Medical visit onboard need Addl Dox !

[kdmbluerzr]

This is our experience from last February, very similar to others that have shared info on this thread. My husband had to go to the Encore medical center on our cruise this past winter. He had pnuemonia. After many tests (the medical center doctor and staff were very thorough), this was his diagnosis. For the next 3 days he had to go to the medical center in the mornings and again in the evenings for IV antibiotics and nebulizer breathing treatments. Prior to disembarking the ship, the medical center staff gave us a very detailed itemized list of everything the doctors and nurses did. As well as an itemized list of charges for everything. They were amazing. At the end of the cruise we had a bill of &18,000.00 that was charged to my credit card. Far exceeded my credit card limit. Well, long story short..... NCL will give you everything you need to send to Medicare, yes we are over 65. Medicare will cover some expenses outside of the US, however, very specific limitations, the big kicker being they will only cover services provided by a USA liscensed physician. There are no USA credentialed liscensed doctors on NCL ships. Medicare will not cover any of it. But you must have the EOB from Medicare to submit to your supplemental insurance. We have a plan G supplemental plan, very similar to the plan F. Many of the Plan G have a foreign travel coverage benefit that will pay 80% of approved charges. So after we recieved the denial EOB from Medicare I sent the required documentation to the supplemental insurance. About 7 weeks later my husband recieved a check in the mail for the 80% of the entire bill. I then sent the required documentaion to AON Affinity travel insurance, within a few days I received an email from AON giving me the option to have payment sent via check in the mail or direct deposit to a checking or savings account. I opted for direct deposit, 3 days later we had the balance of the $18,000 paid. It all took about 4 months.  So I guess this was not much of a short story, but this is what we learned and how this process worked for us.  Key points..... make sure you get the complete itemized detailed services and charges from the medical center, you have to go through the step by step process of insurance denials or payments EOBs before AON will do anything, once you have that they will pay the balance up to whatever limit you have. We only had the standard coverage plan which pays up to $20,000. 

Anyway, hope this can help someone else out there.  Good luck to all and happy cruising. 

[omahabob]

And your husband is doing well, I hope.

[victory2020]

14 hours ago, brer111 said:

Here is our experience - My husband woke up one morning complaining about arm pain. To be safe we went to the medical center and many test were run. That evening we had a bill for around 2,000 that we paid up front when we left the cruise. Since we never had done this before I went to see a customer service supervisor. She was quite helpful and even made a call for me to speak to travel insurance to find out what we needed to do. Medicare does not pay out of the US at all. They told me I had to get refusal of payment by Medicare and then file the claim on our travel insurance. I decided to instead fill the claim with my supplemental insurance expecting them to deny my claim since Medicare would not cover it. To my surprise my supplemental paid almost the entire amount. So I filed with the travel insurance for the balance and they paid very quickly to us. Our travel insurance was thru NCL. Hope this helps!

What supplemental are you on? I just signed up with Scan because they supposedly pay overseas but I wasn't aware of one that would work on a ship

[uneamie]

49 minutes ago, njhorseman said:

Bankers Life appears to offer all the standard Medicare Supplement plans including those that provide coverage for emergency medical care when outside the USA.

https://www.bankerslife.com/medicare-supplement-insurance/

Wow...why didn't I know this? I guess I didn't read our policy very well. Agent never pointed that out either and she knows we travel. Thank you so much for posting this. Much appreciated. 

[omahabob]

Wow. Just found out Tricare For Life covers me overseas, so I'm feeling better about this.

 

https://www.aarp.org/health/medicare-qa-tool/does-medicare-cover-me-outside-the-us/

 

By the way, there's other info at that link related to the discussion here.

 

Edited July 8, 2023 by omahabob

[RocketMan275]

10 hours ago, omahabob said:

Wow. Just found out Tricare For Life covers me overseas, so I'm feeling better about this.

When I qualified for Medicare I called Humana about a supplemental policy.  When the person I spoke with learned I had TFL, she told me that while she was more than willing to sell me a supplemental policy TFL was at least as good as anything Humana offered and, best of all, TFL cost me nothing.  Between medicare and TFL I rarely have any out of pocket medical expenses.

[peg013]

TFL is $150 deductible and 25% of cost overseas for Group A Retirees. Copayments & Cost-Shares | TRICARE

 

However - TFL will not fly you home - only to the nearest hospital so you'll need other insurance to cover that.

Edited July 8, 2023 by peg013

[omahabob]

I always take care of that separately. Very few travel plans cover anything else, and most that do are more expensive than my separate flight coverage.

[kdmbluerzr]

On 7/7/2023 at 8:54 PM, omahabob said:

And your husband is doing well, I hope.

Yes, thank you.

[kdmbluerzr]

On 7/7/2023 at 8:58 PM, victory2020 said:

What supplemental are you on? I just signed up with Scan because they supposedly pay overseas but I wasn't aware of one that would work on a ship

He has Aetna supplemental.