Tale of Med Evac and Insurance Companies

We can answer one of Mustgo's questions. If you are evacuated from a ship at sea...such evacuation is handled by the Coast Guard who charges no fees for their service. This is the case throughout most of the world.

Hank

Yes Hank that is true. A problem may still remain with Geoblue for such a trip. The onboard doctor is not a US doctor but foreign registered. I am not sure US medicare would cover the onboard expense. I do have a small claim filed now to cover a ship doctor visit on Princess. We have Princess insurance on that one. First time I ever bought it. My primary medicare insurance is still processing the claim so it will useful to know if they do pay. If not, Princess insurance will pay but they are secondary. Insurance does get complicated as one gets older.

I am interested in the info that GeoBlue does not cover a cruise to Hawaii. The actual language of their policy is interesting as there is no mention of coverage on any cruise ship...although they recently settled our claim including payment for services rendered on the Golden Princess. An issue with Hawaii might have something to do with GeoBlue only covering medical services delivered in a country "other then the USA."

Hank

An issue with Hawaii might have something to do with GeoBlue only covering medical services delivered in a country "other then the USA."

 

Hank

I'd say that you hit the nail on the head.

Thanks for coming back to us with the results, because we also use this combo...Reserve and GeoBlue.

I guess I won’t fault the Chase underwriter much because we had a friend who had a cancellation claim against a regular travel insurance company which also initially denied the cancelled air over the amount of a change fee. Only when he proved he had stage 4 cancer and said it would be unlikely he could use the air credit, did they relent.

I will also give credit to GeoBlue for not requiring you to pay someone to translate the Japanese medical records. I once, many years ago, had to file a claim on my employer healthcare for a Japanese emergency room visit (DH). Blue Cross required us to have translated records which we had to pay to get the claim filed.

Did GeoBlue pay the hospital directly, or was it a case where you paid and were later reimbursed?

No one responded to this so I did call Geoblue and spoke to an agent. I would like to share the response as it might affect others. Cruises to Hawaii are no longer covered by Geoblue Trekker. To be covered at sea you must try another insurance. I then asked about a repositioning cruise in the US from New York to Florida with stops in the Caribbean. No problem with that. It would be covered

Mustgo. We have a question regarding the response you received from GeoBlue regarding their Trekker policy. I totally understand why any medical care received in the Islands would not be covered nor would evacuation to any of the Islands be covered as that would be covered by the Coast Guard and your own insurance would cover at a hospital there.

Our concern now is over a cruise that departs from Vancouver BC over to the Islands. We do not understand why medical care if needed while onboard the ship by the ships physician would not be covered while you are in transport while at sea in International waters. Would you be able to expand more as to their explanation for this. Can you share who you spoke with at GeoBlue?

Thank you

Mary

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To clarify the coverage on GeoBlue to Hawaii from a US Port we called GeoBlue this am. The representative told us we are covered in International Waters on a cruise to Hawaii. She told us we are covered no matter where we are going or coming from once in International waters.

We have a Blue Cross Medicare supplement that covers us while in the Islands.

Mary [emoji41]

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Mary, I agree with you. I specifically asked the agent to whom I spoke about a Hawaii cruise from Vancouver and got the answer in my comment. I guess Geoblue is like the reps anyplace. Different rep, different answer. I hope your answer was the correct one. Sure makes sense to me. I had not bought the Geoblue policy so bought another specific to my Hawaii cruise. It was not expensive since I am not insuring the cruise itself. Have the Chase card for that. The insurance I got is a primary payer for medical bills and evacuation. It sure becomes complicated for us older folks to keep traveling. Bummer.

Mustgo, I called and spoke with a different representative at GeoBlue and they reconfirmed what we were told yesterday that our GeoBlue Trekker Choice policy definitely covers us while at Sea. There is no coverage while in the Hawaiian Islands which we already knew.

I guess the technically could occur between Islands. How far off shore between Islands is considered International waters? Do we reach a International Waters between the two ports on the Big Island? Probably not there. Our own health policy covers us in Hawaii.

Mary[emoji41]

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I guess someone needs to file a claim on their voyage to/from Hawaii. That way we'll find the real answer vs, what a phone rep tells us.

Reading this thread got me thinking and I looked up my Chase Sapph Reserve benefits, which are $100k for medevac. You talked about using GeoBlue for your medevac..why?

In reviewing Chase benefits, seems like the only hole in them is the medical coverage, assuming you are good on the 60-day look back for pre-existing conditions?

Thanks for coming back to us with the results, because we also use this combo...Reserve and GeoBlue.

 

I guess I won’t fault the Chase underwriter much because we had a friend who had a cancellation claim against a regular travel insurance company which also initially denied the cancelled air over the amount of a change fee. Only when he proved he had stage 4 cancer and said it would be unlikely he could use the air credit, did they relent.

 

I will also give credit to GeoBlue for not requiring you to pay someone to translate the Japanese medical records. I once, many years ago, had to file a claim on my employer healthcare for a Japanese emergency room visit (DH). Blue Cross required us to have translated records which we had to pay to get the claim filed.

 

Did GeoBlue pay the hospital directly, or was it a case where you paid and were later reimbursed?

We would absolutely agree with your comment about GeoBlue handling the translation with no hassles. When I told them (on the phone) that I was forwarding dozens of pages of medical records written in Kanjii (the Japanese alphabet) they immediately told me "no problem, we can handle it" which they did. They also told me that it could add up to 2 weeks to the claims process since they had to take the extra step of getting documents translated. We were very pleased and thought the extra time very reasonable.

GeoBlue did not directly pay our hospital since they are not one of their partner providers. We paid on our own credit card and GeoBlue sent us several checks for reimbursement. Within the medical insurance world (where I worked for over thirty years) the norm for processing a clean claim is within 30 days (Medicare actually has such a standard in its contracts with their fiscal intermediaries). GeoBlue processed our claim in about 2 weeks which would be considered outstanding service by anyone familiar with the industry. I should add that direct payments to medical providers are not very common with international claims.

As to Chase, I had less of an issue with their claims processor then with their communications system which makes it very difficult to get to the actual claims processor. Customer Service is handled by friendly folks who have to deal with the limited information they see on their computer screen. It was only after weeks of back and forth that I was able to communicate directly with the actual professional claims processor supervisor....which finally gave me enough understanding of her issues...which I was then able to resolve.

Hank

People - I have a serious question about this one. I spent a bunch of time on the phone yesterday with my health insurance provider and the travel insurance store. I also read the PDF about travel insurance - the detailed one, not the slick marketing stuff - from CSR (Chase Sapph Reserve) which says they give 100k medical evacuation. I looked at travel delay which is minimal on CSR, but Insurance Store says what they would sell me is comparable. My health provider confirmed I am covered at IN NETWORK rates for medically-necessary urgent or emergency care out of the US, including on a cruise ship. They will reimburse me, but will pay what the bill is for "medically-necessary" care. I suppose that could always be debated, whether xx was medically necessary...

Posts above talk about having CSR but using Geoblue.

Am I missing something? I'm thinking that CSR plus my health insurance is absolutely all I need for coverage, and I asked the travel insurance store and they really didn't think they could add anything other than perhaps minimal additional trip delay coverage.

Are there issues with CSR paying claims? I get their medical coverage is totally inadequate, but assuming I have that from my regular health insurance, what am I missing? $100k seems like a healthy amount of medevac, and my health insurance notes that have that too = although I'm sure I would have to call both Chase & health insurance co to coordinate benefits if it came to that....

Hello Hank,

Thanks for this first hand account of a serious medical situation overseas. I'm glad your wife has recovered enough for another trip.

Can you please answer another couple questions about the GeoBlue coverage. Are you old enough to be covered by Medicare? If so do you have a supplemental policy that provides coverage for foreign travel? Typically this appears to be $50k of coverage for your lifetime.

Did GeoBlue pay ahead of any Medicare supplemental coverage or did you use up your wife's $50k benefits before Geoblue started coverage?

People - I have a serious question about this one. I spent a bunch of time on the phone yesterday with my health insurance provider and the travel insurance store. I also read the PDF about travel insurance - the detailed one, not the slick marketing stuff - from CSR (Chase Sapph Reserve) which says they give 100k medical evacuation. I looked at travel delay which is minimal on CSR, but Insurance Store says what they would sell me is comparable. My health provider confirmed I am covered at IN NETWORK rates for medically-necessary urgent or emergency care out of the US, including on a cruise ship. They will reimburse me, but will pay what the bill is for "medically-necessary" care. I suppose that could always be debated, whether xx was medically necessary...

 

Posts above talk about having CSR but using Geoblue.

 

Am I missing something? I'm thinking that CSR plus my health insurance is absolutely all I need for coverage, and I asked the travel insurance store and they really didn't think they could add anything other than perhaps minimal additional trip delay coverage.

 

Are there issues with CSR paying claims? I get their medical coverage is totally inadequate, but assuming I have that from my regular health insurance, what am I missing? $100k seems like a healthy amount of medevac, and my health insurance notes that have that too = although I'm sure I would have to call both Chase & health insurance co to coordinate benefits if it came to that....

CSR has some cancellation benefits. Note, if the reason for the cancellation is due to a pre-existing condition, there is no waiver under the CSR coverage. There is a 60 day look back, which I believe is from initial trip payment. Most of using the CSR benefits along with GeoBlue do not have out of country healthcare.

The two cobble together something similar to a comprehensive policy (Without a pre-existing waiver). Many of us are willing to absorb cancellation risk, so whatever CSR provides is gravy. But, we are unwilling to travel without ample medical coverage overseas....hence the need for GeoBlue. The combo does result in duplication of evac coverage. And, when we traveled to SE Asia on a longer land trip, I also added a Medjet Assist...so we were covered three ways on Evac. The CSR does have six hour delay coverage, which isn’t too much worse and better than some comprehensive policies.

We had a small luggage delay claim with CSR and we had no issues with payment or filing.

Thanks for the excellent info. Until I started reading this board I hadn’t realized how much of an issue out of the country coverage will be once I retire. Still another reason to postpone Medicare as long as possible!

Hello Hank,

 

Thanks for this first hand account of a serious medical situation overseas. I'm glad your wife has recovered enough for another trip.

 

Can you please answer another couple questions about the GeoBlue coverage. Are you old enough to be covered by Medicare? If so do you have a supplemental policy that provides coverage for foreign travel? Typically this appears to be $50k of coverage for your lifetime.

 

Did GeoBlue pay ahead of any Medicare supplemental coverage or did you use up your wife's $50k benefits before Geoblue started coverage?

Old enough? Yeah, am as old as dirt :). And yes, both DW and I are on Medicare with a Medicare PPO (Aetna). Our policy does provide worldwide emergency coverage but it was never used. When I was getting ready to file our claim with GeoBlue I called them and asked if I should first submit a claim to Medicare (Aetna) and get a denial. GeoBlue told me they were primary and not to even bother with Medicare. Since we have never received any related "EOB" it appears that GeoBlue did not try to coordinate the claim with Aetna.

I must admit to be pleasantly surprised at not having to first get a Medicare payment (or denial). I am grateful to GeoBlue for not making me have to deal with the hassles of another claim :).

Hank

Old enough? Yeah, am as old as dirt :). And yes, both DW and I are on Medicare with a Medicare PPO (Aetna). Our policy does provide worldwide emergency coverage but it was never used. When I was getting ready to file our claim with GeoBlue I called them and asked if I should first submit a claim to Medicare (Aetna) and get a denial. GeoBlue told me they were primary and not to even bother with Medicare. Since we have never received any related "EOB" it appears that GeoBlue did not try to coordinate the claim with Aetna.

 

 

I must admit to be pleasantly surprised at not having to first get a Medicare payment (or denial). I am grateful to GeoBlue for not making me have to deal with the hassles of another claim :).

 

Hank

Hank, still another question - is there such a thing as a medicare supplement that covers worldwide care, that is decent? You sound like you have one, but then you talk about getting a denial? I'm of medicare age, not sure how much longer I'm going to keep my fulltime job, so the better educated I am the better. TIA

Hank, still another question - is there such a thing as a medicare supplement that covers worldwide care, that is decent? You sound like you have one, but then you talk about getting a denial? I'm of medicare age, not sure how much longer I'm going to keep my fulltime job, so the better educated I am the better. TIA

I do not think it exists. All the supplements (and Advantage Plans) are constrained by having to meet strict Federal guidelines as far as coverage. Offering more then the minimum would not only be contrary to contractual requirements but would have to come out of the pocket of the insurer as they would not be able to claim reimbursement from the Feds.

When I read your post I actually pulled out my Aetna book to read their language...which truly sucks. But it does refer to "Worldwide" emergency coverage....which I assume is subject to the $50,000 lifetime limit mentioned in your post. Anyone who has had dealings with insurance companies (and Medicare Fiscal Intermediaries) knows that getting reimbursed is not always as easy as it sounds in the booklets.

Medicare is a minefield and we can be grateful to getting to the age where we have the "privilege" of strolling through that field :). Since we spend as much as 7 months a year traveling outside the USA, there is just no way we can rely on Medicare. So far (my fingers are crossed), Geoblue has met our needs when outside the USA.

Hank

Wow, I had no idea about all this. Thanks for the schooling. It is much needed.

I do not think it exists. All the supplements (and Advantage Plans) are constrained by having to meet strict Federal guidelines as far as coverage. Offering more then the minimum would not only be contrary to contractual requirements but would have to come out of the pocket of the insurer as they would not be able to claim reimbursement from the Feds.

 

When I read your post I actually pulled out my Aetna book to read their language...which truly sucks. But it does refer to "Worldwide" emergency coverage....which I assume is subject to the $50,000 lifetime limit mentioned in your post. Anyone who has had dealings with insurance companies (and Medicare Fiscal Intermediaries) knows that getting reimbursed is not always as easy as it sounds in the booklets.

 

Medicare is a minefield and we can be grateful to getting to the age where we have the "privilege" of strolling through that field :). Since we spend as much as 7 months a year traveling outside the USA, there is just no way we can rely on Medicare. So far (my fingers are crossed), Geoblue has met our needs when outside the USA.

 

Hank

Do Employer retiree health insurance plans (with Medicare B primary after separation; only Medicare A required while still employed) have the same requirements as other "open" (not restricted to former employees) plans that add onto plain vanilla Medicare?

Our Employer self-insures, if that is relevant.

Thanks.

GC

Old enough? Yeah, am as old as dirt :). And yes, both DW and I are on Medicare with a Medicare PPO (Aetna). Our policy does provide worldwide emergency coverage but it was never used. When I was getting ready to file our claim with GeoBlue I called them and asked if I should first submit a claim to Medicare (Aetna) and get a denial. GeoBlue told me they were primary and not to even bother with Medicare. Since we have never received any related "EOB" it appears that GeoBlue did not try to coordinate the claim with Aetna.

 

 

I must admit to be pleasantly surprised at not having to first get a Medicare payment (or denial). I am grateful to GeoBlue for not making me have to deal with the hassles of another claim :).

 

Hank

Thanks for the quick reply. I’ll be turning 65 next year and starting Medicare. It was useful to see that GeoBlue acted as the primary coverage because one of the requirements for the Trekker policies is to have primary coverage from another company. I’ve also got conflicting responses from GeoBlue on this question. First they said Medicare/Medicare Supplement would be primary and then they reversed themselves and said they would be primary. It was good to see that they covered your wife. Your case also shows the need for selecting the Choice plan with the higher level of coverage since they will be acting as the primary coverage.

I think I’ll continue to use your approach of doing self insure on the trip coverage or using the Credit Card coverage and using GeoBlue for the medical and evacuation.

Old enough? Yeah, am as old as dirt :). And yes, both DW and I are on Medicare with a Medicare PPO (Aetna). Our policy does provide worldwide emergency coverage but it was never used. When I was getting ready to file our claim with GeoBlue I called them and asked if I should first submit a claim to Medicare (Aetna) and get a denial. GeoBlue told me they were primary and not to even bother with Medicare. Since we have never received any related "EOB" it appears that GeoBlue did not try to coordinate the claim with Aetna.

 

 

I must admit to be pleasantly surprised at not having to first get a Medicare payment (or denial). I am grateful to GeoBlue for not making me have to deal with the hassles of another claim :).

 

Hank

Wow...that is great to know! I had always assumed they were secondary.

Our next trip has a bit higher dollar cancellation risk than I am used to assuming, so I was going to buy a comprehensive policy for my husband’s portion only in the event of a cancellation due to a PE event. I figured gettin half of our loss back would be better than nothing. It looked like I could buy one for $220 more than buying a Geo for him...which seemed reasonable. But, this has me rethinking the whole strategy I worked out only yesterday. I may try re pricing the whole strategy buying a comprehensive policy on me, with a preexisting waiver that would extend to a cancellation due to a PE condition for him and going with the Geo on him. I still am covered by employer insurance...and would only be hit with with very high out of network medical costs on my high deductible HMO if something happened to me overseas.

Note: we would be buying the comprehensive at final...we booked the cruise in April 2017, before a scramble this past winter to postpone a trip to PV, because of a medical issue of DH. Hence why I am considering a partial comprehensive to cover some cancellation risk.

I will expand on my Medicare related comments. We (DW and myself) carry the Annual Treker policy, That policy requires (or did when we made our purchase) that the policy holders have other medical insurance...which in our case is Medicare. When we bought the GeoBlue policy my belief was that GeoBlue would handle claims as the secondary payor....meaning we would first have to file claims with Medicare.

But, as we posted above, our actual experience with a major claim was quite different with GeoBlue handling everything as the Primary Payor. I found this somewhat surprising, but was very pleased with the result :). Given this info I am somewhat puzzled as to why GeoBlue does require one to have other health insurance but we are certainly not going to argue with them about this requirement :).

Hank

After some more thought on the GeoBlue topic I decided to give them a call to resolve some questions in my own mind (we are very dependent on their policy when we travel). I raised the question about cruises between a US port and Hawaii (we periodically take this type of cruise) and coverage. As I suspected, GeoBlue would cover a valid claim for medical treatment received on the ship....while in International waters. So if something happened between Seattle and Honolulu, GeoBlue would generally pay the onboard medical claim (assuming the claim meets all their other requirements). But once that ship gets to Hawaii, the policy would not pay for claims on those islands since GeoBlue does not cover domestic claims (inside the USA and its territories). Once the ship departed Hawaii for other places (such as NZ) the GeoBlue policy would again be in force. I should also add that the policy holder would first need to pay their own medical bills (while onboard) and later seek reimbursement from their insurance. This is a compelling reason for travelers to have at least one major credit card with a high limit...or have the ability to get their limit raised when necessary.

Another question I just had to ask was why GeoBlue requires other insurance (for their Annual Trekker Policy) even if that is only Medicare. The answer I received was simply that other insurance means the policyholder is likely receiving medical care for prior existing conditions. Upon more thought this is a brilliant concept :). Consider a person who might we aware they have a major medical problem...but who has no other insurance. Perhaps that person would simply book an International trip for the primary purpose of seeking treatment in a foreign country which they expect to be covered by their GeoBlue policy.

And finally, the GeoBlue rep did confirm they cannot offer their policies in NY (a recent development), MD and Washington State. Since each of our States has their own insurance regulators and rules we do not find this surprising. Cruisers in those States who find this disappointing might want to lobby their own State Insurance folks on the issue and ask "why?" Good luck in getting a response but it never hurts to try.

Hank