandemics, have large copays, etc).  As to travel policies, as we discuss on CC there are many kinds including basic travel insurance, travel health insurance, medical evacuation insurance, etc.  A majority of all travel policies now EXCLUDE coverage related to COVID.   When we were preparing for our annual winter in Puerto Vallarta (we arrived in early January) we looked at many different policy options and even traded messages with Steve Dasseos (here on CC).    We wanted a high value health policy that included coverage for COVID and we only found a few options.  The policy we ultimately purchased was quite expensive but completely covers medical issues (including COVID) with a $1 million maximum.

 

Cruise lines may well include some COVID coverage in the travel policies they sell those who book cruises, but as we have often pointed out here on CC, most travel policies sold by cruise lines have very low medical limits (usually $10,000 or $20,000).  Hospitalization for a serious COVID episode can easily cost over $100,000 as can many other serious medical issues.  

 

As one who often spends about 6 months a year outside the USA we are very careful about having adequate health and evacuation insurance.  As to trip cancellation....we could care less since that is something we can self-insure.  And one of our major credit cards does offer up to $20,000 ($10,000 per person) of cancellation coverage at no extra cost as long as we book with that credit card.  

 

I think we also need to consider that most folks are not traveling these days and very few are cruising.  By the time most cruise lines begin to resume operations we may see changes in travel med and travel policies.  Folks will need to carefully review any insurance (before they purchase) to look for limitations and exclusions.  Exclusions for things like COVID can be hidden inside a policy in several ways such as tying exclusions to a CDC or Department of State Warning Level, specifying "pandemics" or more specifically COVID.  As an example, our usual annual Geoblue travel medical policy has a specific exclusion for COVID/Pandemics...which is why we had to purchase a different policy for our lengthy trip to Mexico.

 

Hank

[ldubs]

1 minute ago, Hlitner said:

Then you would be very surprised :(.  Many traditional health care policies do not even cover care rendered outside the home country while others have limitations (which may exclude Pandemics, have large copays, etc).  As to travel policies, as we discuss on CC there are many kinds including basic travel insurance, travel health insurance, medical evacuation insurance, etc.  A majority of all travel policies now EXCLUDE coverage related to COVID.   When we were preparing for our annual winter in Puerto Vallarta (we arrived in early January) we looked at many different policy options and even traded messages with Steve Dasseos (here on CC).    We wanted a high value health policy that included coverage for COVID and we only found a few options.  The policy we ultimately purchased was quite expensive but completely covers medical issues (including COVID) with a $1 million maximum.

 

Cruise lines may well include some COVID coverage in the travel policies they sell those who book cruises, but as we have often pointed out here on CC, most travel policies sold by cruise lines have very low medical limits (usually $10,000 or $20,000).  Hospitalization for a serious COVID episode can easily cost over $100,000 as can many other serious medical issues.  

 

As one who often spends about 6 months a year outside the USA we are very careful about having adequate health and evacuation insurance.  As to trip cancellation....we could care less since that is something we can self-insure.  And one of our major credit cards does offer up to $20,000 ($10,000 per person) of cancellation coverage at no extra cost as long as we book with that credit card.  

 

I think we also need to consider that most folks are not traveling these days and very few are cruising.  By the time most cruise lines begin to resume operations we may see changes in travel med and travel policies.  Folks will need to carefully review any insurance (before they purchase) to look for limitations and exclusions.  Exclusions for things like COVID can be hidden inside a policy in several ways such as tying exclusions to a CDC or Department of State Warning Level, specifying "pandemics" or more specifically COVID.  As an example, our usual annual Geoblue travel medical policy has a specific exclusion for COVID/Pandemics...which is why we had to purchase a different policy for our lengthy trip to Mexico.

 

Hank

 

I was talking about a domestic health insurance policy vs travel insurance.  It is understood by most that domestic policies have limited coverage while traveling internationally.   So, nope, I would not be surprised.  And I would still be surprised if a standard health ins policy excluded COVID treatment.  But I do have to circle back around and say US policies.  I have no idea of standard terms in other countries. 

[Hlitner]

5 hours ago, ldubs said:

 

I was talking about a domestic health insurance policy vs travel insurance.  It is understood by most that domestic policies have limited coverage while traveling internationally.   So, nope, I would not be surprised.  And I would still be surprised if a standard health ins policy excluded COVID treatment.  But I do have to circle back around and say US policies.  I have no idea of standard terms in other countries. 

I think I should have been clearer then many domestic policies (in the USA) do not include coverage for anything outside the USA while many other policies limit their coverage to emergencies (often with deductibles, copays, and limits).   For those of us on Medicare, some supplemental and Advantage plans include limited foreign coverage while many other plans have zero coverage outside the USA.  Normal Medicare (for those that do not have any supplemental policy) will pay for zero outside the US and it's territories (with two very small exceptions).   Having traveled extensively for over fifty years we have often been surprised to meet other travelers that either have no healthcare coverage or have no clue as to what kind of coverage they might have.   

 

I should also mention that CC has done its many readers a terrific service by making Steve Dasseos (tripinsurance store) available (from time to time) to handle questions.   In the interest of full disclosure I do not have any kind of relationship with Mr, Dasseos but recognize him as a true expert on all kinds of travel insurance.  There is also a "Cruise/Travel Insurance" blog here on CC for anyone that wants to share of seek travel insurance advice.

 

Hank

 

 

[ldubs]

Just now, Hlitner said:

I think I should have been clearer then many domestic policies (in the USA) do not include coverage for anything outside the USA while many other policies limit their coverage to emergencies (often with deductibles, copays, and limits).   For those of us on Medicare, some supplemental and Advantage plans include limited foreign coverage while many other plans have zero coverage outside the USA.  Normal Medicare (for those that do not have any supplemental policy) will pay for zero outside the US and it's territories (with two very small exceptions).   Having traveled extensively for over fifty years we have often been surprised to meet other travelers that either have no healthcare coverage or have no clue as to what kind of coverage they might have.   

 

I should also mention that CC has done its many readers a terrific service by making Steve Dasseos (tripinsurance store) available (from time to time) to handle questions.   In the interest of full disclosure I do not have any kind of relationship with Mr, Dasseos but recognize him as a true expert on all kinds of travel insurance.  There is also a "Cruise/Travel Insurance" blog here on CC for anyone that wants to share of seek travel insurance advice.

 

Hank

 

 

 

Thanks Hank.  And, oh boy, I sure agree with your last paragraph.   Like a public service.  

 

Maybe a trivia tidbit.  I read somewhere that Medicare will pay for Doc visits in a few places in Canada.  The reason being there is no close viable alternative on the US side of the border.    Can't remember the details and as far as I know it might not even be true.  

[Hlitner]

2 hours ago, ldubs said:

 

Thanks Hank.  And, oh boy, I sure agree with your last paragraph.   Like a public service.  

 

Maybe a trivia tidbit.  I read somewhere that Medicare will pay for Doc visits in a few places in Canada.  The reason being there is no close viable alternative on the US side of the border.    Can't remember the details and as far as I know it might not even be true.  

Ahh, so now you are getting into the "exceptions" I mentioned which few folks know exist.  Yes, it is true that in some rare circumstances when folks live near the border where healthcare is easily accessible in Canada but too far away in the USA...we might pay the Canadian system (folks in that situation are aware of the rule).  Likewise, there are some Canadians along the border that may be able to get covered by the Canadian system for a similar reason.  So, just for fun here are the other exceptions.  If you are transiting between Alaska and the Lower 48 (or vice versa) and you need emergency care while enroute....Medicare will pay for care in Canada.  And the other rule (which is very interesting for cruisers) is that there is an obscure rule that says Medicare will cover care on a ship if it is within 6 hours of the USA!   That last rule is very interesting  because it is codified in terms of hours!  I once asked a Medicare buddy (I worked at the State level) for the proper interpretation of that 6 hour rule and got a big laugh.   Nobody knows exactly what it means.   If a ship like the QM2 that can make 30 knots is 150 miles off the coast that would be (in theory) within 6 hours.  And if a normal cruise ship with a top speed of 18 knots was 150 miles off shore they could not possibly be within 6 hours.   This rule is rarely used but is usually used in a case where a ship has embarked from a US port and somebody gets sick within 6 hours of embarkation.  But that is not the technical language so who knows what it means?

 

Hank

[evandbob]

It appears that the OP is concerned about contracting COVID, so I would restate the question as being concerned with booking the cruise line which will give me the least chance of catching the virus on the ship.

 

Prevention, strict adherence to health and mitigation policy by the cruise line and wide acceptance by its passengers can make finding qualified medical facilities or an evac highly unlikely.

[ilikeanswers]

8 hours ago, Hlitner said:

Cruise lines may well include some COVID coverage in the travel policies they sell those who book cruises, 

 

On the Singaporean cruises to nowhere it is mandatory to purchase Covid insurance which is offered by the cruise lines. 

[Hlitner]

1 hour ago, evandbob said:

It appears that the OP is concerned about contracting COVID, so I would restate the question as being concerned with booking the cruise line which will give me the least chance of catching the virus on the ship.

 

Prevention, strict adherence to health and mitigation policy by the cruise line and wide acceptance by its passengers can make finding qualified medical facilities or an evac highly unlikely.

In my little mind that means the ship must have a 100% vaccination policy (both crew and passengers) with zero exceptions.  That would seem to meet your criteria of having the least chance or catching the virus.  But I would not go on a cruise unless both DW and I were up to date on our COVID vaccinations.  That would make it very unlikely that we would get COVID.  But our concern is that if anyone else on the ship gets COVID it will result in itinerary changes or even an early end to the cruise.  So while we agree with you on protecting ourselves we also think a cruise needs to do everything possible to avoid even a single case of COVID.

 

Hank

[clo]

1 hour ago, Hlitner said:

But I would not go on a cruise unless both DW and I were up to date on our COVID vaccinations.  That would make it very unlikely that we would get COVID. 

No, but you could get it and transmit it.

[crazyank]

On 2/28/2021 at 7:47 PM, Underwatr said:

Based on my experience - choose the private hospital over the public hospital.

 

But given that AFAIK any of the available vaccines are sufficient to keep you out of the hospital should you contract COVID away from home, the first priority is to travel vaccinated, stay home until then.

Completely agree, get vaccinated or stay home.

[crazyank]

On 2/28/2021 at 10:32 PM, evandbob said:

Many countries are requiring COVID insurance for entry. 

Please name a few and quote your source.  We can't seem to find this info.

[ilikeanswers]

10 minutes ago, crazyank said:

Please name a few and quote your source.  We can't seem to find this info.

 

Countries That Require Covid-19 Travel Insurance

 

Aslso read somewhere that Singapore cruises require passengers to buy Covid Isnaurance

[Hlitner]

9 hours ago, clo said:

No, but you could get it and transmit it.

The idea is that if everyone on a vessel has been vaccinated it is very unlikely that anyone would get COVID.   Is that a perfect scenario?  No, but perfection does not exist when it comes to vaccines and disease.  In fact, if you want a 100% guarantee before you travel then you just as well forget traveling for the next few thousand years.  

 

As to asymptomatic spread from those who have been vaccinated that appears to be more theory then fact.  It is not a good thing to believe that our leaders and experts have lied to us (remember when they said wearing masks was dangerous?).  But Rand Paul did raise a point (last week) during a confirmation hearing of a so-called expert when he asked is there any science that proves a vaccinated person can spread COVID?  No answer!   But consider any other vaccination and ask yourself, do we lockdown the world (and the person) after they have been vaccinated?   Because if that is the new standard then the world is going to be in a permanent lockdown.

 

Hank

[iancal]

Our out of country medical/evac insurance, to our suprise, covers covid.  

 

There is a great deal of false information floating around about covid.   Often disseminated by those who are simply repeating nonsense from Dr. Facebook or by those with an agenda.

 

Our knowledge base of covid is growing but there are still many unknowns.  Better to have a scientist remain silent on an issue than make an opinion statement that could be misinterpreted as fact.

 

When it comes to those misleading or lying to us....who would you choose??  A health care professional, a scientist, etc. or a self serving politician.

 

Edited March 6, 2021 by iancal

[TheOldBear]

1 hour ago, Hlitner said:

The idea is that if everyone on a vessel has been vaccinated it is very unlikely that anyone would get COVID.   Is that a perfect scenario?  No, but perfection does not exist when it comes to vaccines and disease.  In fact, if you want a 100% guarantee before you travel then you just as well forget traveling for the next few thousand years.  

 

As to asymptomatic spread from those who have been vaccinated that appears to be more theory then fact.  It is not a good thing to believe that our leaders and experts have lied to us (remember when they said wearing masks was dangerous?).  But Rand Paul did raise a point (last week) during a confirmation hearing of a so-called expert when he asked is there any science that proves a vaccinated person can spread COVID?  No answer!   But consider any other vaccination and ask yourself, do we lockdown the world (and the person) after they have been vaccinated?   Because if that is the new standard then the world is going to be in a permanent lockdown.

 

Hank

 

The asymptomatic spread conjecture [conjecture is 'weaker' than a theory ] so far seems to have no supporting evidence. One would think that attempts to 'track and trace' new infections would have reported at least one instance [and received widespread coverage].

 

I do recall an anecdote from about this time last year claiming asymptomatic transmission [UK citizen at a business meeting in Germany] but it turned out that it was not asymptomatic at all - the patient was aware they were sick, and taking over the counter cold medicine.

[evandbob]

By this Monday, both of us will have received our 2nd COVID shot.  Our next booked cruise is in December, 8 months away.  We'll be hoping that should be enough time to get a majority of citizens vaxxed as well as 100% of the crew.

 

And we suspect that the cruise lines will require proof of Vax during the boarding process.

[Hlitner]

1 hour ago, TheOldBear said:

 

The asymptomatic spread conjecture [conjecture is 'weaker' than a theory ] so far seems to have no supporting evidence. One would think that attempts to 'track and trace' new infections would have reported at least one instance [and received widespread coverage].

 

I do recall an anecdote from about this time last year claiming asymptomatic transmission [UK citizen at a business meeting in Germany] but it turned out that it was not asymptomatic at all - the patient was aware they were sick, and taking over the counter cold medicine.

I will confess to having worked in the government healthcare industry for over 35 years :(.  While this leaves me with a lot of respect for many hard working government professionals it also leaves with me with what I would call a "healthy degree of skepticism."  There are times when those in the upper reaches of our government (beyond my old pay grade) feel it is appropriate to "slant" comments to achieve what they think is the greater good.  There are times when some officials and politicians do not give us the whole truth because they perceive the public to be incapable of dealing with truth.  It is also a veiled attempt to control public behavior.  So, for example, telling folks that wearing masks is dangerous of that any kind of mask will do are seen as a justified lie to discourage the public from purchasing good masks (such as N95, KN95, and KF95) because they want to reserve those for healthcare workers (a good thing) and themselves and friends (not a good thing).    Telling folks they need to keep wearing masks (even lousy quality masks) weeks after they have been vaccinated (and built up their immunity) also seems to be an attempt to avoid having part of the public maskless while others are masked.  Instead of telling vaccinated folks that they do not need masks and telling those that have not been vaccinated that they must continue to be very cautious and wear masks it is more expedient to tell everyone to maximize caution.  After all, we cannot trust the general public to do the right thing and actually use a degree of personal responsibility.  We know need Big Brother to control every aspect of our lives :(.  So, for example, when the Governor of Texas drops Statewide mandates and urges folks to use "personal responsibility" and appropriate mitigation he is referred to as a Neanderthal.  After all, we cannot allow the public to use their free will, common sense, etc.

 

Hank

P.S.  By the way, researchers now think that Neanderthals were pretty intelligent.  Perhaps some of our politicians could rise to that level 🙂

 

Hank

[ldubs]

17 hours ago, Hlitner said:

Ahh, so now you are getting into the "exceptions" I mentioned which few folks know exist.  Yes, it is true that in some rare circumstances when folks live near the border where healthcare is easily accessible in Canada but too far away in the USA...we might pay the Canadian system (folks in that situation are aware of the rule).  Likewise, there are some Canadians along the border that may be able to get covered by the Canadian system for a similar reason.  So, just for fun here are the other exceptions.  If you are transiting between Alaska and the Lower 48 (or vice versa) and you need emergency care while enroute....Medicare will pay for care in Canada.  And the other rule (which is very interesting for cruisers) is that there is an obscure rule that says Medicare will cover care on a ship if it is within 6 hours of the USA!   That last rule is very interesting  because it is codified in terms of hours!  I once asked a Medicare buddy (I worked at the State level) for the proper interpretation of that 6 hour rule and got a big laugh.   Nobody knows exactly what it means.   If a ship like the QM2 that can make 30 knots is 150 miles off the coast that would be (in theory) within 6 hours.  And if a normal cruise ship with a top speed of 18 knots was 150 miles off shore they could not possibly be within 6 hours.   This rule is rarely used but is usually used in a case where a ship has embarked from a US port and somebody gets sick within 6 hours of embarkation.  But that is not the technical language so who knows what it means?

 

Hank

 

The simplified policy language!  Exceptions to exclusions -- so easy to read.  Lol.  

[frantic36]

7 hours ago, Hlitner said:

  So, for example, when the Governor of Texas drops Statewide mandates and urges folks to use "personal responsibility" and appropriate mitigation he is referred to as a Neanderthal.  After all, we cannot allow the public to use their free will, common sense, etc.

 

 

Hank as an outsider looking in I must say that over the last year I saw many cases of people taking no personal responsibility in the States.Though to be fair I do know many who have taken mask wearing etc seriously. As Australians we have been amazed at this lack of caution.

[donaldsc]

On 3/4/2021 at 5:14 PM, ilikeanswers said:

 

That is very true. Just travelling around Australia a supposedly developed first world nation and you can still easily find yourself too far from medical care🤕. 

 

However, in Australia they have a volunteer organization called the Flying Doctors that will do their best to get you to an appropriate medical facility.  When we did our 3 month Australia trip, I fell while hiking on a tour and gashed my face really badly with a whole lot of blood.  They were discussing calling the Flying Doctors for me.  Turned out that they were able to stabilize my wounds and then they drove me 90 miles to the nearest hospital where I got wonderful care.  Of course, if I had a heart attack or a stroke instead of the facial wounds, I would have been dead because of where I was but such is life.  I am not going to base travel decisions on the availability of medical facilities.

 

DON

[Hlitner]

21 minutes ago, frantic36 said:

 

 

Hank as an outsider looking in I must say that over the last year I saw many cases of people taking no personal responsibility in the States.Though to be fair I do know many who have taken mask wearing etc seriously. As Australians we have been amazed at this lack of caution.

We agree.  Bottom line is that those who refuse to take this seriously do not listen to the government or anyone else.  But you can consider me a libertarian who does not want to live in a society where government acts as my mother, grandmother, father, grandfather, keeper, etc.  If I had my way nobody working at the high end of our Federal government would get vaccinated until everyone else on earth (including all the illegal immigrants they love) had gotten their shots.  And I also would not allow anyone in our government to get paid until Congress passed a real budget.  And finally I would require that everyone working in Congress must work at least 250 days a year (in Washington).

 

Hank

[clo]

1 hour ago, donaldsc said:

Of course, if I had a heart attack or a stroke instead of the facial wounds, I would have been dead because of where I was but such is life.  I am not going to base travel decisions on the availability of medical facilities.

One of our adult daughters and family (kids 5 and 9) at least once a year go "off the grid" for a week at a time. Life is short. I agree with you.