Medicare and getting sick onboard a cruise ship

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#1
South Carolina
3 Posts
Joined Aug 2016
My husband and I went on an Alaska cruise August 2016-the first 4 days I was fine, on the 4th day I developed a 104.8 temp, severe vomiting and was taken to the medical facility onboard the ship. After 8 hrs of IV fluids they let me go back to the cabin only to return back to medical the next morning to be checked. This time they admitted me, said that I was a very sick woman and had to stay there so they could care for me properly. The bottom line was I was near organ failure, they were ready to transport me to Juno Hospital had the medications they were given me did not work. My final diagnosis was SEPSIS, they told my husband I was a very sick woman. Thank God the meds worked and I did not need to go to Juno hospital. Our bill was $2250.00 that was paid out of our pocket. Then came the joy and fun of dealing with Medicare. I submitted everything to Medicare only to be told it had been denied..Reasons: Ship not registered to US, Dr. not licensed to practice in US and we were not in US waters. Today is Nov. 21st and I am still waiting on Medicare to send me my denial letter so that I can submit it to Anon Travel Insurance for reimbursement. This type of info should be made known to cruise folks so that they don't go into this blind sided. Not everyone is well versed in the cruise industry and not everyone understands the in and outs of getting ill onboard ship. I guess had my husband not taken me to Medical, it would not be a problem, I would be dead by now. Can't they make some kind of booklet "if you get sick on board the cruise ship" with all the important points listed so that folks don't go into this blind sided.
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#2
1,175 Posts
Joined Oct 2009
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Thank you for sharing your personal story. It really makes you think about our health
Insurance coverage on a cruise ship. So glad you are doing well.
Hope your travel insurance responds quickly.
#3
USA
2,977 Posts
Joined Aug 2013
Originally posted by MB2014
My husband and I went on an Alaska cruise August 2016-the first 4 days I was fine, on the 4th day I developed a 104.8 temp, severe vomiting and was taken to the medical facility onboard the ship. After 8 hrs of IV fluids they let me go back to the cabin only to return back to medical the next morning to be checked. This time they admitted me, said that I was a very sick woman and had to stay there so they could care for me properly. The bottom line was I was near organ failure, they were ready to transport me to Juno Hospital had the medications they were given me did not work. My final diagnosis was SEPSIS, they told my husband I was a very sick woman. Thank God the meds worked and I did not need to go to Juno hospital. Our bill was $2250.00 that was paid out of our pocket. Then came the joy and fun of dealing with Medicare. I submitted everything to Medicare only to be told it had been denied..Reasons: Ship not registered to US, Dr. not licensed to practice in US and we were not in US waters. Today is Nov. 21st and I am still waiting on Medicare to send me my denial letter so that I can submit it to Anon Travel Insurance for reimbursement. This type of info should be made known to cruise folks so that they don't go into this blind sided. Not everyone is well versed in the cruise industry and not everyone understands the in and outs of getting ill onboard ship. I guess had my husband not taken me to Medical, it would not be a problem, I would be dead by now. Can't they make some kind of booklet "if you get sick on board the cruise ship" with all the important points listed so that folks don't go into this blind sided.
Apparently this long delay for the denial from Medicare is well known among many, either from experience or reading here/elsewhere.

One thing to consider in the future is to see if there is a travel insurance plan that would offer PRIMARY coverage, so it is the "first payor", and there would be no need for any other insurer to decline initially.

You might want to discuss this particular concern with Steve at
www.TripInsuranceStore.com

He is familiar with this problem, of course, and could guide you to a policy that might work better in the future.

This is indeed annoying with Medicare, as in most out-of-country medical care situations, there is absolutely no way Medicare would pay.
So waiting for the denial when the care is in a distant foreign location seems useless.

Note: Your cruise was in Alaska, so this could well be different.
For example, if you were in a USA port or perhaps near such a port, then Medicare would probably cover it, so in this case (Alaska), at least it makes a little sense for the travel insurer to need to make sure that Medicare really isn't going to pay.

You are very fortunate to have recovered so quickly on a cruise ship from sepsis. The outcome might have been much worse, so that is something to be grateful for!
(Also, the bill could have been far more, so that's good, too!)
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#4
Palm City, Fl
4,711 Posts
Joined Dec 2002
So glad you are recovering, sounds like a close one.

As for Medicare, long time members of CC know the limitations it holds and, like you, buy insurance to cover possible medical expenses.

As for the denial list, I think it is next to impossible to do an Alaskan cruise and not be in US waters for most of the time.
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#5
Near Orlando but California Dreaming
14,321 Posts
Joined Sep 2002
I don't think it is the responsibility of the ship to make cruisers aware--they would then be accepting liability for every different possible health insurance scenario out there. It is the responsibility of the cruiser to know how and for what they are or are not covered and buy secondary insurance accordingly.
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#6
SoCal
3,308 Posts
Joined Dec 2005
$2250, though quite a chunk is only a fraction of what our granddaughter paid for 2 days in a regular land hospital. Just be grateful you will be reimbursed.


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#7
Columbia, Md
2,643 Posts
Joined Nov 2001
We are in the process of medical claims. I was in American Samoa so Medicare should cover it (it is listed as a place where they do) and my DH was "at sea". For his we are sending the info to our secondary insurance (not travel insurance). Medicare is primary for him. The secondary (Aetna) told us that we just needed to send a copy from the Medicare and You book showing that it is not covered by them so we don't have to wait for them to deny it first. In that book it actually states that they cover it as long as you are within 6 hours of the US. I would think being in Alaska you would be within 6 hours. I would look it up to see the actual wording. Your might have to contact Medicare again.

Glad though that you pulled through!
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#8
New Cumberland,PA, USA
30,167 Posts
Joined May 2000
The "6 hour rule" is a mystery to many Medicare claims processors . I went through this rule in another post so will not do it again. But interpretation of the 6 hour rule is tricky and seldom honored unless one can really document the situation (hard to do after a cruise). And then you might get a claims processor who will not accept the non-Medicare forms (and codes) given by the ship, the issue of a physician not licensed in the USA, etc. It is so darn complicated and our government does not normally make claims easy.

That is why we always "preach" that folks need to document everything (in as much detail as possible) and be prepared for a long process. But do not give up..because eventually you will probably prevail...although the reimbursement will likely come from your secondary travel policy (if you have one) rather then Medicare.
#9
NYC
4,027 Posts
Joined Mar 2011
I'm happy that your are on the road to recovery. I hope that all those who denigrate travel insurance as some kind of industry "rip off" will read of your experience. Some decide to self-insure, which is fine. But others need to check their coverage and decide if they can write some hefty checks if the "IF" happens.
#10
New Cumberland,PA, USA
30,167 Posts
Joined May 2000
Originally posted by BlueRiband
I'm happy that your are on the road to recovery. I hope that all those who denigrate travel insurance as some kind of industry "rip off" will read of your experience. Some decide to self-insure, which is fine. But others need to check their coverage and decide if they can write some hefty checks if the "IF" happens.
We do not necessarily think Trip Insurance is a "rip off" but do think it is generally an overpriced product (often costing 7-10%+ of trip costs). However, we do purchase an Annual Travel Medical Policy which provides $250,000 of Medical Coverage (as compared to the inadequate $10,000 of many Trip Insurance policies). And our annual policy costs $450 a year which is the total cost for DW and me....and covers the first 70 days of EVERY trip we take throughout the entire year. In our case that one policy gave us coverage for 103 days of cruising and 2 months in Mexico.....during the current year.

If one really wants to get some trip cancellation coverage it is easy to get one of the Credit Cards (such as Chase Sapphire) that gives you cancellation coverage (in the case of Chase it is $10,000 per trip).

Hank
#11
446 Posts
Joined Mar 2011
Originally posted by MB2014
...This type of info should be made known to cruise folks so that they don't go into this blind sided...
I believe Medicare documents what they cover. My health insurance documents what it covers, the British health care documents what it covers, etc, etc.

I would argue that it *is* made known to cruise folks. And to anyone else that cares. Just not in a pre-digested form easy for consumption by our Tweet-additcted society. The world would be so much nicer without the fine print.
#12
Near Orlando but California Dreaming
14,321 Posts
Joined Sep 2002
Originally posted by Hlitner
We do not necessarily think Trip Insurance is a "rip off" but do think it is generally an overpriced product (often costing 7-10%+ of trip costs). However, we do purchase an Annual Travel Medical Policy which provides $250,000 of Medical Coverage (as compared to the inadequate $10,000 of many Trip Insurance policies). And our annual policy costs $450 a year which is the total cost for DW and me....and covers the first 70 days of EVERY trip we take throughout the entire year. In our case that one policy gave us coverage for 103 days of cruising and 2 months in Mexico.....during the current year.

If one really wants to get some trip cancellation coverage it is easy to get one of the Credit Cards (such as Chase Sapphire) that gives you cancellation coverage (in the case of Chase it is $10,000 per trip).

Hank


If you buy through the cruise line, it is a rip off as they add their mark up to it. I just bought a policy through insuremytrip.com for $117 for two people, 10 days in Ireland next spring. It includes $50k as primary medical and $250k medical evacuation. For two adults in their 50's. The only policy I have ever purchased that I felt was a little pricey was French Polynesia, but that included $500k medical evacuation.


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June 2012--Windstar Wind Surf Back-To-Back, Rome to Venice to Athens
October 2011--Disney Dream Bahamas
October 2005--RCCL Mariner Western Caribbean
August 2002--Disney Magic Eastern Caribbean

Three weeks in Europe (two on a ship) with a 20" roll aboard and a tote bag--packing list here.
My all in a 20" wheeled bag for a warm weather cruise packing list here
20" rolling bag packing list for two weeks in a cool/cold climate here.
#13
New Cumberland,PA, USA
30,167 Posts
Joined May 2000
Originally posted by ducklite
If you buy through the cruise line, it is a rip off as they add their mark up to it. I just bought a policy through insuremytrip.com for $117 for two people, 10 days in Ireland next spring. It includes $50k as primary medical and $250k medical evacuation. For two adults in their 50's. The only policy I have ever purchased that I felt was a little pricey was French Polynesia, but that included $500k medical evacuation.


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The 50K is sure better then the cruise line policies although we prefer policies with at least $100k med. The Trip Evacuation issue has become a real con...that is used by darn near all the companies. The reality is that its almost impossible for a company to spend over $50K on any med evac (even a chartered private medical evac jet costs less). So most companies are now marketing real high numbers (ours has $500k), but not providing the very high medical limits.

What we find outrageous are the low medical limits sold by the cruise lines! A $10K Medical policy might not even cover a single day in some medical facilities. And a passenger that suffers some type of major cardiac or CVA (stroke) event can easily find themselves with 10s or thousands of dollars in Medical bills...without the possibility of being evacuated due to being too unstable.

The BIG CON is that cruise lines have convinced folks (through good marketing) to spend hundreds of dollars for policies that primarily cover cancelation...which limits their liability to the cost of a cruise. And yet, that same passenger is underinsured for Medical that has a potential liability that is nearly unlimited. Its akin to insuring the bumper on your car...and not worrying about the rest of the car (for lack of a better analogy)
Hank
#14
Near Orlando but California Dreaming
14,321 Posts
Joined Sep 2002
Originally posted by Hlitner
The 50K is sure better then the cruise line policies although we prefer policies with at least $100k med. The Trip Evacuation issue has become a real con...that is used by darn near all the companies. The reality is that its almost impossible for a company to spend over $50K on any med evac (even a chartered private medical evac jet costs less). So most companies are now marketing real high numbers (ours has $500k), but not providing the very high medical limits.



What we find outrageous are the low medical limits sold by the cruise lines! A $10K Medical policy might not even cover a single day in some medical facilities. And a passenger that suffers some type of major cardiac or CVA (stroke) event can easily find themselves with 10s or thousands of dollars in Medical bills...without the possibility of being evacuated due to being too unstable.



The BIG CON is that cruise lines have convinced folks (through good marketing) to spend hundreds of dollars for policies that primarily cover cancelation...which limits their liability to the cost of a cruise. And yet, that same passenger is underinsured for Medical that has a potential liability that is nearly unlimited. Its akin to insuring the bumper on your car...and not worrying about the rest of the car (for lack of a better analogy)

Hank


We have insurance that will cover us out of network to a certain amount, and then full coverage after that threshold it hit. If we had medical bills over $50k, we would be out about $10K. We are comfortable with that risk.

I beg to differ on the cost of a private medivac charter. $100k is about right from Europe, from Tahiti it could be $250K to LA, at least an additional $50K to our home in Orlando. I know someone who was flown air ambulance from Myrtle Beach to Chicago after a catastrophic injury, and the cost was $50K. My cousin was just medivaced from the west coast to NYC, no idea on the cost, and obviously this isn't the time to ask, but I will eventually find out.


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Past Cruises...
April 2014--Paul Gauguin to French Polynesia
June 2012--Windstar Wind Surf Back-To-Back, Rome to Venice to Athens
October 2011--Disney Dream Bahamas
October 2005--RCCL Mariner Western Caribbean
August 2002--Disney Magic Eastern Caribbean

Three weeks in Europe (two on a ship) with a 20" roll aboard and a tote bag--packing list here.
My all in a 20" wheeled bag for a warm weather cruise packing list here
20" rolling bag packing list for two weeks in a cool/cold climate here.
#15
Chicago SW Suburb
379 Posts
Joined Jul 2011
Your Medicare supplement may cover you out of US. Mutual of Omaha policies provide coverage out of the US.
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#16
New Port Richey FL
556 Posts
Joined Jan 2003
Medicare supplement policies are identified by letters (A,F, etc) which define their benefits. They are identical across all providers except in cost. SOME cover out of country medical benefits, but many do not. Be very careful!
#17
Grosse Pointe, MI
3,844 Posts
Joined Apr 2008
Originally posted by LDVinNC
Medicare supplement policies are identified by letters (A,F, etc) which define their benefits. They are identical across all providers except in cost. SOME cover out of country medical benefits, but many do not. Be very careful!
Follow up question. DH is on Medicare with a suplllement F (which has limited out of the country benefits - not enough). If we ever had a large medical claim, would it have to go through Medicare first to refuse, then the supplemental policy and then the medical travel insurer (we usually buy Geoblu, which is secondary)?

I'm beginning to see the wisdom of buying a primary medical policy for cruises (one where I can put the value of the trips $1 and forego cancellation insurance and doesn't require full cost of trip insured). For overseas land trips, I might continue with Geoblu, if Medicare, does in fact accept a copy of there own words from the Medicare and You book, for a quick denial. This thread definitely has me rethinking our medical travel insurance strategies.

In fact, I might be giving Steve at the trip insurance store a call for our next trip which is land Vietnam. I haven't bought the medical yet. If a primary medical policy for DH isn't very expensive, I might go that route for him. For me, I'm in the same situation as ducklite, I just need to have insurance to underwrite a very high out of network deductible. (I'll know how much this deductible is on Monday, when I meet with the agent who sells our company's yearly health insurance...it looks like we're changing plans once again and I'm in charge of that purchase for our small group.)
#18
Columbia, Md
2,643 Posts
Joined Nov 2001
Originally posted by buggins0402
Follow up question. DH is on Medicare with a suplllement F (which has limited out of the country benefits - not enough). If we ever had a large medical claim, would it have to go through Medicare first to refuse, then the supplemental policy and then the medical travel insurer (we usually buy Geoblu, which is secondary)?

I'm beginning to see the wisdom of buying a primary medical policy for cruises (one where I can put the value of the trips $1 and forego cancellation insurance and doesn't require full cost of trip insured). For overseas land trips, I might continue with Geoblu, if Medicare, does in fact accept a copy of there own words from the Medicare and You book, for a quick denial. This thread definitely has me rethinking our medical travel insurance strategies.

In fact, I might be giving Steve at the trip insurance store a call for our next trip which is land Vietnam. I haven't bought the medical yet. If a primary medical policy for DH isn't very expensive, I might go that route for him. For me, I'm in the same situation as ducklite, I just need to have insurance to underwrite a very high out of network deductible. (I'll know how much this deductible is on Monday, when I meet with the agent who sells our company's yearly health insurance...it looks like we're changing plans once again and I'm in charge of that purchase for our small group.)
We have our secondary insurance through dh former employer instead of a Medigap policy. Dh had to see dr while at sea. Aetna said we just needed to show them the page in the Medicare and you book that says Medicare won't cover it and just submit to Aetna. We will see if they are right or not. My hunch is they will say to send to Medicare first. Time will tell.
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#19
Chicago SW Suburb
379 Posts
Joined Jul 2011
Originally posted by buggins0402
Follow up question. DH is on Medicare with a suplllement F (which has limited out of the country benefits - not enough). If we ever had a large medical claim, would it have to go through Medicare first to refuse, then the supplemental policy and then the medical travel insurer (we usually buy Geoblu, which is secondary)?

I'm beginning to see the wisdom of buying a primary medical policy for cruises (one where I can put the value of the trips $1 and forego cancellation insurance and doesn't require full cost of trip insured). For overseas land trips, I might continue with Geoblu, if Medicare, does in fact accept a copy of there own words from the Medicare and You book, for a quick denial. This thread definitely has me rethinking our medical travel insurance strategies.

In fact, I might be giving Steve at the trip insurance store a call for our next trip which is land Vietnam. I haven't bought the medical yet. If a primary medical policy for DH isn't very expensive, I might go that route for him. For me, I'm in the same situation as ducklite, I just need to have insurance to underwrite a very high out of network deductible. (I'll know how much this deductible is on Monday, when I meet with the agent who sells our company's yearly health insurance...it looks like we're changing plans once again and I'm in charge of that purchase for our small group.)
Check out the Geoblue app. It list all of there world wide Dr's and hospitals with english speaking staff. it also list the ones that are part of their network which they is primary coverage if you use them. A quick call to Geoblue can confirm this and correct any errors in my statement. This is what I use to have a list of the providers in each country were visiting ahead of time. In the event of emergancy I have the info instantly to look at on my phone or tablet. Hope this info is helpful for you and everyone else on CC.
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12/4/2016 Silhoutte 7 day
1/20/2017 Equinox 10 day
2/18/2017 Summit 9 day
10/27/2017 Equinox 10day
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1/226/2018 Silhouette 9day











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11/30/2018 Silhouette 9day
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#20
New Cumberland,PA, USA
30,167 Posts
Joined May 2000
Originally posted by buggins0402
Follow up question. DH is on Medicare with a suplllement F (which has limited out of the country benefits - not enough). If we ever had a large medical claim, would it have to go through Medicare first to refuse, then the supplemental policy and then the medical travel insurer (we usually buy Geoblu, which is secondary)?

.............

)

You ask a complex question. In the industry many of us call it Third-Party Liability. But the consumer question is more generally referred to as "coordination of benefits" and how its handled does vary from company to company and policy to policy. Unfortunately, most travel insurance companies prefer to dump most of the burden on the customer (the insured). So in most cases you would first have to pay the medical bill (or try to stall the payment) and first submit the claim information to your primary insurer (which could be your Medicare plan). You then must wait to get your "EOB" which shows what will be paid/covered and what is denied. You would then submit that, along with the appropriate form and all the billing info, to your secondary company (travel insurance) and again wait.

The process does suck and it can take many months to get your reimbursement. And that assumes there are no further issues. One big problem is that many foreign hospitals/physicians do not provide enough billing detail to satisfy US insurers. So before you even leave a hospital it is wise to try to get as much detailed info as possible..

Another issue is that some insurers want all the billing info in English and converted to US Dollars (usually based on the exchange rate at the time of the services). Some insurance providers are very good at finding "innovative" ways to delay reimbursement...sometimes for months or even years. One thing that attracted to us to GeoBlue is that they actually utilize an international netwok of BC/BS Providers. If you are able to use one of their providers you might be able to avoid having to pay most of the bill out-of-pocket.

And finally we add another comment about Medical Evacuation. Not all evacuation coverage will evacuate you to your home country...or home town (MedjetAssist is one exception). If you need evacuation from a place like Egypt, you might well end up in a European hospital or possibly nearby Israel. Many policies simple say they will evacuate you to the nearest "suitable hospital". That is one way the insurers keep their cost down (and also annoy customers). So most policies will not evacuate you from Europe to the USA....but rather to a "suitable" European hospital. This is why many frequent travelers pay the extra money for a Medjetassist Policy.....which will actually evacuate you (if medically necessary) to a suitable hospital (or your choice) near home.

Hank