Travel Insurance

[lmcdonnold]

Does Royal Caribbean have good insurance or should you go with other companies?

[klfrodo]

Too many variables in your question to help you with your decision.

What do you want to insure against?

Do you even know what travel insurance covers vs. what it does not cover?

Is RCCL travel insurance adequate? Yes? Does RCCL travel insurance cover my needs? No.

$25K of medical is woefully too low for me.

[ljones]

Klfrodo -

 

I see you live in WA State.  I sent an email to the Insurance Commissioner about Annual Travel Insurance and received a reply with very "slim pickings".  Do you have Annual Insurance?  I am looking toward perhaps Chase Sapphire Preferred + more Medical if can't find an Annual Plan..

 

Have Medicare Advantage Plan that is Primary & covers Worldwide...think what I have been getting is not worth the cost.   Just looking for ideas.

[klfrodo]

3 hours ago, ljones said:

Klfrodo -

 

I see you live in WA State.  I sent an email to the Insurance Commissioner about Annual Travel Insurance and received a reply with very "slim pickings".  Do you have Annual Insurance?  I am looking toward perhaps Chase Sapphire Preferred + more Medical if can't find an Annual Plan..

 

Have Medicare Advantage Plan that is Primary & covers Worldwide...think what I have been getting is not worth the cost.   Just looking for ideas.

I do not have annual travel insurance.

I do have CSR card and working with Steve at Trip Insurance Store I buy the TravelSafe Washington policy for $35pp each trip. I put in a trip cost of $500pp. This pretty much cancels out any Trip Cancellation and such (but does give me 150% of trip cost in case I need to spend an extra night in a hotel or change a flight or something), but more importantly gives me $100K in medical (Primary,,, so no need to send into Medicare only to wait for denial)and $250K evac and repatriation. There is no provision with this policy for Washington residents where you must insure the full trip to waive pre-existing conditions.

 

Note: I'm not a Medicare expert (Hank is pretty close though) but I would recommend that you take another look at your Advantage Plan. Some of them have a limited lifetime payout.

Edited November 6, 2021 by klfrodo

[Hlitner]

We find the Medicare situation interesting.  Like Ljones, we have a Medicare Advantage Plan (Aetna PPO) that provides worldwide coverage for both Urgent and Emergency Care.  While that sounds good the devil is always in the details and the question is just how much will they pay on foreign medical bills?  To be very honest I do not know the answer (not sure anyone else has a good answer) but I suspect they would likely use some kind of formula in order to pay less then an entire claim.   The thing about Medicare is while basic Medicare does not provide coverage outside the USA and its territories (with two rare exceptions) some of the Advantage Plans offer some foreign coverage.  If you ever bother to read your Explanation of Benefits (EOBs) you will find that all Medicare providers (including Advantage Plans) pay a relatively small percentage of what is billed (called Charges).  Since Medicare Providers (which is just about all US hospitals and a majority of physicians) are obligated to accept Medicare Payments as payment in full (subject to deductibles) we patients only pay our annual deductable.  But no foreign medical provider is enrolled with Medicare and have no obligation to accept anything less than their billed charges.  

 

But the way it usually works is that you (the patient) will need to settle all the foreign medical bills on the spot.  This is where having a major credit card with a very high limit comes in very handy :).  Once you get back home you can submit a claim (assuming you have all the necessary documents) and will possibly get reimbursed within a couple of months (do not hold your breath).   If your travel insurance is not primary they can (and often do) demand that you first submit the claim to your primary provider (which could be your Medicare Advantage Plan) and wait for that plan to settle the claim (with you).  Once you get the EOB from Medicare (this can often take at least 2 months) you would then submit that along with all the other supporting medical documents in order to get the claim processed by your travel insurance provider.   All this is a hassle but eventually you should recover most of the claim.  But meanwhile many folks have issues because they are out all that money for many months.  But if you rely completely on a Medicare Advantage Plan (that covers foreign claims) you might find yourself in a situation where the Advantage Plan only pays a part of your claim and you would be out the rest.

 

When DW was treated in Osaka Medical Center (a major teaching hospital) we were taken to the accounting department as part of the discharge process where they insisted on full payment before we could leave the hospital.  I have no clue what would have happened if we did not have the ability to pay...but I imagine they have a huge kitchen with lots of dishes to wash :).

 

Hank

[ljones]

Thanks to both.  I have Kaiser Medicare Advantage (WA State).  I called & hopefully got correct info (asked for the entire Evidence of Coverage booklet & have it pretty marked up!:

 

My coverage is PRIMARY but, as it explains, I will be REIMBURSED for my 'OUT-of- NETWORK' (Worldwide) expenses - "that would have been covered had you received them from a network provider" AND the services were necessary to treat an unforeseen illness or injury to prevent serious deterioration of your health."  There are also examples of 'Emergencies' and 'Urgent"... 

 

It also has the requirements to get "Prior approval"   But - for example, "Ambulance Service" is shown to include: fixed wing, rotary wing, and ground ambulance services to the nearest appropriate facility ...if other means of transportation could endanger the person's health or if authorized...MY plan cost for a one-way trip is $150.00 (in Network - the plan does not separately list 'out-of-network' cost.  But I have a maximum annual Out-of-Pocket plan of $2,500.00 which I was told is regardless of In or Out of Network...of course, it was just from a voice on the phone...but she was looking through HER information on MY plan.  I did not ask - and do not see - a Lifetime Maximum.  Will need to make another call with more questions!

 

I was thinking of getting the Chase Preferred card for a bit of extra coverage beyond Medical or perhaps Allianz AllTrip plan - any additional info on those?   Will also check the TravelSafe WA policy - so far, the only Multi-trip plan I've found covering WA is the Allianz Plan

[ljones]

20 hours ago, klfrodo said:

I do not have annual travel insurance.

I do have CSR card and working with Steve at Trip Insurance Store I buy the TravelSafe Washington policy for $35pp each trip. I put in a trip cost of $500pp. This pretty much cancels out any Trip Cancellation and such (but does give me 150% of trip cost in case I need to spend an extra night in a hotel or change a flight or something), but more importantly gives me $100K in medical (Primary,,, so no need to send into Medicare only to wait for denial)and $250K evac and repatriation. There is no provision with this policy for Washington residents where you must insure the full trip to waive pre-existing conditions.

 

Note: I'm not a Medicare expert (Hank is pretty close though) but I would recommend that you take another look at your Advantage Plan. Some of them have a limited lifetime payout.

 

[ljones]

How are you able to under-report the amount of your travel and get coverage for a Country far outside WA / US?  Wouldn't the insurance company question the amount you paid for the "Total Expenses / Trip" in order to receive Evacuation or even Medical in a distant location?  The Insurance Companies  are so determined NOT to pay - I would think they might investigate the $500.00 estimate.  

[GeezerCouple]

31 minutes ago, ljones said:

How are you able to under-report the amount of your travel and get coverage for a Country far outside WA / US?  Wouldn't the insurance company question the amount you paid for the "Total Expenses / Trip" in order to receive Evacuation or even Medical in a distant location?  The Insurance Companies  are so determined NOT to pay - I would think they might investigate the $500.00 estimate.  

This works for policy types that do *not* require insuring the full trip cost.

 

GC

[ljones]

I'd like to know which they are...and that ANYONE has been paid for an Evacuation from a location that is further than $500.00 could get you. 

 

For the State of WA I spent decades as an Investigator & presented cases for Criminal prosecution:  Fraud cases, including Welfare Fraud, Vehicle Fraud (on Task Force w/ WSP) & Business Fraud.  However, I met many Insurance, Bank & Credit Card Fraud Investigators during Countywide meetings.  

 

In order to present documentation necessary for the payout of any large claim, you have to have the Evidence:  In this case, Plane tickets, travel documents, possibly (and more often than you would suspect) a photo copy of your Passport showing where you traveled to.  I never was a Private Insurance Fraud Investigator but I highly doubt they would pay out Thousands or Hundreds of Thousands of dollars for a Policy that cost $34.00 for a Covered $500.00 trip that isn't verified as such. 

 

In WA State - a fraud against the State will cost you not only what was rightfully due the State but an additional 50% penalty and interest on the payment from the date the fraud began.

 

I suggest people be careful and aware that Large Insurance claims will Not be taken at face value...you may end up not only denied the very expensive claim but much more. 

Edited November 6, 2021 by ljones
addition

[klfrodo]

I'M not a lawyer but the policy clearly states that if you buy this policy the policy covers up to $100K in Medical and $250K in Evac and repatriation.

It does not say we prorate coverage on how much you insure your trip for.

It does say that if you need to cancel for a covered reason, it will pay up to 100% of trip cost. It does say that if you experience a Trip Interruption within the definition of Trip Interruption, it will pay up to 150% of trip costs.

Nowhere does the policy say that medical or evac is based on a % of trip cost.

[ljones]

It's not me you'd have to convince.  They have investigators AND lawyers and most likely fine print you have not read in the Certificate of Coverage.  But if you have and you are comfortable with your coverage, enjoy.  I'm retired.

Edited November 6, 2021 by ljones
addition

[ljones]

On 11/5/2021 at 8:48 PM, Hlitner said:

While that sounds good the devil is always in the details and the question is just how much will they pay on foreign medical bills?  To be very honest I do not know the answer (not sure anyone else has a good answer) but I suspect they would likely use some kind of formula in order to pay less then an entire claim. 

I found the following on my Kaiser Medicare Advantage Plan:  You must have plan authorization prior to seeking care from an out-of-network provider for services to be covered. You will pay the same for authorized out-of-network services as you would pay if you got the care from a network provider. **  If you obtain routine care from out-of-network providers neither Medicare nor Kaiser Permanente will be responsible for the costs."

 

Note that it is not specific to Foreign Medical bills but was told previously that it is simply "Out-of-Network"...of course when the lawyers dive into the weeds - who knows what they will determine.

[Hlitner]

44 minutes ago, ljones said:

I found the following on my Kaiser Medicare Advantage Plan:  You must have plan authorization prior to seeking care from an out-of-network provider for services to be covered. You will pay the same for authorized out-of-network services as you would pay if you got the care from a network provider. **  If you obtain routine care from out-of-network providers neither Medicare nor Kaiser Permanente will be responsible for the costs."

 

Note that it is not specific to Foreign Medical bills but was told previously that it is simply "Out-of-Network"...of course when the lawyers dive into the weeds - who knows what they will determine.

The word that jumps out at me in what you posted is "authorized."  Wonder what that means?  KP is an excellent HMO company but one most always be cautious with HMOs since they generally treat Out-of-Network services somewhat differently when it comes to reimbursement.   What I like about some PPOs (such as the one we have from Aetna) is they no longer have a network.  That being said there is always the question of what they will pay a non Medicare enrolled provider.  I truly have no idea and since we have GeoBlue I will not likely ever find out :).

 

Hank

[ljones]

6 hours ago, Hlitner said:

"authorized."  Wonder what that means? 

It means:  You or a representative for you must call (was given a number if Out-of-Country) PRIOR to any service (who thinks about that in an emergency?!) and have the service "authorized" in advance.  I taped the phone number on my Medical card (& will make sure anyone traveling with me is aware of it.)  If it is not "authorized", you are not covered. 

 

I have also noticed that MANY insurance plans have the same requirement & I'm afraid many people don't read through the "weeds" of the policy to know exactly what is & what is not covered...Generally, it is very limited & strictly to the letter.  The majority of 1 *  reviews complain about things that are NOT covered but people believe simply reading the word "Cancellation" coverage means for ANY reason...  And wringing compensation from Insurance companies can be a 'match of wills' - they often request massive documentation...

[Hlitner]

8 minutes ago, ljones said:

It means:  You or a representative for you must call (was given a number if Out-of-Country) PRIOR to any service (who thinks about that in an emergency?!) and have the service "authorized" in advance.  I taped the phone number on my Medical card (& will make sure anyone traveling with me is aware of it.)  If it is not "authorized", you are not covered. 

 

I have also noticed that MANY insurance plans have the same requirement & I'm afraid many people don't read through the "weeds" of the policy to know exactly what is & what is not covered...Generally, it is very limited & strictly to the letter.  The majority of 1 *  reviews complain about things that are NOT covered but people believe simply reading the word "Cancellation" coverage means for ANY reason...  And wringing compensation from Insurance companies can be a 'match of wills' - they often request massive documentation...

Good job reading through the boring stuff :).  Most folks never read the details which is where they truly hide the devil.  If you look at some travel policies such as the Global Blue Annual Trekker Plan (I buy this policy) you will not see any of that similar language.   That being said we have often posted here (and elsewhere) that when you get into a medical situation overseas, it can be very wise if somebody can get on the phone to the insurance company in real time.  When my DW was being treated (with outpatient surgery) in Osaka, Japan, I was right outside the procedure room on my cell phone to the GeoBlue folks (who immediately opened a case file) advising them that we would likely need their help.  This ultimately led to medical evacuation at a cost in excess of $10,000 (so cheap because we could use a commercial flight (lay flat seat).

 

But getting the insurer involved at an early stage and continuing daily contact (the cruise ship physician was also involved in telephoning the insurance company case manager) paved the way for a pretty smooth process.  There was some give and take when it came to the medical evacuation, but the ship's physician eventually convinced the insurance companies medical director that evacuation was in everyone's best interest.    But my point is that we got them involved, kept them advised, and worked through some issues.  When I finally filed our claim (it took me a few weeks to put it all together) GeoBlue paid every penny (except for one transportation by taxi bill) in about 3 weeks.  Since they were already familiar with the case through their own nurse case manager they had no follow-up questions (which saved a lot of time).

 

Hank

 

[ljones]

12 hours ago, Hlitner said:

where they truly hide the devil. 

Indeed it is...I am unable to buy virtually any annual plans (Thank you WA State)...but in looking at one that I seem able to has this:  

 

'OUR MEDICAL TEAM WILL CONSULT WITH THE LOCAL DOCTOR

WE WILL IDENTIFY THE CLOSEST APPROPRIATE HOSPITAL...

WE WILL ARRANGE AND PAY FOR A MEDICAL ESCORT IF WE DETERMINE ONE IS NECESSARY

 

YOU OR SOMEONE ON YOUR BEHALF MUST CONTACT US, AND WE MUST MAKE ALL TRANSPORTATION ARRANGEMENTS IN ADVANCE.  IF WE DID NOT AUTHORIZE AND ARRANGE THE TRANSPORTATION, WE WILL ONLY PAY UP TO WHAT WE WOULD HAVE PAID IF WE MAD THE ARRANGEMENTS.  (Freudian slip? - or Perhaps it was mine in copying it!)

 

MUST BE "MEDICALLY NECESSARY"...

 

Additionally, my Health Insurance has the same requirement to receive advance Authorization as well.  

 

There are MANY "gotchas" in Insurance policies - which generally go unread.

[Hlitner]

yep lots of "gotchas" in the insurance world.  Just as an example you will often see posts and hear praise given to MedJetAssist for their expansive evacuation insurance.  No question it is the Cadillac of evacuation policies and folks think they can simply snap their fingers and get evacuation from just about any foreign country to the country/hospital of their choice.  But alas the "gotcha" is you must be an inpatient in a hospital transferring to another hospital....but to do so your "attending physician," the physician at the receiving hospital" and the insurance folks must all agree.  The catch is that if your attending physician does not think it is medically necessary or medically appropriate, you are generally not going to get your transfer.   So, for example, consider a person who is in Mexico and comes down with a very bad case of COVID.  In Mexico there are still physicians that make house calls.  And assume the physician treating you says that you do not need to be hospitalized and will manage your case in your hotel/condo.  You are going to be there for weeks (probably at your own expense) while your body slowly recovers from a serious illness and will not get the OK for travel for at least a month.

 

Well Medjetassist and probably no other evacuation program will do anything to help.  A real bummer and this scenario has happened to many in the past 2 years.   But assume your evacuation coverage is provided by the same policy as your trip medical insurance.  You then have a little leverage because you can say to your insurance companies case manager, "I am going to be stuck here for many weeks and your policy is responsible to cover all the medical bills."   "On the other hand, if you can somehow get me transferred home then you would no longer be on the hook for any additional costs."  Would this work?  Perhaps...perhaps not.  But if the insurance company thinks that paying for evacuation is a better financial gamble then leaving you in that foreign country and running the risk of spending a lot more for medical bills they might just bite.

 

Hank

[Babr]

1 hour ago, ljones said:

Indeed it is...I am unable to buy virtually any annual plans (Thank you WA State)...but in looking at one that I seem able to has this:  

 

'OUR MEDICAL TEAM WILL CONSULT WITH THE LOCAL DOCTOR

WE WILL IDENTIFY THE CLOSEST APPROPRIATE HOSPITAL...

WE WILL ARRANGE AND PAY FOR A MEDICAL ESCORT IF WE DETERMINE ONE IS NECESSARY

 

YOU OR SOMEONE ON YOUR BEHALF MUST CONTACT US, AND WE MUST MAKE ALL TRANSPORTATION ARRANGEMENTS IN ADVANCE.  IF WE DID NOT AUTHORIZE AND ARRANGE THE TRANSPORTATION, WE WILL ONLY PAY UP TO WHAT WE WOULD HAVE PAID IF WE MAD THE ARRANGEMENTS.  (Freudian slip? - or Perhaps it was mine in copying it!)

 

MUST BE "MEDICALLY NECESSARY"...

 

Additionally, my Health Insurance has the same requirement to receive advance Authorization as well.  

 

There are MANY "gotchas" in Insurance policies - which generally go unread.

I’m not surprised that the insurance company plays a prominent role in the evacuation process. In fact, I thought that is the way they all worked. An evacuation is a medically necessary move from hospital to hospital with the concurrence of the attending physician, the receiving physician, and the insurance company. To be sure, they don’t want to be on the hook for costly transportation if you can be cared for where you are. On the other hand, they do not want to be responsible for denying life-saving treatment or for continued high level care if you can reasonably be transferred.

 

The difference in the evacuation only policies like MedJet is that you do have a voice in the decision, but there are still restrictions as outlined on their website. I suppose during the worst of Covid there were some instances where the receiving physician at the hospital of your choice could not accept a patient.

[ljones]

1 hour ago, Babr said:

but there are still restrictions as outlined on their website.

That is the Main point.  Many times people are unaware of the restrictions...it is in the Fine Print.

[ljones]

I've also often found in many / most Legal Documents - including insurance - the following (or similar) wording:

 

"Concealment and Misrepresentation":  The entire coverage will be void, if before, during or after a loss, any material fact or circumstance relating to this Policy or claim has been concealed or misrepresented."

 

LEGAL:  A material fact is a piece of information that is vital to evaluating and interpreting a subject matter in legal documents. This means that it is necessary, significant or essential to a reasonable person when deciding whether or not to engage in a particular transaction. In insurance, material facts are used to determine the amount of coverage and the cost of the premium that will be charged.

 

Here's to all staying safe and secure in their travels.

[iamtrustworthy]

19 hours ago, ljones said:

I've also often found in many / most Legal Documents - including insurance - the following (or similar) wording:

 

"Concealment and Misrepresentation":  The entire coverage will be void, if before, during or after a loss, any material fact or circumstance relating to this Policy or claim has been concealed or misrepresented."

 

LEGAL:  A material fact is a piece of information that is vital to evaluating and interpreting a subject matter in legal documents. This means that it is necessary, significant or essential to a reasonable person when deciding whether or not to engage in a particular transaction. In insurance, material facts are used to determine the amount of coverage and the cost of the premium that will be charged.

 

Here's to all staying safe and secure in their travels.

Hi ljones,

 

If someone buys a trip cancellation and they insure a $500 per person trip cost (even if their trip was more expensive), the most money they will receive, if have a Trip Cancellation claim for a covered reason, is a $500 per person reimbursement. Even if they claimed a larger loss they still will only get a $500 per person reimbursement.

 

If they have any other covered claim, they are reimbursed to the policy maximum for that particular coverage.

 

Choosing to insure a trip cost that is less than the full trip cost is not "Concealment and Misrepresentation".

 

"Concealment and Misrepresentation" refer to things like date of birth and State or County of residence. I currently have someone who already told me they live in New Your State trying to convince me that they live in Georgia because the plan they want to buy isn't available for NY.

 

I said they can't buy it as a GA resident and they said they are taking their business elsewhere. That's fine with me.

 

If they buy a policy as a GA resident, they will have any claims denied due to the "Concealment and Misrepresentation" principle.

 

Steve Dasseos

[ljones]

20 hours ago, ljones said:

A material fact is a piece of information that is vital to evaluating and interpreting a subject matter in legal documents. This means that it is necessary, significant or essential to a reasonable person when deciding whether or not to engage in a particular transaction. In insurance, material facts are used to determine the amount of coverage and the cost of the premium that will be charged.

 

To me the information & definition is straightforward.  For those who disagree, you'll leave the question of interpretation to the lawyers whether insuring an actual documented trip that, for example, cost $5,000.00 but was insured for $500.00 would, in fact, pay $100,000.00 in Medical / Evacuation costs if submitted for payment.  It is not the interpretation / belief of the insured or any assurances, it is the Evidence that will be required & reviewed.  I'm not a lawyer.  Nor do I have the money to loose for being denied by the Insurance provider nor the money to fight those lawyers.  

 

Safe and Secure travels to all.

Edited November 9, 2021 by ljones
addition

[klfrodo]

I'm going with what the Washington State Insurance Commissioner allows, what I would imagine the State Attorney General has determined legal, and what Steve Dasseos who has been in the business for over 20 years recommends.

I do appreciate sharing the concern though.

[ljones]

What does the Washington State Insurance Commissioner allow?  Might be informative to those in ALL states...