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INR testing on board??


nunuc2000
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I have to have my INR tested weekly, but have had varying experiences on different cruise lines. On some, the medical centre insists on a doctor's consultation both before and after the blood draw, and even insisting on a subsequent doctor's consult for blood tests a week apart on longer cruises, resulting in some pretty hefty medical fees (as much as $980 US on one 2 week cruise! :o), not to mention bad advice. On others, I have been permitted to simply have my blood drawn and the results provided to me, all for just a nominal fee (as low as $30 on one line). I am more than capable of self-adjusting my warfarin levels according to my INR results, and have noted that without exception, every single time a doctor has been consulted regarding my results, I have been given incorrect advice on how to adjust my warfarin dosing.

 

For any of you who have your INR tested on Celebrity, what has been your experience? Hope that Celebrity is more reasonable than some of the other lines we've been on.

 

Celine

 

P.S. I DID contact Celebrity directly to inquire about this, but they would only state that INR testing is available on board, and that I would have to visit the medical centre for further info.

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I have my own test kit that I use for my tests. Easy to use and pack, TSA really didn't know what it was and really took a long look at tester. It is no bigger than a large cell phone. I leased mine thru my doctor. Maybe check with your doctor, about self testing.

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Unfortunately, my ins plan doesn't cover a self testing apparatus for INR, so the cost out of pocket would be even higher than onboard testing. Testing while in my home town is free and only entails going to the lab a few blocks away.

 

Airbalancer... not sure what you mean by "change you mess so you don't need a test"...?

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Unfortunately, my ins plan doesn't cover a self testing apparatus for INR, so the cost out of pocket would be even higher than onboard testing. Testing while in my home town is free and only entails going to the lab a few blocks away.

 

Airbalancer... not sure what you mean by "change you mess so you don't need a test"...?

Autocorrect strikes again

That should be " meds "

I went from warfarin to Rivaroxban , no more blood test https://en.m.wikipedia.org/wiki/Rivaroxaban

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Autocorrect strikes again

That should be " meds "

I went from warfarin to Rivaroxban , no more blood test https://en.m.wikipedia.org/wiki/Rivaroxaban

 

 

OOOHHH ok... I should have been able to decipher that, sorry! :) LOL!! Totally makes sense now!!

 

 

I would change, however my specialists won't take me off warfarin - my need is such that I also require a quick antidote in an emergency because of a serious heart condition I have. For now, the new blood thinners on the market just aren't there yet, and the ones that have claimed to have produced antidotes in the US are now being challenged. The Canadian drug approvals division of Health Canada is considerably stricter than the the FDA in the US, and as such, it will likely be years yet before I have access to something suitable for my needs. :(

 

So... stuck with warfarin and weekly INR testing for the foreseeable future. BUT... death being the alternative, I'll gladly take my warfarin and subject myself to weekly pokes. :D

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OOOHHH ok... I should have been able to decipher that, sorry! :) LOL!! Totally makes sense now!!

 

 

I would change, however my specialists won't take me off warfarin - my need is such that I also require a quick antidote in an emergency because of a serious heart condition I have. For now, the new blood thinners on the market just aren't there yet, and the ones that have claimed to have produced antidotes in the US are now being challenged. The Canadian drug approvals division of Health Canada is considerably stricter than the the FDA in the US, and as such, it will likely be years yet before I have access to something suitable for my needs. :(

 

So... stuck with warfarin and weekly INR testing for the foreseeable future. BUT... death being the alternative, I'll gladly take my warfarin and subject myself to weekly pokes. :D

I was warfarin for about 6 years before switching this July

I found I could go about month between tests

By the way I am in Ontario

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Unfortunately, my ins plan doesn't cover a self testing apparatus for INR, so the cost out of pocket would be even higher than onboard testing. Testing while in my home town is free and only entails going to the lab a few blocks away.

 

 

I looked into a Coagu-Check unit and they run from $600 to $750 US; that's less than what you paid on one of your trips. The test strips ran about $9 at the places I looked. It would be a convenience, but one you would only use during traveling if your tests are 100% covered at home.

 

I'm considering it, but I get my monthly tests done for $8.35 "private pay" (with insurance my co-pay would be at least $10). My medical insurance would pick up part of the cost of the machine. If I had to go weekly I would really consider the home test unit as it's less than $2 more per test for the convenience.

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I have had my INR tested on ALL Celebrity ships....I go into the office and tell them I need an INR check with no doctors consultation. They take my blood pressure and temperature.....Then I go back and they prick my finger and put it in the machine and I'm done. last INR including everything was $78.

 

NOTE however that when my INR was off...too high or low...They offered for me to meet the doctor and I politely declined as I can make my own adjustments.

 

Lastly, as I think of the medical center as Germ central......I have the Butler contact them in advance and let me know when they are empty....Then I go for my tests without having been sitting in a room filled with sick people waiting. I am sure Guest Relations could handle this as well if you ask them to.

 

Safe sails to all!

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I travel with my mom... she has her own INR test kit. A couple years ago the results were quite high. We went and had it done at the med center, just to be sure it was an accurate reading and not an issue with her device. She was charged $150 for the test and subsequent dr consultation. If you get travel insurance, check to see if this might be a covered expense. It was for her.

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I looked into a Coagu-Check unit and they run from $600 to $750 US; that's less than what you paid on one of your trips. The test strips ran about $9 at the places I looked. It would be a convenience, but one you would only use during traveling if your tests are 100% covered at home.

 

I'm considering it, but I get my monthly tests done for $8.35 "private pay" (with insurance my co-pay would be at least $10). My medical insurance would pick up part of the cost of the machine. If I had to go weekly I would really consider the home test unit as it's less than $2 more per test for the convenience.

 

Wow , you have pay for tests :eek:

Do you have pay for a doctor visit ?

What are your insurance rates ? Just wondering

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My travel insurance does pay for any testing onboard, including the dr consult... but I would rather not be submitting claims for that as I worry that my premiums will increase as a result. My preference is to pay out of pocket if it's a small cost.

 

I DID have an INR home testing kit about 2 years ago (Coaguchek $1200CAD), but it produced inaccurate results far too frequently for my comfort level, plus the costly strips have an expiry period of usually 12-18 months, so bulk buying those to keep costs down wasn't feasible.

 

I guess I'll just hope the insurance company continues to renew our annual plan at the same rate without increases, and suck it up if they do impose an increase.

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My travel insurance does pay for any testing onboard, including the dr consult... but I would rather not be submitting claims for that as I worry that my premiums will increase as a result. My preference is to pay out of pocket if it's a small cost.

 

I DID have an INR home testing kit about 2 years ago (Coaguchek $1200CAD), but it produced inaccurate results far too frequently for my comfort level, plus the costly strips have an expiry period of usually 12-18 months, so bulk buying those to keep costs down wasn't feasible.

 

I guess I'll just hope the insurance company continues to renew our annual plan at the same rate without increases, and suck it up if they do impose an increase.

How long is your cruise ?

The only time my level change was we did a TA and had a drink package , might had a little too much red wine :D

 

Before I switch meds , Ii was test my levels once a month , and basically did nt change for months

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Wow , you have pay for tests :eek:

Do you have pay for a doctor visit ?

What are your insurance rates ? Just wondering

 

 

Most of the health insurance in the States has at least three ways you can pay even when something is covered by the policy. A "co-pay" is an amount you pay when service is rendered, like a visit to the doctor's office, and is from $10 to $35 for most things. You can also have a "co-insurance" amount that is an amount you pay after the service is rendered and the insurance company has applied their payment, and finally, there is often a deductible that must be met prior to any insurance payout. In the case of my lab work, there was a co-pay of $10, but the test itself was $8.35. If I had paid the co-pay, the resulting paperwork would have shown that the co-pay took care of the entire charge, but the lab would not have refunded the difference (they keep the co-pay). Because my deductible on that policy was high I just paid via private pay.

 

We do the same thing on drugs; often the private pay price of the drugs is less than the co-pay. My warfarin is an example; we get it from Costco where all drugs are marked up a flat percentage and many of the generics are less than the $10 co-pay.

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My travel insurance does pay for any testing onboard, including the dr consult... but I would rather not be submitting claims for that as I worry that my premiums will increase as a result. My preference is to pay out of pocket if it's a small cost.

 

I DID have an INR home testing kit about 2 years ago (Coaguchek $1200CAD), but it produced inaccurate results far too frequently for my comfort level, plus the costly strips have an expiry period of usually 12-18 months, so bulk buying those to keep costs down wasn't feasible.

 

I guess I'll just hope the insurance company continues to renew our annual plan at the same rate without increases, and suck it up if they do impose an increase.

Just a thought but rather than putting the cost of the INR test through your private insurance, could you not submit it to Alberta Health Services for reimbursement? While on a cruise, I had a medical issue in which I saw the ship's doctor and was charged for the doctor's visit. Upon returning back to Calgary, I attempted to seek reimbursement from my travel insurer who, in turn, directed me to AHS for reimbursement. In the event that AHS did not or would not reimburse me then the travel insurer would look at covering the claim. I simply abandoned the claim which was about $50.00 because it just wasn't worth the rigamorale of jumping through all of the hoops and I realized that it would take months to conclude.

 

I can sympathize with having weekly INR testing. I did it for 8 years and was finally taken off of Warfarin last year at the onset of my third experience with cancer. There is nothing more freeing than no more blood thinners and weelky visits to Calgary Lab. :)

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Just a thought but rather than putting the cost of the INR test through your private insurance, could you not submit it to Alberta Health Services for reimbursement? While on a cruise, I had a medical issue in which I saw the ship's doctor and was charged for the doctor's visit. Upon returning back to Calgary, I attempted to seek reimbursement from my travel insurer who, in turn, directed me to AHS for reimbursement. In the event that AHS did not or would not reimburse me then the travel insurer would look at covering the claim. I simply abandoned the claim which was about $50.00 because it just wasn't worth the rigamorale of jumping through all of the hoops and I realized that it would take months to conclude.

 

I can sympathize with having weekly INR testing. I did it for 8 years and was finally taken off of Warfarin last year at the onset of my third experience with cancer. There is nothing more freeing than no more blood thinners and weelky visits to Calgary Lab. :)

 

That's not a bad idea, Tink! I'll give AHS a call on Monday and see if that might be an option. Hope your health is improving and you're well enough to continue to cruise :)

 

Celine

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Most of the health insurance in the States has at least three ways you can pay even when something is covered by the policy. A "co-pay" is an amount you pay when service is rendered, like a visit to the doctor's office, and is from $10 to $35 for most things. You can also have a "co-insurance" amount that is an amount you pay after the service is rendered and the insurance company has applied their payment, and finally, there is often a deductible that must be met prior to any insurance payout. In the case of my lab work, there was a co-pay of $10, but the test itself was $8.35. If I had paid the co-pay, the resulting paperwork would have shown that the co-pay took care of the entire charge, but the lab would not have refunded the difference (they keep the co-pay). Because my deductible on that policy was high I just paid via private pay.

 

We do the same thing on drugs; often the private pay price of the drugs is less than the co-pay. My warfarin is an example; we get it from Costco where all drugs are marked up a flat percentage and many of the generics are less than the $10 co-pay.

Thank for the info

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Wow , you have pay for tests :eek:

Do you have pay for a doctor visit ?

What are your insurance rates ? Just wondering

 

 

Not on this type of medicine but just for reference. My insurance premium is in the neighborhood of $600+ a month (that's where it was a few years ago when I checked); of that I pay $32 a month, the remainder is paid by my employer. Although per contract negotiations that is about to go up to $70 a month. That plan gets me a health plan with a $300 deductible, with a 20% co-insurance cost thereafter. So pre-deductible being met, a doc visit usually costs around $75 plus any testing they do. Post deductible it's closer to $15. I also pay copays for prescriptions of $10-$30 a month per med depending on the medicine. And this is an excellent plan/benefit (I'm union); most Americans have much higher out of pocket costs for less benefits. A deductible in the thousands isn't unusual.

 

- Note - those costs are for health care/prescription coverage only. None of that covers dental or vision... our union covers that benefit out of our union fees.

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That's not a bad idea, Tink! I'll give AHS a call on Monday and see if that might be an option. Hope your health is improving and you're well enough to continue to cruise :)

 

Celine

Once you have spoken with AHS, could you please let me know what they have to say. If you were to receive INR testing and a doctor's attendance in a US medical facility, a portion or all of it would be billed to and covered by AHS. A ship has a medical facilty with the exception that you pay for the services upfront then seek reimbursement from AHS on your return to Alberta. I will be interested to hear what AHS has to say about this.

 

Thank you for asking about my health. I did manage to squeeze a cruise in last fall between chemo treatments and the chemo was finished in November, 2016. I am once again in remission and I hope to cruise again this fall.

Liz :cool:

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Not on this type of medicine but just for reference. My insurance premium is in the neighborhood of $600+ a month (that's where it was a few years ago when I checked); of that I pay $32 a month, the remainder is paid by my employer. Although per contract negotiations that is about to go up to $70 a month. That plan gets me a health plan with a $300 deductible, with a 20% co-insurance cost thereafter. So pre-deductible being met, a doc visit usually costs around $75 plus any testing they do. Post deductible it's closer to $15. I also pay copays for prescriptions of $10-$30 a month per med depending on the medicine. And this is an excellent plan/benefit (I'm union); most Americans have much higher out of pocket costs for less benefits. A deductible in the thousands isn't unusual.

 

- Note - those costs are for health care/prescription coverage only. None of that covers dental or vision... our union covers that benefit out of our union fees.

I am an owner operator in the sheet metal Union ( one man shop , just me )

All doctor visits are covered , no cost for operations , no cost for hip replacement, knees replacements , X-rays , 95% of lab test ,

I pay about $380 a month for extra coverage for family , ( though the union ) messages, drug ( pay $1.34 per prescription ) chiropractic, dental , physiotherapist, orthotics , glasses, knee braces and more, even have a $500 per kitty to pay for my cannabis oil , it works per than Opioids, aand is safer, my oil is low THC , so you not get a buzz

Again thanks for the info

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Once you have spoken with AHS, could you please let me know what they have to say. If you were to receive INR testing and a doctor's attendance in a US medical facility, a portion or all of it would be billed to and covered by AHS. A ship has a medical facilty with the exception that you pay for the services upfront then seek reimbursement from AHS on your return to Alberta. I will be interested to hear what AHS has to say about this.

 

Thank you for asking about my health. I did manage to squeeze a cruise in last fall between chemo treatments and the chemo was finished in November, 2016. I am once again in remission and I hope to cruise again this fall.

Liz :cool:

 

I know it is not polite to hijack threads, but in my desperation I am going to do it anyway.

Tink, it is great to hear you are in remission and i wish you continued good health.

 

I was supposed to start a cruise tomorrow, but had to cancel because we could not sort out travel health insurance for my husband, who finished chemo in October. Our existing insurance was no longer valid because he has a pre existing condition that is not stable in the last 6 months. Were you able to find insurance that would still cover you with your recent chemo?

We are in Ontario and looking outside at 3 feet of snow. I sure would like to figure out a way to still take a trip south. Thank you for any advice and really is good to hear about someone still travelling despite the cancer.

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I know it is not polite to hijack threads, but in my desperation I am going to do it anyway.

Tink, it is great to hear you are in remission and i wish you continued good health.

 

I was supposed to start a cruise tomorrow, but had to cancel because we could not sort out travel health insurance for my husband, who finished chemo in October. Our existing insurance was no longer valid because he has a pre existing condition that is not stable in the last 6 months. Were you able to find insurance that would still cover you with your recent chemo?

We are in Ontario and looking outside at 3 feet of snow. I sure would like to figure out a way to still take a trip south. Thank you for any advice and really is good to hear about someone still travelling despite the cancer.

I did not purchase separate travel insurance. Although I am currently on disability, I am still covered to a certain extent under my employer's travel insurance under their group benefits plan. I felt strong enough both physically and mentally to embark on this cruise. That was a very important factor in my decision to take that cruise considering I travel solo.

 

Having said that, I confirmed with my oncologist that a cruise would not hamper my treatment and he agreed stating that, in fact, it would probably be good for me psychologically. I live in Calgary, Alberta and I chose the Pacific Northwest / California Coastal itinerary for the simple reason that should I need to make a hasty retreat home due to my cancer, I would not be far from airports that would get me home relatively quickly. That was not necessary and I had a most enjoyable trip.

 

Celine, sorry for the deviation from the topic. Now, back to the regularly scheduled topic ... :D

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I would have thought that if your travel insurance company accepted your blood condition without restrictions which included on board testing I would have thought that the insurance company would pick up the cost. That said they may treat each test as a separate claim and the excess may be greater than the actual cost. Worth persuing I think

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Autocorrect strikes again

That should be " meds "

I went from warfarin to Rivaroxban , no more blood test https://en.m.wikipedia.org/wiki/Rivaroxaban

 

 

Can I ask how you like Rivaroxban? How long were you on warfarin before changing? I only ask b/c I've only been on it for about a month & *highly* dislike it. Luckily ins. & Maj. Med allows to get my own device.

 

Thanks!

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