Travel insurance and Medicare

[pilot]

One simple secret I learned when filing a claim with any travel insurance when you have Medicare and Tricare for Life: Make a copy from their respective web pages that states they do not cover any medical bills outside the continental US, and file it with your claim. I've done this three times without any issues or filing to have the EOB state they won't pay - all three times I received full reimbursement for the medical costs on-board quickly.

 

 

Medicare does not pay outside the US or Territories. If outside the US Tricare for Life becomes primary and will pay for services (after deductible is met). Then Cruise Insurance will pay the remainder.

[Colo Cruiser]

Medicare does not pay outside the US or Territories. If outside the US Tricare for Life becomes primary and will pay for services (after deductible is met). Then Cruise Insurance will pay the remainder.

 

I would think one would still have to send them documentation to that effect.

[John99]

I agree with Cool Cruiser -- this topic should be posted onthe "Discussion Topic" boardunder -- "Cruise/Travel Insurance". This topic is about travel insurance, primaryvs. secondary, Medicare, AARP, etc...

 

http://boards.cruisecritic.com/forum...ysprune=&f=635

[NavyVeteran]

Medicare does not pay outside the US or Territories. If outside the US Tricare for Life becomes primary and will pay for services (after deductible is met). Then Cruise Insurance will pay the remainder.

 

I disagree. Tricare for Life is secondary to other medical insurance except insurance explicitly designated as a Tricare supplement. Information about other health insurance is on the Tricare website. The Tricare claim form

asks if the patient is covered by any other health insurance plan. It asks to report anything except TRICARE/CHAMPUS supplemental insurance, and it requires that you provide the EOB from the other health insurance.

 

As I stated in an earlier post, I submitted claims to Princess Vacation Protection and to Travel Insured International. I clearly stated on my forms that I had Medicare and Tricare for Life. Neither insurance company asked for an EOB from Medicare or from Tricare - both paid my bills in full without any submission to Medicare or to Tricare.

[San Diego Ellie]

Having (sadly) lots of experience here, I can tell you that the travel insurance REQUIRES that you submit to both medicare and your supplemental carrier. When you eventually hear back from them, you need to send the denials or EOB's from each of them along with all the other documentation they require in your claim. And medicare DOES pay small amounts. My last claim for one visit to ship doctor was about $329 and medicare paid about $44. My supplemental paid nothing, but I needed the denial. There is no way around this.

[pilot]

I disagree. Tricare for Life is secondary to other medical insurance except insurance explicitly designated as a Tricare supplement. Information about other health insurance is on the Tricare website. The Tricare claim form

asks if the patient is covered by any other health insurance plan. It asks to report anything except TRICARE/CHAMPUS supplemental insurance, and it requires that you provide the EOB from the other health insurance.

 

As I stated in an earlier post, I submitted claims to Princess Vacation Protection and to Travel Insured International. I clearly stated on my forms that I had Medicare and Tricare for Life. Neither insurance company asked for an EOB from Medicare or from Tricare - both paid my bills in full without any submission to Medicare or to Tricare.

 

Not quite. From the Tricare for Life Website:

 

Using TRICARE For Life Overseas

 

Medicare provides coverage in the U.S. and U.S. Territories. Medicare doesn't provide coverage in any other overseas locations.

When using TRICARE For Life in all other overseas locations, whether you live overseas or are traveling overseas, TRICARE is the primary payer and you're responsible for paying TRICARE's annual deductible and cost shares (same costs as TRICARE Standard Overseas).

[Colo Cruiser]

I agree with Cool Cruiser

 

 

Everyone is a Cool Cruiser!! :D

[NavyVeteran]

Not quite. From the Tricare for Life Website:

 

Using TRICARE For Life Overseas

 

Medicare provides coverage in the U.S. and U.S. Territories. Medicare doesn't provide coverage in any other overseas locations.

When using TRICARE For Life in all other overseas locations, whether you live overseas or are traveling overseas, TRICARE is the primary payer and you're responsible for paying TRICARE's annual deductible and cost shares (same costs as TRICARE Standard Overseas).

 

This applies unless you have other health insurance. The other health insurance exception applies to overseas coverage as well as to domestic coverage. If you submit a claim to Tricare, you are required to report all other health insurance.

[NavyVeteran]

Everyone is a Cool Cruiser!! :D

 

Not everyone. According to Cruise Critic, you are not a Cool Cruiser.:D You are a member of the "50,000+ Club" instead.:)

[Colo Cruiser]

Not everyone. According to Cruise Critic, you are not a Cool Cruiser.:D You are a member of the "50,000+ Club" instead.:)

 

Thanks........Guess I can't see the forest for the trees. :rolleyes:

[RMM34667]

I have zero experience filing claims with Princess insurance. Do you open the claim then wait for all the necessary treatment and documents? Or wait until you have completed treatment and have all the documentation to contact them.

 

Mom went to the orthopedic dr today for the pain she has had since the fall. She has some bursa sack inflamed (in her replaced knee) from the fall. Could possibly require surgery. She got a shot today but it could be weeks before we know if she needs further treatment.

[Colo Cruiser]

I have zero experience filing claims with Princess insurance. Do you open the claim then wait for all the necessary treatment and documents? Or wait until you have completed treatment and have all the documentation to contact them.

 

Mom went to the orthopedic dr today for the pain she has had since the fall. She has some bursa sack inflamed (in her replaced knee) from the fall. Could possibly require surgery. She got a shot today but it could be weeks before we know if she needs further treatment.

 

With Princess we open it when we return home. If we have any further treatment just send it all in together. If its going to be long term then I would call Princess ins and ask them their time parameters.

[lannie180]

When submitting a claim to Medicare how does it take to get an answer pay or denial? With all this what would be a good insurance to buy that would be reasonable? For it to be pay as primary insurance and cover the expenses one can encounter? We usually but the cruise line insurance thinking of needing to cancel after final payment date. I see now this is not enough

[dickinson]

We had to file a claim. We did so with our travel insurance and sent them a photocopy of the page in the Medicare and You book that said they do not pay out of the country. We had no problem with the claim. To whomever said there was no way around it.... yes there is. All you have to do is try and see if they will accept it. We had Global Assist.

[lannie180]

This whiz what I found under Medicare:

 

• 
  
• pay for medically necessary health care services I
  get on a cruise ship?
  Medicare may cover medically necessary health care services you get on a cruise ship inthese situations:
   
  
  • 
    
  • e doctor is allowed under certain laws to provide medical services on the cruise ship.
     
    
  • e ship is in a U.S. port or no more than 6 hours away from a U.S. port when youget the services, regardless of whether it’s an emergency.
    Medicare doesn’t cover health care services you get when the ship is more than 6 hours
     
    

  2 away from a U.S. port.

   

[lannie180]

I'm sorry for all the strange writing on top of the quote from Medicare. I try to delete it but I could not. May be if I was younger I would know more about computers than what I know

[Hlitner]

We would reiterate that Medicare regulations (and policy) say that it "May" give coverage on cruise ships that are in a US Port of within 6 hours of a US Port. When I worked for Medicaid (for over thirty years) part of my job was interacting with Medicare (both the fiscal intermediaries and the Federal staff in Maryland (home of Medicare). On a couple of occasions I asked my Medicare counterparts about the "6 hour rule." In each case, although I was dealing with senior policy folks, they were not even familiar with the clause. One of my Medicare policy friends and I had a great conversation of how to interpret the "6 hour rule." When I pointed out to my friend that 6 hours could be 6 miles out of port, 50 miles out of port, or even 100 miles out of port. We finally decided that this would be one of those government issues that would likely be decided on a case by case basis (this can take months). And then you would further have the issue where most cruise ship physicians are not licensed to practice Medicine in the USA. HAL used to have US/Canadian licensed physicians...but they have no moved away from that practice. Other lines specifically avoid US licensed physicians (sounds like something advised by lawyers).

 

The other major issue is the proper coding of a claim. The entire Medicare Claims system is driven by properly coded claims. Most foreign licensed physicians (such as those on a cruise ship) have no clue how to code a Medicare Claim....and its unlikely that any of the nurse staff has much of a clue. If a Claim is not properly coded, it will not be processed! Period. End of Story.

 

Hank

[lannie180]

Hank, I just wonder since you work with Medicare and any of you who submitted a claim to Medicare how long does it take for Medicare to reply whether it is for cruise ship or personal matter. We never had to do that and going back on this matter we are lucky it is small amount so it doesn't matter but what if it was $1,000.00 or more how long is the process to get decided also in personal matters how log it take to get an answer from Medicare. Just for education. Thanks

[lannie180]

Just an update regarding my claim. I sent my claim and attached the Medicare portion that show that they don't pay for outside the US and I received an email that the $95.00 will be sent to me in the next 2 days. So all is well. Thanks for the idea to add Medicare rules it worked for me.

[NavyVeteran]

Just an update regarding my claim. I sent my claim and attached the Medicare portion that show that they don't pay for outside the US and I received an email that the $95.00 will be sent to me in the next 2 days. So all is well. Thanks for the idea to add Medicare rules it worked for me.

 

I don't think adding the Medicare rules made any difference. The claims people deal with people covered by Medicare all the time, and they know the rules about Medicare coverage outside the United States. I've never attached a copy of the Medicare or Tricare rules, and I've never had any problem receiving payment in full from travel insurance.

[beach_fever_4ever]

As my wife and I have just turned 65 we will be on medicare for our Jan 2018 cruise. We know that medicare and our secondary insurance do not pay for healthcare outside the USA. We are looking at several travel medical insurance companies for our cruise. We are in good health and do not have any preexisting conditions. Our main concern is if a catastrophic event occurs such as a heart attack and the cruise ship evacuates us to a foreign island. Many of the policies allow you to pick a $ amount for primary medical coverage. With not having any experience of hospital costs, we are wondering what dollar amount might be appropriate to cover a catastrophic illness.

[Colo Cruiser]

As my wife and I have just turned 65 we will be on medicare for our Jan 2018 cruise. We know that medicare and our secondary insurance do not pay for healthcare outside the USA. We are looking at several travel medical insurance companies for our cruise. We are in good health and do not have any preexisting conditions. Our main concern is if a catastrophic event occurs such as a heart attack and the cruise ship evacuates us to a foreign island. Many of the policies allow you to pick a $ amount for primary medical coverage. With not having any experience of hospital costs, we are wondering what dollar amount might be appropriate to cover a catastrophic illness.

 

 

Best to ask this on the Cruise/Travel/Insurance Board.

 

http://boards.cruisecritic.com/forumdisplay.php?s=&daysprune=&f=635

[ghstudio]

As my wife and I have just turned 65 we will be on medicare for our Jan 2018 cruise. We know that medicare and our secondary insurance do not pay for healthcare outside the USA. We are looking at several travel medical insurance companies for our cruise. We are in good health and do not have any preexisting conditions. Our main concern is if a catastrophic event occurs such as a heart attack and the cruise ship evacuates us to a foreign island. Many of the policies allow you to pick a $ amount for primary medical coverage. With not having any experience of hospital costs, we are wondering what dollar amount might be appropriate to cover a catastrophic illness.

 

 

I wouldn't insure for less than$50k of medical insurance. Talk to a professional such as insure my trip.com

 

 

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[Thrak]

As my wife and I have just turned 65 we will be on medicare for our Jan 2018 cruise. We know that medicare and our secondary insurance do not pay for healthcare outside the USA. We are looking at several travel medical insurance companies for our cruise. We are in good health and do not have any preexisting conditions. Our main concern is if a catastrophic event occurs such as a heart attack and the cruise ship evacuates us to a foreign island. Many of the policies allow you to pick a $ amount for primary medical coverage. With not having any experience of hospital costs, we are wondering what dollar amount might be appropriate to cover a catastrophic illness.

 

We are leaving in a couple of weeks for 2 month land vacation to Canada and Alaska (from California) as well as a 28 day cruise to Hawaii and the South Pacific in October and a 14 day Circle Caribbean next March. I'm purchasing a one year plan with Medjet Assist that will fly us home in case of medical catastrophe. Most evacuation plans require it to be deemed a "medical necessity" before they will evacuate you back home but Medjet Assist doesn't require this. The plan isn't expensive and will cover both of us for an entire year from date of purchase so we will be covered for all 3 of those planned trips. Hopefully we won't need it but I really wouldn't want to be stranded in Tahiti or Bora Bora or somewhere like that. I'd much rather be flown home to my local hospital.