AARP Plan F as secondary coverage.

[bananavan]

We had a Transatlantic cruise this past April. We purchased the cruise line insurance .
I had two visits to the clinic onboard the ship and was sent to a hospital for treatment on one day. 
I paid for everything when I was billed. The total came to almost $1000. 
I returned home and submitted my bills to my United Health care Plan F claims department. 
That was on May 29. I have receipts for their arrival at the Insurance offices. 
I have been waiting since then for word as to how much will be reimbursed. 
Plan F supposedly pays 80% of foreign claims. 
I am waiting for this before I can file a claim with AON which insures Celebrity.
I have been told that the claims are paid in the order that they are received and that they are getting to those for the month of May soon. They hope that they will resolve. this by the end of the month. 
Does this sound normal? 
As I paid for the hospital bill with my Chase Sapphire card am I better off trying to get reimbursement there? 
Thanks in advance. 
 

[Suzanne123]

I could be wrong, but I don’t think that Chase pays for actual medical expenses unless they are emergencies.  They cover things like hotels, flights and cruise costs as part of trip delay and cancellation coverage. You missed their 20 day deadline to file a claim anyway.

( page 34)

 

https://static.chasecdn.com/content/services/structured-document/document.en.pdf/card/benefits-center/product-benefits-guide-pdf/BGC10979_SapphirePreferred_VisaSignature.pdf

I think that the timeline you were given by United Healthcare does sound normal these days, unfortunately.  As long as you have opened a case with AON, all you can do is wait to apply for their remaining 20% after United pays their 80%.

 

 

[bananavan]

7 minutes ago, Suzanne123 said:

I could be wrong, but I don’t think that Chase pays for actual medical expenses unless they are emergencies.  They cover things like hotels, flights and cruise costs as part of trip delay and cancellation coverage. You missed their 20 day deadline to file a claim anyway.

( page 34)

 

 

 

Thanks for that information. 
I am trying to be patient and not put too many irons in the fire at this point. 
We have multiple claims because we also dealt with Covid and isolation for three weeks. 
I have not made the Health claim with Aon yet. 
I have filed for missed hotels and prepaid trips through the trip interruption and am waiting for that as well.  I did not file those with Chase and it would have been useless because we were unable to return home within the claim filing deadline. 
 

[klfrodo]

1 hour ago, bananavan said:

Does this sound normal? 

 

I can only share my experience. I had a claim (it was not with a Medicare Group) and my claim took about 6 weeks to resolve.

My wife had a claim (and Medicare was involved) and it took about 4 weeks to receive the denial letter. In this case, I knew that the claim would be denied, and I requested expedited denial in the claim.

In another instance, in this forum, someone had been waited 6 - 8 weeks for AON to process the claim.

 

In most cases, I would refer you to your State Insurance regulator because they establish time limits as to how long an insurance company can screw you around before processing your claim. However, you're dealing with Medicare and UHC, so, good luck.

[Jersey42]

1 hour ago, bananavan said:

We had a Transatlantic cruise this past April. We purchased the cruise line insurance . I had two visits to the clinic onboard the ship and was sent to a hospital for treatment on one day. I paid for everything when I was billed. The total came to almost $1000. 

 

I returned home and submitted my bills to my United Health care Plan F claims department. 
That was on May 29. I have receipts for their arrival at the Insurance offices. I have been waiting since then for word as to how much will be reimbursed. Plan F supposedly pays 80% of foreign claims. 

 

I am waiting for this before I can file a claim with AON which insures Celebrity. I have been told that the claims are paid in the order that they are received and that they are getting to those for the month of May soon. They hope that they will resolve. this by the end of the month. Does this sound normal? 

 

As I paid for the hospital bill with my Chase Sapphire card am I better off trying to get reimbursement there? 

I don't think I can answer all of your questions, but here are some thoughts that might help with some of them.

 

All cruise line insurance that I am aware of (including Celebrity's) pays medical claims as secondary, so you have to file with other insurance first before and get the explanation of benefits before you can file with the cruise line insurance carrier.  If you have the Chase Sapphire Reserve card, it provides $2,500 of medical coverage, but it is also secondary coverage so that won't help you.  If you have the Preferred card, they do not cover any medical expenses, so no help there either.

 

All Medicare Supplement plans (like your United Healthcare plan F) that cover foreign emergency travel work the same way.  There is a $250 annual deductible, then they pay 80% of covered charges up to a $50K lifetime maximum. So assuming this is your first claim this year and the claim was for exactly $1000 of covered expenses, UHC should pay $600 - i.e. 80% of ($1000 - $250).  AON should pay the remaining $400.

 

What I do not know is your process for filing the initial claim.  Is it like a claim in the US where you first file with Medicare and then UHC takes it after they receive the Medicare denial? Or can you directly file with UHC, because they know Medicare will deny it?  I assume you have talked with UHC and they told you how to do it.  Only UHC can then tell you how long they take to process these claims, but if I read your response correctly it sounds like they should be getting to yours shortly.  Too long in my opinion, but not surprising today.  Then you will have to wait perhaps another 6-8+ weeks after filing with AON.  But eventually you should get paid.

 

In the future you might want to look at third party travel insurance that pays medical claims as primary.  Then you won't have to file with Medicare or UHC, and you won't use up any more of your $50K lifetime maximum.

Edited August 11, 2022 by Jersey42

[Babr]

1 hour ago, Suzanne123 said:

I could be wrong, but I don’t think that Chase pays for actual medical expenses unless they are emergencies.  They cover things like hotels, flights and cruise costs as part of trip delay and cancellation coverage. You missed their 20 day deadline to file a claim anyway.

( page 34)

 

https://static.chasecdn.com/content/services/structured-document/document.en.pdf/card/benefits-center/product-benefits-guide-pdf/BGC10979_SapphirePreferred_VisaSignature.pdf

I think that the timeline you were given by United Healthcare does sound normal these days, unfortunately.  As long as you have opened a case with AON, all you can do is wait to apply for their remaining 20% after United pays their 80%.

 

 

 

Check the Benefits Guide again. Trip Delay pays up to $500 per person for a Covered Hazard. That means equipment failure, strike, etc. - not illness. It would not have paid for hotel or meals in this situation. See page 41.

 

Also note under Trip Interruption that it will reimburse for unused nonrefundable expenses, but it pays only change fees for return transportation, not the difference in cost if you have to buy new tickets. See page 33 - last item under Conditions for Cancellation and Trip interruption.

 

It does not cover pre-existing conditions. See page 33 under What’s Not Covered? The OP did not indicate that treatment was related to a pre-existing condition, but it is an important point for anyone who relies on this coverage.