newcruzer2 Posted September 25, 2016 #1 Share Posted September 25, 2016 Hopefully like All insurance coverage we don't need it. But knowledge is power so here goes my scenario , to make sure I'm understanding correctly....... Purchased Princess' insurance ,I'm on the ship I slip and fall, twisting my ankle or having a large cut (or something they're just examples). I go to ship doc and the charges go on my ship acct. and I pay. When I return home, I contact travel insurance, they tell me to file with bcbs (out of network) . I have great medical insurance BUT my 'out of network' well its bad :(, as soon as bcbs does EOB not paying, simply applying to my 'out of network's deductible I contact travel insurance and they reimburse me for ship's doctor charges??? Is this correct ??? I mostly ask because this is how I told my DH it works , he is anti-doctor at home so I Really don't see him taking time from his vacation unless it were a necessity. But if I mis-informed him, he'll repeatedly tell the story to annoy me. Ty for the feedback Link to comment Share on other sites More sharing options...
Rare Hlitner Posted September 25, 2016 #2 Share Posted September 25, 2016 You sound like somebody who has worked in the insurance industry :). You have it about right....as most travel medical insurance policies (including Princess) are secondary. Under your scenario the Princess policy would normally reimburse you everything (using their "reasonable and customary" limitations) that was not reimbursed by BC/BS less the deductible. While the cruise line policies are fine for small things....their downside are the very low (by medical insurance standards) coverage limits ($10,000 on the standard policy). But most younger cruisers just do not seem to care about this issue....and in any case, your BC/BS coverage would likely pay the lions share of medical bills in the case of a serious medical problem with high charges. Hank Link to comment Share on other sites More sharing options...
newcruzer2 Posted September 26, 2016 Author #3 Share Posted September 26, 2016 Ty for your reply. You said "less the deductible". Question, as mentioned above my policy thru work is great 100/0 (no deductible, no out of pocket), but that is in-network ONLY ....'out of network' I have an outrageous $8000 deductible , YEAH So if your truly saying ..."less the deductible", I would still have to cover 1st $8000 and travel Insurance would cover over $8000 till limit??? ( not that a twisted anything cost thousands) Link to comment Share on other sites More sharing options...
Rare Hlitner Posted September 27, 2016 #4 Share Posted September 27, 2016 Ty for your reply. You said "less the deductible". Question, as mentioned above my policy thru work is great 100/0 (no deductible, no out of pocket), but that is in-network ONLY ....'out of network' I have an outrageous $8000 deductible , YEAH So if your truly saying ..."less the deductible", I would still have to cover 1st $8000 and travel Insurance would cover over $8000 till limit??? ( not that a twisted anything cost thousands) $8000! Ouch. Such is the modern day insurance benefits. So in your case lets assume you had a legit $7000 claim. As you suggested, it would first be submitted (by you) to your BCBS plan...they might spend the time to reduce your claim to what they consider "customary and reasonable" and then they would apply the deductible and pay zero. Once you received the EOB (Explanation of Benefits) from BCBS, you would submit the claim to the Princess carrier attaching a copy of the EOB. The Princess carrier would review the claim, apply their usual and customary standard (hopefully that does not reduce the claim amount) and then apply their own (Princess deductable). The $8000 deductible of your BCBS policy would not be relevant...so the Princess policy should pay everything less their own small deductible. And if the entire bill was incurred at the ship's medical center...it would be laughable if Princess's own carrier did not accept the entire amount as "usual and customary." Hank Link to comment Share on other sites More sharing options...
newcruzer2 Posted September 27, 2016 Author #5 Share Posted September 27, 2016 MANY thanks for your replys and info. I appreciate you taking the time to answer, this is truly the great part of CC. Thanks again. And here's hoping I won't NEED to put your info to use :) Wishing EVERYONE safe travels :) Link to comment Share on other sites More sharing options...
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