HEALTH INSURANCE reimbursement for Medical facility

[giadav]

I have a question. We had to use the medical facility, my husband had a severe infection that needed to be treated w/antibiotics by IV on the last full day of our cruise. The next morning we would be in the Port of Miami and the ship Dr. advised us to go directly to the hospital for further treatment. We did and my husband was admitted for 2 days so that they could stabilize him before flying home.

 

My question is we have travel insurance and we have health insurance. My health insurance is Blue Cross Blue Shield. The rep told me that it would probably be covered if it were medically necessary (which it was) but I'm afraid to trust this information. I have to submit ORIGINAL RECEIPTS and can not get them back if it is denied. The Travel Insurance may cover it too but I may have to fight with them because it may fall under ther PRE-existing condition clause, they need the original receipt. So has anyone ever been reimbursed through their health insurance co??

 

I would love to hear your input.

[GloriaF]

This is an interesting question. I would think the first thing to consider is what is your deductible on the health insurance policy and have you already met it? It seems that the health insurance should cover costs, just as they do on land. I think I might file both claims with copies of the receipts. Then if one policy will actually pay for the coverage, they can request the original receipts. I would just pretend I didn't realize the originals were required until I found out if they would pursue the claim.

[saw1953]

My husband had to go the the ship's doctor on our first cruise. Nothing as serious as what you husband had but we still had to go the the medical facility. When I called the trip insurance company I was told that I had to submit the claim to our health insurance company first. I submitted the claim to Blue Cross and they reimbursed me in full. We are on an HMO so I expected it to be denied but it wasn't. I don't think you have to submit the original receipt to Blue Cross. I think I sent them a copy. Hope this helps.

[Coral]

I would also submit a copy and see if they say anything.

 

This has to be a dilemma many have run into because many travel insurance companies want you to submit to your health insurance company first. If given the same circumstance in the future - I will ask for 2 copies of the form from the ship's medical office.

[ahracer]

My sister in-law works for Blue Cross and I was talking to her about travel related medical cost. She said as long as it is medically necessary it will be covered. That included med-evac flights and things of that nature.

 

That conversation has me thinking that the only trip insurance I really need is for cancellation not the medical that comes with it. Does anybody know if you can just buy cancellation insurance?

 

Scott

[Gaynors]

On our cruise in December 2004 my son had to go to the medical facility because of difficulty breathing and needed to have a nebulizer treatment. When we got home we called BCBS (and we have the HMO) they sent us some papers which we filled out and attached the receipts. We got a check back from them within 3 weeks for everything but our copay amount.

 

I was pleasantly suprised by the ease of the whole thing.

 

FYI- We also had to submit originals with our paperwork. I made copies and kept the copies for our records.

 

Good Luck!! :D

[Crowsie]

I think it depends on what kind of travel insurance you buy.

I'm not sure about this, but I think the cruise line insurance is secondary coverage..meaning they pay only after your personal coverage denies.

 

However, some travel insurance can be primary coverage..you need to look at your policy.

[giadav]

Thank you for all your replies. My preference was to deal with the health insurance co because if it was covered, I would get a check faster than if I was to deal with the travel insurance co!!

[Coral]

Thank you for all your replies. My preference was to deal with the health insurance co because if it was covered, I would get a check faster than if I was to deal with the travel insurance co!!

 

You would be surprised. I submitted a claim with Access America for a cancelled cruise (had to surrender original cruise and air tickets plus doctor's note) and within 10 days, I had a check from the company in my hand. Considering 3 days each way for mail - they processed that check right away.

 

I believe Access America is a secondary coverage and TravelGuard is a primary coverage.

 

I also would submit through my own health insurance first, like you are.

[bjboothman]

My sister in-law works for Blue Cross and I was talking to her about travel related medical cost. She said as long as it is medically necessary it will be covered. That included med-evac flights and things of that nature.

 

That conversation has me thinking that the only trip insurance I really need is for cancellation not the medical that comes with it. Does anybody know if you can just buy cancellation insurance?

 

Scott

 

Scott, not to quibble with your sis-in-law, but Blue Cross is not a one-size-fits-all program. They have various plans some of which cover only in-network, and some that cover both in and out of network, with varying degrees of copayment. I have a Blue Cross policy also which differs from my sis-in-law's Blue Cross policy and she also works for Blue Cross. Each traveler must take the initiative to determine what it is that he/she has. One can't make a blanket statement about Blue Cross - there are many different policies under that one name.

 

Another point to consider is that some folks have a million dollar (or such) cap on their medical coverage (lifetime). It could be that buying an additional travel policy - should it be needed - would prevent maxing out the primary policy.

 

To answer your question, I feel fairly certain that on insuremytrip.com, one of the options was for travel insurance that did not cover any medical conditions, just the cancellation part of it.

[S.S.Oceanlover]

I would also submit a copy and see if they say anything.

 

This has to be a dilemma many have run into because many travel insurance companies want you to submit to your health insurance company first. If given the same circumstance in the future - I will ask for 2 copies of the form from the ship's medical office.

 

Coral,

That's why I always pick a travel insurance policy that is primary coverage. I hate having to jump through hoops. I have used travelex lately and fortunately we haven't had to use it.

 

Bill

[bobbyd6363]

My BF and I were on the Adventure of the Seas last year and about mid-way through the cruise he got what I thought was the norovirus and literally threw up everywhere and over and over! We went to the ship's medical center and they gave him 4 or 5 shots and several bags of IV and antibiotics. The bill was staggering but we submitted it to Blue Cross and got all of it back without having to pay the co-pay. We did send the original reciepts to Blue Cross but had certified copies made of the original reciepts for our records. Access America told us the same thing as someone mentioned before that we had to go through our medical insurance first. Seems to me that travel insurance isnt really worth it at all.

[bjboothman]

Access America told us the same thing as someone mentioned before that we had to go through our medical insurance first. Seems to me that travel insurance isnt really worth it at all.

 

The time to find out if your insurer is a primary payer or a secondary payer is before you buy the insurance. If it is a primary payer, you do not have to use your medical insurance first.

 

Just for the sake of an example, at www.insuremytrip.com you can see who is a primary payer and who is a secondary payer by the colorcoding of the shading on the list of benefits.

 

I learn something new every day.

[KreinKrunker]

Used the ship's medical facilities once. Had to submit the bill to my health insurance, as they were primary. They paid 90%, as they would on most office calls. Then submitted to the travel insurance, and they paid the remainder.

[Dreamer333]

If you are planning on sending the original receipts, you may want to get notarized copies of the them before sending them out!

[zurmoly]

Most major health plans have paperwork you can take on your trip to have filled out by whomever sees you when traveling out of the US. Just call and ask them to send it before you leave and take it with you.