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karen s

Pre-existing condition question

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I am licensed to sell travel insurance AND I have a pre-existing condition so I make it my business to know. You can buy CSA Freestyle Luxe (must be the freestyle luxe) at final payment and it will cover your pre-existing condition with NO look back period. The only conditions are that it must be at or before final payment and you must be physically able to travel on the day you purchase the insurance (you can't purchase it if you're in the hospital recovering from an illness but the doctor says you will be able to travel on that day - you must be able to travel on the day you purchase it).

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I am licensed to sell travel insurance AND I have a pre-existing condition so I make it my business to know. You can buy CSA Freestyle Luxe (must be the freestyle luxe) at final payment and it will cover your pre-existing condition with NO look back period. The only conditions are that it must be at or before final payment and you must be physically able to travel on the day you purchase the insurance (you can't purchase it if you're in the hospital recovering from an illness but the doctor says you will be able to travel on that day - you must be able to travel on the day you purchase it).

 

 

I looked into CSA as I have to buy insurance right after deposit. My DH has preexisting conditions.

 

The thing about CSA is that it is secondary coverage. To me that means that I would have to pay the hospital bill. Since neither Medicare nor our supplemental insurance covers us in foreign countries, I'd be responsible for medical bills until I could prove that my own coverage will not pay. That can be a hefty charge on my credit card that I most certainly would have to pay myself until the insurance company settled.

 

With a primary carrier, I just have to request that they pay the bill and I can submit the (useless) paperwork from our insurance company not paying later.

 

I can't afford to be out of pocket for a potential of tens of thousands of dollars for a month or two while I wait for the insurance companies to deny the claims and the travel insurance company to reimburse us.

 

What I do now with Travelex is pay the minimal amount for the coverage package I want. As I get closer to sailing I add coverage and pay the difference. This helps when a cruise is booked years in advance as is my Asia cruise. Travelex says we can always add coverage, but not decrease it.

 

Insurance is a personal thing as we all have different needs. I have found, through trial and error (and a horrible experience with Travel Guard) that I need insurance for our particular situation and mine won't necessarily fit yours.

 

I also maintain a MedJet Assist policy for DH. Never will I rely upon any travel insurance company to honor the medical evacuation clause again.

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Check Holland American;s CPP plan (platinum) -- it has no Pre Existing clause.period.

 

The CPP Platinum allows you to cancel for any reason (like those mentioned above) so no pre-ex clause for that benefit is necessary. But if you interrupt your trip or have a medical claim due to a pre-ex condition your claim will be denied and there's no waiver available to change that.

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I am licensed to sell travel insurance AND I have a pre-existing condition so I make it my business to know. You can buy CSA Freestyle Luxe (must be the freestyle luxe) at final payment and it will cover your pre-existing condition.

 

You're confusing the CSA Freestyle plans with the CSA Custom plans.

 

With the Freestyle plans you can get pre-ex coverage up to the final payment date with either the standard version or the Luxe version -- paying the extra $$$ for the Luxe version is NOT required.

 

But with the Custom plans, the pre-ex waiver is only available on the more expensive Luxe version.

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I looked into CSA as I have to buy insurance right after deposit. My DH has preexisting conditions.

 

The thing about CSA is that it is secondary coverage. To me that means that I would have to pay the hospital bill. Since neither Medicare nor our supplemental insurance covers us in foreign countries, I'd be responsible for medical bills until I could prove that my own coverage will not pay..

 

That's one nice thing about the CSA claims process. Right on the form there's a box you can check off and sign that basically says "I have no other insurance that would cover this loss." If that's the case with you, you'd just check off the box, sign it and send the claim to CSA for processing.

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That's one nice thing about the CSA claims process. Right on the form there's a box you can check off and sign that basically says "I have no other insurance that would cover this loss." If that's the case with you, you'd just check off the box, sign it and send the claim to CSA for processing.

 

Found it! Here's the link:

 

http://www.csaclaims.com/clmfrmmedical.pdf

 

On page 2 is the affidavit of no insurance. I'm sure there's some huge database the insurers share that lets CSA double check tha statementt to keep you honest, but if you truly have no other insurance that will cover the loss it saves you from sending useless claim forms to your other insurer(s).

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That's one nice thing about the CSA claims process. Right on the form there's a box you can check off and sign that basically says "I have no other insurance that would cover this loss." If that's the case with you, you'd just check off the box, sign it and send the claim to CSA for processing.

 

But you still have to pay the hospital bill on your credit card in the foreign country.

 

When my DH was sick in Italy there was another person from the ship in the same hospital and she had secondary coverage. They had to pay thousands on their credit card on discharge. Our insurance was primary and we never paid a cent.

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But you still have to pay the hospital bill on your credit card in the foreign country.

.

 

As you will with Travelex.

 

"Primary" does not equal "direct payment to the hospital."

 

With a primary plan like Travelex you will be expected to pay the hospital bill at the time you're released and then submit the claim for reimbursement.

 

All "primary" and "secondary" refer to is the order that whatever insurance you have is to pay the claim. If you have a primary plan you submit the claim to them first, they pay up to their limit and if that doesn't cover the full loss you file a claim for the extra amount with any other coverage you might have.

 

If your travel insurance is secondary and you have other coverage you have to file first with the other insurer first and the secondary travel insurer will pay what's left over.

 

But in neither of these cases do they pay the hospital/doctor directly. If you can pay the bill, you will be expected to do so.

 

Some plans, once you have exhausted all of your resources (credit cards, etc) will make you a loan for whatever is needed to get you treated but, after the claim has been filed and reviewed, if the claim is denied you have to pay them back. But this feature has nothing to do with a plan being primary or secondary. In fact, I think TravelSafe has the best coverage for these types of emergencies and they're a secondary plan. If I was worried about not being able to pay the hospital bill with my credit cards I'd much rather have TravelSafe (secondary) than Travelex (primary).

 

Don't confuse one that will direct bill with a "primary" coverage plan.

 

By the way, CSA (secondary) is one of the few that does have a true direct-bill feature. They're owned by EuropAssist that has a huge worldwide network of doctors and hospitals so if you have a medical situation you call their 24-hour help line and they'll refer you to the nearest in-network provider. If the bill is under $1000 you sign a form and go on your way with no claims forms involved at all. Although probably 95% of medical situations on vacation cost less than $1000 to fix (severe sunburn, cut foot, tummy upset, etc) if it's over that you have to go through the regular process.

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As you will with Travelex.

 

"Primary" does not equal "direct payment to the hospital."

 

With a primary plan like Travelex you will be expected to pay the hospital bill at the time you're released and then submit the claim for reimbursement.

 

All "primary" and "secondary" refer to is the order that whatever insurance you have is to pay the claim. If you have a primary plan you submit the claim to them first, they pay up to their limit and if that doesn't cover the full loss you file a claim for the extra amount with any other coverage you might have.

 

If your travel insurance is secondary and you have other coverage you have to file first with the other insurer first and the secondary travel insurer will pay what's left over.

 

But in neither of these cases do they pay the hospital/doctor directly. If you can pay the bill, you will be expected to do so.

 

Some plans, once you have exhausted all of your resources (credit cards, etc) will make you a loan for whatever is needed to get you treated but, after the claim has been filed and reviewed, if the claim is denied you have to pay them back. But this feature has nothing to do with a plan being primary or secondary. In fact, I think TravelSafe has the best coverage for these types of emergencies and they're a secondary plan. If I was worried about not being able to pay the hospital bill with my credit cards I'd much rather have TravelSafe (secondary) than Travelex (primary).

 

Don't confuse one that will direct bill with a "primary" coverage plan.

 

By the way, CSA (secondary) is one of the few that does have a true direct-bill feature. They're owned by EuropAssist that has a huge worldwide network of doctors and hospitals so if you have a medical situation you call their 24-hour help line and they'll refer you to the nearest in-network provider. If the bill is under $1000 you sign a form and go on your way with no claims forms involved at all. Although probably 95% of medical situations on vacation cost less than $1000 to fix (severe sunburn, cut foot, tummy upset, etc) if it's over that you have to go through the regular process.

 

 

I have spoken with Travelex and they have assured me that if one of us winds up in a foreign hospital, all I have to do is request that they pay the bill and they will. I don't think they have any reason to not speak the truth.

 

When someone gets very sick on a cruise ship there isn't time to first check with an insurance company to determine where to put you. The medical staff on the ship calls the local ambulance and they take you to the closest hospital. I've been there. I know.

 

We've never had a minor medical situation and only one major one.

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I have spoken with Travelex and they have assured me that if one of us winds up in a foreign hospital, all I have to do is request that they pay the bill and they will. I don't think they have any reason to not speak the truth.

 

 

The true test is what they're willing to put in writing. I just emailed them with the following. As soon as I get a response I'll post it here (it's Friday night so it might be Monday)

 

"If I'm traveling outside the US and need to be treated in a hospital can I just give you a call and you'll take care of the bill? Thanks."

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The true test is what they're willing to put in writing. I just emailed them with the following. As soon as I get a response I'll post it here (it's Friday night so it might be Monday)

 

"If I'm traveling outside the US and need to be treated in a hospital can I just give you a call and you'll take care of the bill? Thanks."

 

 

The policy states that they will assist with advancing funds to pay the hospital bill. Since there is no personal insurance coverage, their advance of funds is what pays the bill.

 

I think your email is a bit flippant, does not address a specific type of medical situation and does not reflect the conversation I had with them, but go ahead and do whatever you feel is necessary for your own edification. I won't mind.

 

I'm quite confident that my conversation and the written statement on my policy are sufficient for my personal needs. I don't have any financial associations with any insurance company other than my personal policies, so I have nothing to prove here.

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The CPP Platinum allows you to cancel for any reason (like those mentioned above) so no pre-ex clause for that benefit is necessary. But if you interrupt your trip or have a medical claim due to a pre-ex condition your claim will be denied and there's no waiver available to change that.

 

I wish you knew what you are talking about... Have you read their policy?? Or web page??

 

There is so much misinformation on this thread -- the best for the OP is call the insurance companies you are interested in and ask questions..

 

Four reasons to choose the Holland America Line Cancellation Protection Plan:

 

 

 

  1. YOU CAN CANCEL BEFORE DEPARTURE FOR ANY REASON. Even if it's up to 24 hours before departure under our Standard Plan or right up to departure with our Platinum Plan. For any reason whatsoever, your reservation may be cancelled with ease.
     
  2. YOU GET MONEY BACK. Only Holland America Line refunds 80-90% of eligible amounts paid, regardless of your reason for canceling, as long as you cancel more than 24 hours prior to departure (right up to departure with the Platinum Plan).
     
  3. SAME PRICE FOR ALL AGES. We offer the same excellent protection for everyone, at the same cost.
     
  4. NO PRE-EXISTING CONDITIONS. Our Standard and Platinum Plans do not contain pre-existing condition exclusions.

 

 

Our Standard and Premium plans at a glance

 

Unforeseen events do happen. When you book your next cruise, be sure to ask about our Cancellation Protection Plans for the utmost peace of mind.

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Here in Europe, the travel insurance we purchase is always serviced by one of the large, multinational assistance subsidiaries of the major insurance companies.

 

If it is primary insurance, all of those policies will process a "payment guarantee" if you are admitted to hospital, so that you don't have to pay the bill.

 

Sometimes an outpatient visit or visit to an emergency room must be paid for upfront and a claim submitted. But a visit to an emergency room is not going to cost tens of thousands of dollars.

 

Many international policies (HTH, CSA, and the ones we purchase here in Europe) also have their network of outpatient providers and if you arrange the treatment with their assistance company, you don't have to pay, either.

 

Kind regards,

 

Gunther and Uta

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I wish you knew what you are talking about... Have you read their policy?? Or web page??

 

There is so much misinformation on this thread -- the best for the OP is call the insurance companies you are interested in and ask questions..

 

Four reasons to choose the Holland America Line Cancellation Protection Plan:

 

 

 

  1. YOU CAN CANCEL BEFORE DEPARTURE FOR ANY REASON. Even if it's up to 24 hours before departure under our Standard Plan or right up to departure with our Platinum Plan. For any reason whatsoever, your reservation may be cancelled with ease.
     
  2. YOU GET MONEY BACK. Only Holland America Line refunds 80-90% of eligible amounts paid, regardless of your reason for canceling, as long as you cancel more than 24 hours prior to departure (right up to departure with the Platinum Plan).
     
  3. SAME PRICE FOR ALL AGES. We offer the same excellent protection for everyone, at the same cost.
     
  4. NO PRE-EXISTING CONDITIONS. Our Standard and Platinum Plans do not contain pre-existing condition exclusions.

 

 

Our Standard and Premium plans at a glance

 

Unforeseen events do happen. When you book your next cruise, be sure to ask about our Cancellation Protection Plans for the utmost peace of mind.

 

Yes, I have read ALL of the pertinent information. The following is the basis for what I posted. Those reading this can decide for themselves if it's accurate or not.

 

First of all, I don't dispute that the CPP plans don't have an exclusion for pre-ex conditions -- they're truly "cancel for any reason". But what about trip interruptions or medical bills?

 

The "C" in "CPP" stands for "Cancellation". The marketing info quoted above is 100% accurate when referring to the CPP. But what if you want the other benefits?

 

Here's how HAL describes how they're set up:

 

"tion.

 

CPP PLATINUM PLAN: Our CPP Platinum Plan enables you to supplement the CPP Standard Plan with insurance coverage underwritten by Virginia Surety Company, Inc. under Policy Number HTP04195. The CPP Platinum Plan also includes various travel assistance services arranged by BerkelyCare"

 

So if you're now talking about trip interruptions or medical bills you have to go outside the CPP (and the quoted marketing wording) and dig into the BerkleyCare details.

 

Say, a week before I book my cruise and buy my CPP Platinum plan I'm in the hospital with a kidney stone. The stone doesn't pass, the doctor gives me some pain pills, and sends me home.

 

While on the ship the stone starts to pass again so I see the doctor who charges nme for the visit and advises that I leave the ship at the next port and go home. I've got medical billls plus a trip interruption loss -- the value of th days on the cruise I'm missing and the cost of getting home.

 

Since CPP is a pre-departure-only benefit (cancellation only) it's no help to me. If I'm going to be reimbursed it's going to have to be through the BerkeleyCare "supplement" to the CPP.

 

Looking at the BerkeleyCare plan wording I find this:

 

"General Exclusions

We will not pay for any loss under the plan caused by or occurr3ed resulting from: . . . . . 13) a loss that results from an illness, disease, or other condition, event or other circumstance that occurs at a time that the plan is not in effect for you."

 

My interpretation is that the loss is a result of a condition (the kidney stone) that occurred at a time the plan was not in effect (prior to purchasing the plan). It pre-existed.

 

Others may not agree.

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Looking at the BerkeleyCare plan wording I find this:

 

"General Exclusions

We will not pay for any loss under the plan caused by or occurr3ed resulting from: . . . . . 13) a loss that results from an illness' date=' disease, or other condition, event or other circumstance that occurs at a time that the plan is not in effect for you."

 

My interpretation is that the loss is a result of a condition (the kidney stone) that occurred at a time the plan was not in effect (prior to purchasing the plan). It pre-existed.

 

Others may not agree.[/quote']

I agree with this and that the plan information given in post #37 discusses cancellation and is not applicable to pre-existing conditions that make themselves known during the cruise.

 

I just do not understand why people don't eliminate this problem, and purchase insurance at the time of the initial deposit with a plan that will then cover them for pre-existing conditions with no problem.

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I just do not understand why people don't eliminate this problem, and purchase insurance at the time of the initial deposit with a plan that will then cover them for pre-existing conditions with no problem.

Because sometimes we book so far in advance that we don't want to lose the insurance premium if we cancel.

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I agree with this and that the plan information given in post #37 discusses cancellation and is not applicable to pre-existing conditions that make themselves known during the cruise.

 

There are many situations where reasonable, intelligent people can look at the same set of facts and come to different conclusions. I'm just enough of a pessimist that my default position is that the cold-hearted insurance folks are going to tend to interpret these things in their own favor.

 

For years I've argued that the very name that HAL uses (CPP Platinum Plan) is vague enough to be deceptive. It should be something like "CPP Plus Additional Platinum Benefits" so people will realize that while indeed the CPP has no exclusions of any sort including for pre-ex conditions, those additional benefits provided through the supplemental BerkeleyCare plan do in fact have lots of exclusions. Heck, that exclusion I posted was number 13 on the list.

 

But they're selling something called the CPP Platinum Plan that's structured like this:

 

CPP (applies only to pre-departure cancellations)

 

plus:

 

BerkeleyCare supplemental plan that has any post-departure benefits.

 

So when they have something on their web site that says:

 

"Four reasons to choose the Holland America Line Cancellation Protection Plan:

 

1) YOU CAN CANCEL BEFORE DEPARTURE FOR ANY REASON. Even if it's up to 24 hours before departure under our Standard Plan or right up to departure with our Platinum Plan. For any reason whatsoever, your reservation may be cancelled with ease.

2) YOU GET MONEY BACK. Only Holland America Line refunds 80-90% of eligible amounts paid, regardless of your reason for canceling, as long as you cancel more than 24 hours prior to departure (right up to departure with the Platinum Plan).

3) SAME PRICE FOR ALL AGES. We offer the same excellent protection for everyone, at the same cost.

4) NO PRE-EXISTING CONDITIONS. Our Standard and Platinum Plans do not contain pre-existing condition exclusions"

 

they are telling the 100% truth as it applies to the standard CPP or the CPP portion of the Platinum combo plans. But do they apply to the BerkeleyCare portion of the combined package? Especially #4? I maintain that general exclusion #13 says it might not. Others might disagree.

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Because sometimes we book so far in advance that we don't want to lose the insurance premium if we cancel.

I usually purchase with Travelguard, who has always let me roll over the premium to another trip, if I have to cancel.

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Regarding the primary insurer paying directly to the provider, wouldn't that put them at extreme risk? You could be going to get treatment for something not covered, pre-existing condition, injury done while intoxicated, etc..... How in the world would they ever recover their expenses? By bringing a lawsuit? the person being insured may not even have the money to be recovered.

 

I look forward to cruiseco's answer in writing.

 

I think the weasel words about advancing funds, could mean anything - help you get your cc limit increased, help you get a signature loan, work a deal at the hospital.

 

yuk...

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Regarding the primary insurer paying directly to the provider, wouldn't that put them at extreme risk? You could be going to get treatment for something not covered, pre-existing condition, injury done while intoxicated, etc..... How in the world would they ever recover their expenses? By bringing a lawsuit? the person being insured may not even have the money to be recovered.

 

I look forward to cruiseco's answer in writing.

 

I think the weasel words about advancing funds, could mean anything - help you get your cc limit increased, help you get a signature loan, work a deal at the hospital.

 

yuk...

 

Of course, none of this should be taken to mean that it never happens. Only under what circumstances and whether or not they'll do it just so you don't have to make payments on your credit card for the time you're waiting to be reimbursed.

 

The only case that I have first hand knowledge of happened to be with CSA. A couple of clients of mine were in South Africa on a photo safari. She was attacked and critically injured by a Cape Buffalo. She was air lifted to a hospital in Cape Town and was there for three weeks before she was stable enough to be airlifted back home for more hospitalization -- the first 10 days in intensive care.

 

Since the hospital did not require pre-payment there was plenty of time for CSA to coordinate with her regular health insurance provider to figure out who was going to pay what. I believe it was something like the regular insurer paying 80% since it was out of network and CSA was picking up the remaining 20% up to their $50,000 limit (CSA is a secondary insurer). They could contact the hospital every day for cost updates so they knew what was going on. And since CSA knew this was not a pre-existing condition or subject to any of the other plan exclusions, on the day she was released CSA (knowing exactly what they were on the hook for) paid the hospital directly for the amount they were obligated for and the client never had to put any amount on her credit card nor file a claim when she got home.

 

But that was a very unusual case.

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There are no cruise line policies that I'm aware of that have a waiver of their pre-existing condition exclusion no matter when their plan is purchased.

 

In general, if you have a pre-existing condition and buy a cruise line policy you'd better be happy with at best a partial future cruise credit if the pre-ex condition causes you to cancel.

 

HAL's can be purchased a final and covers pre-existing conditions. It is their Platinum Plan that has the insurance coverage through BerkeleyCare that covers you post departure.

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HAL's can be purchased a final and covers pre-existing conditions. It is their Platinum Plan that has the insurance coverage through BerkeleyCare that covers you post departure.

 

From the HAL plan information:

 

"Cancellation Policy and Cancellation Protection Plans

 

Holland America Line offer passengers the opportunity to purchase either Standard Cancellation Protection Plan (CPP Standard) or the Platinum Cancellation Protection Plan (CPP Platinum Plan). Both of these plans are optional and must be paid for at time of deposit. Payments are not refundable. The CPP Platinum Plan is only available for U.S. and Canadian residents.

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From the HAL plan information:

 

"Cancellation Policy and Cancellation Protection Plans

 

Holland America Line offer passengers the opportunity to purchase either Standard Cancellation Protection Plan (CPP Standard) or the Platinum Cancellation Protection Plan (CPP Platinum Plan). Both of these plans are optional and must be paid for at time of deposit. Payments are not refundable. The CPP Platinum Plan is only available for U.S. and Canadian residents.

 

That has changed as of a couple of years ago. HAL's plan can now be purchased at final payment and covers pre-existing conditions.

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That has changed as of a couple of years ago. HAL's plan can now be purchased at final payment and covers pre-existing conditions.

 

You're absolutely right. Here's the up to date wording:

 

"The CPP Standard and CPP Platinum Plans are optional and must be purchased prior to the date on which cancellation fees begin to accrue. Payment for the plan is due at time of purchase and is non-refundable. The per person, per cruise costs for both plans are listed with the cruise fares."

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You're absolutely right. Here's the up to date wording:

 

"The CPP Standard and CPP Platinum Plans are optional and must be purchased prior to the date on which cancellation fees begin to accrue. Payment for the plan is due at time of purchase and is non-refundable. The per person, per cruise costs for both plans are listed with the cruise fares."

 

I think it's the best cruise line plan out there if you can live with $10,000 in medical and $50,000 in medi vac. We can as we have primary insurance that pays out of network as if it is in-network if there is no other option. We found out in the past year that if we went to see the ships doctor all we were responsible for was a $15.00 co-pay.

 

We have only once put a claim on the HAL plan, but it was on the pre-departure coverage provided by HAL when our teenager just decided 5 years ago she was not going with us to Italy one month before we were scheduled to depart. At 31 days notification we received 95% back (less the cost of the Platinum Policy- at the time $99.00), on our credit card. No questions asked and no paperwork or medical records required (maybe an email confirmation of the cancelation). At 30 days and closer to departure it would have been a 90% refund. And, if we had purchased air through the cruise line it too would have been covered with a 95% refund at 31 days cancelation.

 

The plan can get very expensive since it is based on trip cost and not age, but that is an advantage to many older passengers.

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