Obamacare and Travel Ins Costs

[Jimsgirl]

I have recently had to use Travel Ins.

 

I had a stroke whilst on QM2, Medical costs on board, were nearly $3,000 , charged to my credit card without any- by -my leave, (yes I know that is normal so please do not flame me, I am merely replying to the question of the thread.

 

Off loaded from ship to hospital in Belgium, had to pay hospital , bill before I could leave to be medically flown home by Call International

 

Points you should consider (IMO) having credit card available money to cover medical bills . Enough money in Insurance to cover cost of being flown home, business class (my flight was 13 hours Belgium to Florida plus the cost of a nurse attendant for the l3 hours.)

If you have to leave the ship because of your illness you might wish to consider adding Ins for Trip interruption. I lost 12 days out of the original 19 days.

 

Since coming home Medicare and normal Suppl. ins have been paying my USA hospital bills suffice to say, they amount to the cost of a World Cruise on Cunard.

[sail7seas]

Are there any policies that doesn't cover health related costs, or have a low (3k? 5k?) max benefit? Health costs are already covered by our health insurance policies.

 

IMO, coverage for trip costs only should be quite cheap since it's for relatively low amounts, eg. under 10k.

 

It's actually just the opposite in many cases.

I only started to insure for medical coverage when my late DH and I went on Medicare which does not pay out of the country. We always self-insured for trip cancellation/interruption and didn't pay premiums on a great many cruises. When I started to investigate about writing travel medical coverage, I learned (from the insurers I was investigating) the premium for cancellation/interruption is far higher than when covering only medical. The premium is really low and makes absolutely no sense to book any cruise and not have out of the country insurance UNLESS your usual, regular medical policy will pay.

 

[Hlitner]

I guess a lifetime working in the Health Insurance industry has given me a different take on the insurance issue. We would not dream of leaving the USA (and we were out of the country about 7 months this year) without having a very good Medical Policy (and trip evacuation) that would cover at least $100,000 (we prefer $250,000 minimum) of medical costs plus evacuation cost. As to Trip Cancellation, we could care less. It is a known amount (the cost of the trip) which can afford or we would not have booked the trip. But potential medical liability is unlimited and can become a financial game changer that can impact the remainder of your life.

 

As to those who think they are already covered by their regular insurance, it is helpful to read the fine print and perhaps ask for some clarification. Many US Policies will only cover what they call "usual and customary" rates which can leave you with a huge bill (and months/years of appeals). Most foreign healthcare facilities will not accept direct assignment from US insurers, so you might find yourself having to pay a huge bill before you are allowed to leave a hospital and/or country. You then have to fight with your insurer to get reimbursed. We know of one insurer who insisted that all the medical bills be itemized and translated into English....and the hospital did not want to provide a detailed item by item bill.

 

Many times, folks will not have to pay to be evacuated off the ship, but that is only the beginning of the medical bill nightmare.

 

Also beware of the Medical Evacuation terms. Most policies leave the final evacuation decisions to your primary physician (who is a stranger with other priorities) and the insurance company. If you are in a third world country (like Egypt) they might pay to evacuate you to a European country...but may not agree to evacuate you home. For those who want to have a lot to say about evacuation arrangements, they can look into a "Cadillac" policy such as that offered by Medjetassist.

 

The entire Medical subject is a real minefield, and yet most folks give it little attention. Those of us in the USA who are on Medicare need to pay very close attention to their coverage since Medicare does not generally pay for anything outside the USA (there are a couple of obscure exceptions). As to Medicare Advantage Plans, everything depends on the specific plan....as some will afford some emergency coverage...and others will pay nothing.

 

Lastly, frequent travelers might want to consider an annual travel medical policy. Some of these, like Geoblue, can cost less then $400 a year (total cost per couple) for $250,000 or more of insurance. These type of policies will cover every trip you take within the policy year, although they usually have a maximum number of days per trip (ours covers the first 70 days of any trip). AMEX Card holders might also want to look into the annual Travel Med policy offered by AMEX.

 

Hank

Edited December 26, 2014 by Hlitner

[zaos]

We would not dream of leaving the USA (and we were out of the country about 7 months this year) without having a very good Medical Policy (and trip evacuation) that would cover at least $100,000 (we prefer $250,000 minimum) of medical costs plus evacuation cost. As to Trip Cancellation, we could care less. It is a known amount (the cost of the trip) which can afford or we would not have booked the trip. But potential medical liability is unlimited and can become a financial game changer that can impact the remainder of your life.

 

Thanks Hank for your post - it is great general travel advice!

 

I agree - but I am looking to arbitrage the the fixed risk premium with better information. It's like people who usually carry HSAs but switch to an expensive "Cadillac" plan when they can plan ahead of time their major surgery or medical expenses (pregnancy, or other more major surgery).

 

Not too concerned about health costs since:

1. Vanishingly tiny likelihood of major incapacitating health issues that would preclude boarding a regularly scheduled flight.
   
2. I carry a HDHP, so I deal with myself for minor issues not meeting the low 1.5k ded, and the plan actually covers 100% instead of some lesser percentage out of network up to the OOP max outside the US.
   
3. In this instance, I'm on a Caribbean cruise. Can't imagine they would balk at covering an evac to Florida.
   
4. Other places I go to tend to have much cheaper health costs than the US. For example, developed East Asia. Many parts of Europe.
   
5. Insurance Hurdles - my employer self insures, so there's the option of bypassing the administrator, and contacting HR to sort out the BS
   

 

Now if I'm going to be skydiving, bungee jumping, snowboarding, skiing, river rafting, all on the same trip, you'd be damn right I'll get something supplementary to cover the increased risk.

 

But this is a cruise. The biggest healthcare risk is probably the triple cheeseburger with loaded fries on the side. :D

 

Edit: BTW, I don't think AMEX is offering that 9.95 travel med policy anymore to new signups.

Edited December 26, 2014 by zaos

[donaldsc]

Thanks Hank for your post - it is great general travel advice!

 

I agree - but I am looking to arbitrage the the fixed risk premium with better information. It's like people who usually carry HSAs but switch to an expensive "Cadillac" plan when they can plan ahead of time their major surgery or medical expenses (pregnancy, or other more major surgery).

 

Not too concerned about health costs since:

1. Vanishingly tiny likelihood of major incapacitating health issues that would preclude boarding a regularly scheduled flight.
   
2. I carry a HDHP, so I deal with myself for minor issues not meeting the low 1.5k ded, and the plan actually covers 100% instead of some lesser percentage out of network up to the OOP max outside the US.
   
3. In this instance, I'm on a Caribbean cruise. Can't imagine they would balk at covering an evac to Florida.
   
4. Other places I go to tend to have much cheaper health costs than the US. For example, developed East Asia. Many parts of Europe.
   
5. Insurance Hurdles - my employer self insures, so there's the option of bypassing the administrator, and contacting HR to sort out the BS
   

 

Now if I'm going to be skydiving, bungee jumping, snowboarding, skiing, river rafting, all on the same trip, you'd be damn right I'll get something supplementary to cover the increased risk.

 

But this is a cruise. The biggest healthcare risk is probably the triple cheeseburger with loaded fries on the side. :D

 

Edit: BTW, I don't think AMEX is offering that 9.95 travel med policy anymore to new signups.

 

For the rest of us, could you please explain what all your abbreviations mean. Except of "BS" which I understand.

 

DON

[zaos]

For the rest of us, could you please explain what all your abbreviations mean. Except of "BS" which I understand.

 

DON

 

Sorry.

 

Ded - Deductible - The amount above which the insurer would start paying. For example, premium drinks package on X where drinks below ~$13 are included, but a $20 drink would cost you $7. For insurance purposes, think of yourself as the insurer, the drink package cost as the premium, and the cruiseline as the insured. ;)

Co-Pay: It's like the upcharge you pay at specialty restaurants, where each visit costs $25, but lets you eat as much as you want and fill your takeout containers at the end of it. :D

HDHP - High Deductible Health Plan. Usually a couple grand, min 1-2k to qualify as a HDHP.

HSA - Health Savings Account, to be used with HDHP

Out of pocket max - Maximum you have to pay "out of pocket" for otherwise uncovered medical costs in a year. Beyond this limit, the insured will not pay; the insurer will pay.

"Cadillac" plan - High premium plan that (you would think) has generous coverage, low copay, low out of pocket max.

Employer Self Insurance - Many large companies actually don't buy insurance; they hire insurance companies to manage claims, use their doctor/provider networks, manage paperwork, etc. These companies have a pot of money for such claims which is drawn from to pay claims. (They may buy reinsurance to manage their risk, but that's off topic)

 

Arbitrage - Taking advantage of price differences for your benefit. Textbook says it's riskless, but in practice, it may be low risk. An example might be picking up free food/bottle of water onboard to take with you on a shore excursion, where it is would be an additional cost. :)

[sail7seas]

What is Amex 9.95 travel med policy? Is that the Policy Number?

[dhill]

:eek:

Purchased a Travel Guard package yesterday, which was almost double in costs of what we have paid in the past for a similar package. Our TA said Obamacare had changed how insurance companies have designed packages and fee schedules. The primary difference was now packages are "age" based. My DH is 82 and I am 67.

 

Am wondering if anyone else has found Obamacare has changed travel insurance they usually purchase.

 

What I found yesterday, was Travel Guard had a package offering $25,000 in health insurance (Gold Plan), then the next level was $50,000 (Platium), with a option to double it. Even though we are healthy, health care costs can be very expensive if one needs to go through an Emergency Room, etc. So I purchased the higher level plan to play it safe.

 

Am thinking I need to do more research on options before we travel again.

 

I am wondering for seniors what is a reason amount (value) of health insurance and emergency evacuation coverage for an international trip?

 

I don't really care about insuring the trip specific costs, i.e., cruise, air, -- I am primary interested in health and emergency evacuation coverage - since we are older and Medicare does not cover anything outside the US.

 

Any thoughts?

 

:eek::eek::eek::eek:

[Hlitner]

What is Amex 9.95 travel med policy? Is that the Policy Number?

 

AMEX has an insurance program to cover travel delay which costs $9.95 per person. I think they only offer this on some of their cards (used to be called the Blue Sky program). I never mention this in any of my posts since it has nothing to do with travel medical. While AMEX would provide some travel med advice, such as where to find an English speaking doctor, this 9.95 does not cover any related costs. The old AMEX annual Travel Med (which is what I was posting about) is currently on hiatus....and only time will tell if they decide to continue such a program.

 

Hank

[Iamcruzin]

I have used travel guard for years and age was always a factor. Most older passengers choose the cruise line insurance just because it isn't based on age.

[sail7seas]

I have used travel guard for years and age was always a factor. Most older passengers choose the cruise line insurance just because it isn't based on age.

 

If older U.S. cruisers are buying cruise line insurance, I certainly hope they know what they are buying.

 

Most older U.S. persons are on Medicare which covers no medical bills outside U.S. (with rare exception). HAL's Best policy covers only $10,000 in medical. That isn't enough for a complex broken arm. What they sell is cancel for any reason cancellation insurance. It is NOt travel insurance.

 

No different than all the advise given on this forum all the time: Know what re buying and know it before you need to use it.

 

[GeezerCouple]

What is Amex 9.95 travel med policy? Is that the Policy Number?

 

I think this is the FORMER (according to our Amex Travel Agent) travel insurance that is included with some?all? travel purchased using the card. (Ours in Amex Plat; don't know about the other card services.)

 

Unless it has recently been reinstated, it's gone for those now trying to get it.

I don't know if that is a bad thing or not, as I don't know what the coverages were.

 

GeezerCouple

[Hlitner]

I have used travel guard for years and age was always a factor. Most older passengers choose the cruise line insurance just because it isn't based on age.

 

We will jump on the Sail7Seas bandwagon as her last post is excellent advice. We seniors need to be very careful to have sufficient medical insurance when we travel outside our home country and most cruise line insurance policies do not provide adequate coverage. In fact, that is one reason why they can offer policies with no age requirement. The Geo Blu insurance will provide adequate coverage (on an annual basis) for those up to age 84! There are other plans out there that also provide decent med benefits. After age 84 we do not have any answers :(.

 

Hank

[cherylandtk]

I would note that GeoBlue does not provide cancellation or interruption benefits. For folks who need both, it might be appropriate to purchase both the cruiseline policy for the CFAR benefits and the annual GeoBlue Choice for the medical/evacuation benefits. The cost of that approach should be compared to the cost of purchasing individual third party policies for each trip. Again, age is a big factor in the third party policy costs.