Hmm.....Emergency Evacuation fine print ??

So, I'm looking at purchasing travel insurance through Nationwide. In reading the fine print regarding Emergency Evacuation, it seems as if it will only cover the evacuation when you need to be transferred from one hospital to another.

If I or a family member gets sick or injured on the ship and needs to be evacuated, is medical on the ship considered a hospital??

The following is from the fine print:

"

The Company will pay benefits for Covered Expenses incurred, up to the Maximum Benefit shown on the Confirmation of Coverage, if an Accidental Injury or Sickness commencing during the course of the Trip results in Your necessary Emergency Evacuation. An Emergency Evacuation must be ordered by a Physician who certifies that the severity of Your Accidental Injury or Sickness warrants Your Emergency Evacuation.

Emergency Evacuation means:

(a) Your medical condition warrants immediate Transportation from the hospital where You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;

(b) after being treated at a local Hospital, Your medical condition warrants Transportation to the United States where You reside, to obtain further medical treatment or to recover; or

© both (a) and (b), above.

Covered Expenses are reasonable and customary expenses for necessary Transportation, related medical services and medical supplies incurred in connection with Your Emergency Evacuation. All Transportation arrangements made for evacuating You must be by the most direct and economical route possible. Expenses for Transportation must be:

(a) recommended by the attending Physician;

(b) required by the standard regulations of the conveyance transporting You ; and

© authorized in advance by the Company or its authorized representative.

Transportation of Dependent Children: If You are in the Hospital for more than seven (7) days following a covered Emergency Evacuation, the Company will return Your unattended Dependent Children accompanying You on the scheduled Trip, to Your next of kin, with an attendant if necessary.

Transportation to Join You: If You are traveling alone and are in a Hospital alone for more than seven (7) consecutive days or if the attending Physician certifies that due to Your Accidental Injury or Sickness, You will be required to stay in the Hospital for more than seven (7) consecutive days, upon request the Company will bring a person, chosen by You, for a single visit to and from Your bedside.

Transportation services are provided if authorized in advance by the assistance provider, and are limited to necessary

Economy Fares less the value of applied credit from unused travel tickets, if applicable.

Transportation means any Common Carrier, or other land, water or air conveyance, required for an Emergency

Evacuation and includes air ambulances, land ambulances and private motor vehicles.

The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip."

IF Medical Evacuation is required from the ship, there is not going to be any cost anyway.

This is going to be done by a highly trained, highly skilled Gov't entity. Usually the US Coast Guard. Could be another countries Coast Guard. These entities do not charge for this service.

Helicopter evacuation from a ship is highly specialized. Not aware of any "for profit" entities that do this.

Here's Nationwide's definition of a "hospital":

"Hospital means a facility that:

(a) holds a valid license if it is required by the law;

(b) operates primarily for the care and treatment of sick or injured persons as in-patients;

© has a staff of one or more Physicians available at all times;

(d) provides twenty-four (24) hour nursing service and has at least one registered professional nurse on duty or call;

(e) has organized diagnostic and surgical facilities, either on the premises or in facilities available to the hospital on a prearranged

basis; and

(f) is not, except incidentally, a clinic, nursing home, rest home, drug or physical rehabilitation facility or convalescent

home for the aged, or similar institution."

Every ship's medical center I've been in would qualify but you never know.

FYI, whenever you find an unusual capitalization of a word in the plan documents that usually means it has a specific definition. this definition will be found in the "definitions" section of the document. For example:

" . . You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;"

Why would hospital be capitalized? Because this is how they let you know that they define exactly what a hospital is under the terms of the policy. The definitions section is where I found the above.

Ok, lets clear up a misconception. If you must leave a ship for medical reasons, most of the time you will be treated in the ship's medical facility, stabilized, and taken off the ship at the next port. If the situation is very serious, they will sometimes divert the ship to a closer port to get the ill passenger off the ship. The passenger will be responsible for the cost of treatment aboard (usually covered by trip or other medical insurance (but not Medicare)) and would also be responsible for the ambulance cost when take from the ship to a hospital. In rare occasions (in forty years of cruising on over 100 cruises we have seen this 3 times) a passenger may need to be evacuated from a ship by helicopter. When this happens, it is usually done by the nearest Coast Guard (or Military) and it is generally done at no cost to the patient.

The emergency evacuation coverage in insurance policies pretty much all use the same language. They only cover emergency evacuation from a "hospital." And in nearly every case, that evacuation must be necessary and approved by the attending physician and the insurance company. Medjetassist...is somewhat different in that the patient has more rights...but even that wonderful policy requires that you first be admitted to a hospital (on land) before they will consider evacuation.

Hank

IF Medical Evacuation is required from the ship, there is not going to be any cost anyway.

This is going to be done by a highly trained, highly skilled Gov't entity. Usually the US Coast Guard. Could be another countries Coast Guard. These entities do not charge for this service.

 

Helicopter evacuation from a ship is highly specialized. Not aware of any "for profit" entities that do this.

Well yeah, DUH! (slaps forehead) I knew that. lol Think I had a brain fart. Thanks.

Every ship's medical center I've been in would qualify but you never know.

 

FYI, whenever you find an unusual capitalization of a word in the plan documents that usually means it has a specific definition. this definition will be found in the "definitions" section of the document. For example:

 

" . . You are first taken when injured or sick to the nearest Hospital where appropriate medical treatment can be obtained;"

 

Why would hospital be capitalized? Because this is how they let you know that they define exactly what a hospital is under the terms of the policy. The definitions section is where I found the above.

Thanks a bunch. With only one cruise under my belt, I'm still very much a new cruiser. Trying to decipher the legal mumbo jumbo can be daunting sometimes.

The emergency evacuation coverage in insurance policies pretty much all use the same language. They only cover emergency evacuation from a "hospital." And in nearly every case, that evacuation must be necessary and approved by the attending physician and the insurance company. Medjetassist...is somewhat different in that the patient has more rights...but even that wonderful policy requires that you first be admitted to a hospital (on land) before they will consider evacuation.

 

Hank

Thanks a bunch, Hank. This is my first time purchasing trip insurance. Can you tell? :D

Thanks a bunch, Hank. This is my first time purchasing trip insurance. Can you tell? :D

I have been doing a lot of research on this and some policies do seem to declare only hospital to hospital. Not all helicopter evacuations are free. I knew someone who had one off an Alaska cruise and it cost his trip insurance around $30,000. He had had a heart attack.

I would call the insurance company or emial and get something in writing that they will cover evacuation off a ship. the US coastguard does not evacuate outside of the 3mile us limits. I was on a cruise when 7 people were evacuated over a period of 5 days. It is not that rare. Broken bones, heart attacks and all sorts of things that can't be cared for onboard. Go to insure my trip .com and compare insurance. If you don't want cancellation insurance (my credit card covers this up to $10.000) then you have more options and it is less costly. I have an email from Allianz Global assistance that their evacuation includes from a cruise ship if it is deemed necessary. I may not go with them. Other policies have medical coverage that is primary not secondary which is better for me. I am looking for an annual policy as I have multiple trips this year.

the US coastguard does not evacuate outside of the 3mile us limits.

WRONG ... HUGE WRONG

Evacuation ...

Having neutral been in this situation, you won't need emergency evacuation unless you are going to be checked into another hosital.

If your condition allows you to travel home, that does not merit a helicopter or a medjet.

Hope that helps.

I have been doing a lot of research on this and some policies do seem to declare only hospital to hospital. Not all helicopter evacuations are free. I knew someone who had one off an Alaska cruise and it cost his trip insurance around $30,000. He had had a heart attack.

 

I would call the insurance company or emial and get something in writing that they will cover evacuation off a ship. the US coastguard does not evacuate outside of the 3mile us limits. I was on a cruise when 7 people were evacuated over a period of 5 days. It is not that rare. Broken bones, heart attacks and all sorts of things that can't be cared for onboard. Go to insure my trip .com and compare insurance. If you don't want cancellation insurance (my credit card covers this up to $10.000) then you have more options and it is less costly. I have an email from Allianz Global assistance that their evacuation includes from a cruise ship if it is deemed necessary. I may not go with them. Other policies have medical coverage that is primary not secondary which is better for me. I am looking for an annual policy as I have multiple trips this year.

Just an FYI - When filing a claim on a Primary policy, if you check the box asking if you have any other medical insurance policies, the Primary insurance purchased is automatically processed as Secondary.

Just an FYI - When filing a claim on a Primary policy, if you check the box asking if you have any other medical insurance policies, the Primary insurance purchased is automatically processed as Secondary.

???? Never heard of that happening. They can't market a plan as being primary to any other coverage you might have then do the opposite. Insurance regulators would be all over them. And if I was the insurance company now being stuck for the bill because of this there would be hell to pay.

Just an FYI - When filing a claim on a Primary policy, if you check the box asking if you have any other medical insurance policies, the Primary insurance purchased is automatically processed as Secondary.

Then it is not a primary policy!

I have been doing a lot of research on this and some policies do seem to declare only hospital to hospital. Not all helicopter evacuations are free. I knew someone who had one off an Alaska cruise and it cost his trip insurance around $30,000. He had had a heart attack.

 

I would call the insurance company or emial and get something in writing that they will cover evacuation off a ship. the US coastguard does not evacuate outside of the 3mile us limits. I was on a cruise when 7 people were evacuated over a period of 5 days. It is not that rare. Broken bones, heart attacks and all sorts of things that can't be cared for onboard. Go to insure my trip .com and compare insurance. If you don't want cancellation insurance (my credit card covers this up to $10.000) then you have more options and it is less costly. I have an email from Allianz Global assistance that their evacuation includes from a cruise ship if it is deemed necessary. I may not go with them. Other policies have medical coverage that is primary not secondary which is better for me. I am looking for an annual policy as I have multiple trips this year.

Nobody has said, "all helicopter evacuations are free." What we have said is that helicopter evacuations from a cruise ship are free. That is because those evacuations are done by government agencies (Coast Guard or sometimes the military) who do not charge for their services. Once ashore, you will likely pay for any additional evacuation whether it be by air, sea, or ground.

Hank

Nobody has said, "all helicopter evacuations are free." What we have said is that helicopter evacuations from a cruise ship are free. That is because those evacuations are done by government agencies (Coast Guard or sometimes the military) who do not charge for their services. Once ashore, you will likely pay for any additional evacuation whether it be by air, sea, or ground.

 

Hank

This is a quote from Squaremouth who are a search engine for travel insurance. You are correct in that in US waters the Coast guard evacuates for free. They don't, however come to Antartica or Europe or even Mexico to evacuate American cruise ship passengers. It may be that the Mexican equivalent of the Coast Guard does it for free but I am not willing to bet on it.

'Since the costs to medically transport someone can increase the further away they are from home, understanding how much medical evacuation is necessary could alleviate many potential financial burdens. Getting someone home from a resort within in the U.S. may only cost $20,000. At the other end of the scale, evacuating someone from a cruise ship in Antarctica to a hospital in Argentina, then to the United States, could total hundreds of thousands of dollars.

Squaremouth recommends choosing the amount of medical evacuation insurance based on the destination and type of trip. For example, $100,000 in evacuation coverage should be enough protection for a cruise to the Carribbean, however, travelers visiting Asia or Africa may want to consider a travel insurance policy with at least $250,000 in evacuation coverage.'

This is a quote from Squaremouth who are a search engine for travel insurance. You are correct in that in US waters the Coast guard evacuates for free. They don't, however come to Antartica or Europe or even Mexico to evacuate American cruise ship passengers. It may be that the Mexican equivalent of the Coast Guard does it for free but I am not willing to bet on it.

 

'Since the costs to medically transport someone can increase the further away they are from home, understanding how much medical evacuation is necessary could alleviate many potential financial burdens. Getting someone home from a resort within in the U.S. may only cost $20,000. At the other end of the scale, evacuating someone from a cruise ship in Antarctica to a hospital in Argentina, then to the United States, could total hundreds of thousands of dollars.

 

Squaremouth recommends choosing the amount of medical evacuation insurance based on the destination and type of trip. For example, $100,000 in evacuation coverage should be enough protection for a cruise to the Carribbean, however, travelers visiting Asia or Africa may want to consider a travel insurance policy with at least $250,000 in evacuation coverage.'

Over the years, we have been on 4 cruises that had helicopter evacuations....not one of which was the US Coast Guard (we have cruised to 6 continents). No Coast Guard of any country charges for their services..and as we said, helicopter evacs directly from a ship are quite rare. The operations have an element of danger that the Coast Guard's and ships prefer to avoid unless it is absolutely necessary. We have also been on more then a dozen other cruises where the ships diverted to a nearby port to off load a sick or injured passenger/crew member.

The most interesting evacuation (in over forty years of extensive cruising) happened about 2 years ago when we did a trans-pacific cruise on the Oosterdam. We were near the end of the long cruise and only 1 day out of San Diego (coming from the South Pacific) when a passenger became very ill. At the time, our ship was more then 200 miles off the Mexican coast (near the southern part of Baja) out of range of the nearest coast guard copters. The US Navy, in San Diego, sent us a Naval (Seal) helicopter along with a KC-130 Tanker aircraft (used for Seal operations). When the helicopter reached our ship, they orbited while they did a mid-air refueling (from the C130) and then dropped their paramedic onto our deck who assissted in taking the ill passenger off by winch! Quite an operation...which made the newspapers in San Diego. The cost of all this to the passenger was free...compliments of the US Government.

That same year, on another cruise, we witnessed the Portuguese Coast Guard (from Madeira) do a helicopter transfer from our ship (Prinsendam). Again, no charge. We have never heard of any helicopter rescue off a ship that resulted in a penny charge to the passenger (or the cruise line). One cruise line Captain (who recently retired and was a friend) told us it was just another aspect of the "law of the sea" where just about any country (or nearby ship) will do everything possible to save human life...at no cost.

As to Med evac insurance, it is actually quite inexpensive because it is rarely utilized. For example, our annual travel med policy from GeoBlue includes $500,000 of medical evac insurance....which is just one aspect of an annual policy that includes $250,000 of medical coverage. All this for about $450 per year (total cost for a couple)! And this one policy covers every trip we take during an entire year (for up to 70 days per trip).

And by the way, the USCG is expressly PROHIBITED, by federal law, from charging any fees for Search and/or Rescue. Similar statutes exist throughout the world.

Hank

Great post H!

Right , going to London, no need for a big evacuation policy. I was in Bhutan, got $500k as I also wanted a lot of medical insurance.

In general this is the least expensive component of trip insurance, because it is so rare.

Normally an ambulance would be used on ground, or if a ship is near port, they will divert for a medical emergency that warrants it.

Oh, I don't really buy the Antartica scenerio, but I guess it was to make a point, which is well taken.

Even from rural Bhutan. My three transports were less than $125,000.

???? Never heard of that happening. They can't market a plan as being primary to any other coverage you might have then do the opposite. Insurance regulators would be all over them. And if I was the insurance company now being stuck for the bill because of this there would be hell to pay.

Then it is not a primary policy!

Geezer Couple wasn't aware of this either when I told him/her what Steve (insure . . . .) had told me. He/she went to the website where they purchase their insurance. He/she discovered that what Steve told me is true, and it is posted on the website.

Before purchasing any "Primary" insurance, I highly recommend you talk to the representative and tell them you want it in writing.

 

Before purchasing any "Primary" insurance, I highly recommend you talk to the representative and tell them you want it in writing.

It is in writing. Every policy will have the wording that tells the client which benefits are primary and which ar secondary (also called "Excess")

For example, this is from the plan document for the TravelSafe Classic plan for us CA residents:

Excess Insurance: The insurance provided by this Policy

(except Accident and Sickness Medical Expense, Medical

Evacuation and Return of Mortal Remains) shall be in excess

of all other valid and collectible insurance or indemnity. If at

the time of the occurrence of any loss there is other valid and

collectible insurance or indemnity in place, the Company shall

be liable only for the excess of the amount of loss, over the

amount of such other insurance or indemnity, and applicable

deductible. Recovery of losses from other parties does not

result in a refund of premium paid."

What this means is that all of the coverages/benefits EXCEPT for medical, emergency evac, repatriation are secondary (excess). Those other coverages (medical, emergency evac, repatriation) are primary.

This type of wording can't just be made up by the insurer. Every state's department of insurance has very strict requirements about how these types of things are disclosed to residents of their state. Their job is to protect their residents from an insurer promising one thing and doing another. Your tax dollars at work. In this case, the CA dept of insurance requires that this notice be included in the plan documents. The state of Colorado might have different wording but the basic idea will be there somewhere. If TravelSafe wants to sell their plans in any particular state they first have to submit it to that state's dept of insurance and comply with EVERYTHING the dept of insurance wants.

Also, if there is any ambiguity between different insurers on this type of thing the dept of insurance has COB rules (Coordination of Benefits) that will settle any disputes. End result: if an insurer markets a plan as being Primary for any particular benefit they have to treat claims that way or the dept of insurance will have them out of business in no time. And maybe charge them with insurance fraud also.