Where do I start for reimbursement of onboard medical expenses?

[socialworker]

I became very ill on a recent Princess cruise. Medical center bill exceeded $4,000. Advised by attending physician to allow them to transfer me to local hospital upon arrival back in port. I declined their “offer” and made it home. Once home, I was hospitalized for 5 days but those expenses are covered by Medicare and my supplement. How do I get an itemized medical bill from Princess? They’ve already been paid by my credit card company.

We are “Elite” with Princess and always purchase the “better” coverage.

Thanks for any help offered.

[TheOldBear]

What paperwork did you receive from the ship's medical center? The 'walk out statement' may contain sufficient detail for the claim - diagnosis codes, procedure codes, medication dispensed, supplies, provider names - and there should be case reference information.

 

Have you checked the fine print on your travel insurance? [e.g. is coverage 'primary' or 'secondary']

 

Have you contacted your broker? The travel insurance carrier?

[Jersey42]

As the previous poster suggested, hopefully you received enough documentation from the medical center in order to file a claim.  If not, I wish you luck in getting what you need after the cruise. Sometime this can be very difficult at best.  If you are successful, please let us know how you did it.

 

If you have the medical documentation, here is what happens next, based on the following assumptions.

• You purchased Princess Platinum insurance through the cruise line (Nationwide policy administered by Aon).
• You have traditional Medicare.
• You have a true Medicare Supplement (i.e. a letter plan) with limited foreign emergency travel coverage.

 

1. Princess coverage is secondary, so you must first file with Medicare.
2. Medicare will deny coverage and forward to the supplement.
3. The supplement should pay 80% of your bill after the $250 deductible. (this assume you have not reached your $50K lifetime maximum).
4. Once you have the EOBs, you can then file with the Princess Plan (through Aon).  It should cover the deductible and co-pay not covered by your supplement.

 

If your supplement does not have foreign emergency travel coverage, then all you need is the Medicare denial to file with Princess. 

 

If my assumptions about what you have are correct, my suggestion for future cruises is to purchase travel medical insurance that pays primary. This simplifies the claims process and avoids using any more of your lifetime maximum for foreign travel.

[Philob]

Also in your policy documents is a "how to file a claim" insert. Online or a phone call will get the process going. 

[jclinard]

My parents ran into this with a Canadian hospital that did not want to provide itemized bills for insurance.  They disputed the charges with their credit card company.  It was funny how not getting paid spurred them into getting an itemized bill.

 

I suspect that is your best course of action.  

[Hlitner]

This may not be helpful to the OP, but could help others.  When you receive medical treatment on a trip or in any foreign country, make sure to get an itemized statement BEFORE you leave.  In the case of Princess there is usually a small charge assessed to give cruisers a detailed statement (most medical insurance will reimburse that small fee).  

 

As to where to start, my first question would be whether your Medicare Plan covers any urgent/emergency care outside the USA.  Some Advantage Plans (such as our Aetna Medicare PPO) does give some coverage.  Otherwise, you should look to any secondary coverage such as from travel insurance (if any) or possibly your credit card (some cards such as higher end Chase and AMEX offer some medical coverage).   If your Medicare plan does not give you coverage, you purchased no travel or travel medical insurance, and your credit card (that you used for the cruise) does not have any coverage...you are probably out of luck and will pay out of pocket.

 

I will again reiterate an important message to all.  When you get medical treatment on a ship or in a foreign country...do not leave without a detailed statement.  Trying to get such a Statement/billing after the fact can prove to be difficult.  In the case of Princess you (or your travel/cruise agent) need to call Princess and request the Statement/Billing and hope for the best.

 

Hank