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Hlitner

Tale of Med Evac and Insurance Companies

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A few weeks ago we promised to post some info about our real life evac adventure and dealing with insurance companies (I used to work for the government in medical insurance). Back in April, DW sustained a serious lower leg injury while we were in Vietnam. The injury was initially treated on the Golden Princess, but when things did not go well she had some minor surgery in Osaka, Japan (about 5 days after her injury). This led to a decision to medically evacuate home (2 days later from Tokyo) and leave our cruise 28 days early :(.

 

Our philosophy, for decades, has been to NOT purchase trip insurance because of our extensive travel schedule (sometimes as much as 7 months a year out of the country). Instead we have an Annual GeoBlue Global Trek Policy to cover medical and evacuation. We also use a high-end Chase Sapphire credit card which carries $10,000 (under some circumstances this amount can be higher) of cancellation (for cause), interruption insurance, and $500,000 or evacuation coverage.

 

Over the years we estimate that we have saved more then $100,000 by NOT purchasing trip insurance. The money saved is because we avoided paying for that insurance. GeoBlue costs us about $450 a year which provides $250,000 or medical coverage and $500,000 of medical evacuation coverage. We have no interest in "cancel for any reason" and also believe that self-insurance often makes more financial sense for those willing to accept some risk (that would be me).

 

After DW's medical adventure we were able to quickly get reimbursed for all of our medical expenses (less a $50 deductable) from GeoBlue who quickly paid for our medical expenses on the ship and in Osaka at a local hospital. Her medical evacuation was able to be accomplished on a commercial flight...where she had to fly Business Class in order to keep her leg elevated. GeoBlue agreed to pay for the Business Class ticket (they even made the airline reservations) which cost them about $10,000. They would only pay for my economy class (I decided to pay for Business Class out of my pocket to stay close to DW). GeoBlue treated us very well, were actively involved in decision making (via phone calls with myself and the ship's physician) and processed our claim within 2 weeks.

 

We also filed a claim with Chase to recover the unused portion or our cruise (which exceeded $10,000) and our unused return air fare from Vancouver (the ending point of the booked cruise) to PHL. It took 2 months of "negotiation" with Chase in order to meet all their documentation requirements. In the end they agreed to pay the full $10,000 (for unused cruise) but denied the airline ticket reimbursement (about $1000). The air was a real nightmare because it can be difficult dealing with airlines, EZAIR, insurance, etc. In the end we did get AA to give us a credit for the unused air...although they actually have refused to tell us how much credit we have (another long story). Whether we ever get and use that airline credit is questionable.

 

To sum up, we were very pleased with GeoBlue and also satisfied with Chase (although they made my life miserable for nearly 2 months). My warning to any traveler is to make sure you document everything (in writing), contact your insurance company immediately when you have a real problem, and insist on the most detailed medical documentation. In the case of Princess, getting detailed medical records (of DW's treatment aboard) meant paying extra money (I think it was about $50 which turned out to be reimbursable by Geoblue). The best time to get detailed medical records is BEFORE leaving the ship...so its wise to make the request from the Medical Center as discharge.

 

Tip: The stress of a major emergency can impact decision making. One needs to take a deep breath and carefully review your options and act accordingly. In our case that meant refusing medical treatment at a Vietnamese hospital, following the ship's physician advice to seek first class treatment in Japan, and listen to the Japanese surgeon about getting DW home ASAP.

 

Tip 2: When dealing with your insurance companies always keep your cool, be willing to compromise when necessary, and understand they they have their job to do which means they want lots of documentation. We know of too many cases where folks get frustrated and threaten insurance companies and cruise lines with lawsuits. In most cases this is a very bad decision because those companies will simply shift your case to their legal office which then makes your life more miserable. Most of the time using "charm" and understanding will get you a better result (it worked well for us).

 

Hank

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Thank you for relating your experience, Hank.

 

I trust your DW is recuperating well and will be able to sail again soon.

 

bon voyage

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A few weeks ago we promised to post some info about our real life evac adventure and dealing with insurance companies (I used to work for the government in medical insurance). Back in April, DW sustained a serious lower leg injury while we were in Vietnam. The injury was initially treated on the Golden Princess, but when things did not go well she had some minor surgery in Osaka, Japan (about 5 days after her injury). This led to a decision to medically evacuate home (2 days later from Tokyo) and leave our cruise 28 days early :(.

 

Our philosophy, for decades, has been to NOT purchase trip insurance because of our extensive travel schedule (sometimes as much as 7 months a year out of the country). Instead we have an Annual GeoBlue Global Trek Policy to cover medical and evacuation. We also use a high-end Chase Sapphire credit card which carries $10,000 (under some circumstances this amount can be higher) of cancellation (for cause), interruption insurance, and $500,000 or evacuation coverage.

 

Over the years we estimate that we have saved more then $100,000 by NOT purchasing trip insurance. The money saved is because we avoided paying for that insurance. GeoBlue costs us about $450 a year which provides $250,000 or medical coverage and $500,000 of medical evacuation coverage. We have no interest in "cancel for any reason" and also believe that self-insurance often makes more financial sense for those willing to accept some risk (that would be me).

 

After DW's medical adventure we were able to quickly get reimbursed for all of our medical expenses (less a $50 deductable) from GeoBlue who quickly paid for our medical expenses on the ship and in Osaka at a local hospital. Her medical evacuation was able to be accomplished on a commercial flight...where she had to fly Business Class in order to keep her leg elevated. GeoBlue agreed to pay for the Business Class ticket (they even made the airline reservations) which cost them about $10,000. They would only pay for my economy class (I decided to pay for Business Class out of my pocket to stay close to DW). GeoBlue treated us very well, were actively involved in decision making (via phone calls with myself and the ship's physician) and processed our claim within 2 weeks.

 

We also filed a claim with Chase to recover the unused portion or our cruise (which exceeded $10,000) and our unused return air fare from Vancouver (the ending point of the booked cruise) to PHL. It took 2 months of "negotiation" with Chase in order to meet all their documentation requirements. In the end they agreed to pay the full $10,000 (for unused cruise) but denied the airline ticket reimbursement (about $1000). The air was a real nightmare because it can be difficult dealing with airlines, EZAIR, insurance, etc. In the end we did get AA to give us a credit for the unused air...although they actually have refused to tell us how much credit we have (another long story). Whether we ever get and use that airline credit is questionable.

 

To sum up, we were very pleased with GeoBlue and also satisfied with Chase (although they made my life miserable for nearly 2 months). My warning to any traveler is to make sure you document everything (in writing), contact your insurance company immediately when you have a real problem, and insist on the most detailed medical documentation. In the case of Princess, getting detailed medical records (of DW's treatment aboard) meant paying extra money (I think it was about $50 which turned out to be reimbursable by Geoblue). The best time to get detailed medical records is BEFORE leaving the ship...so its wise to make the request from the Medical Center as discharge.

 

Tip: The stress of a major emergency can impact decision making. One needs to take a deep breath and carefully review your options and act accordingly. In our case that meant refusing medical treatment at a Vietnamese hospital, following the ship's physician advice to seek first class treatment in Japan, and listen to the Japanese surgeon about getting DW home ASAP.

 

Tip 2: When dealing with your insurance companies always keep your cool, be willing to compromise when necessary, and understand they they have their job to do which means they want lots of documentation. We know of too many cases where folks get frustrated and threaten insurance companies and cruise lines with lawsuits. In most cases this is a very bad decision because those companies will simply shift your case to their legal office which then makes your life more miserable. Most of the time using "charm" and understanding will get you a better result (it worked well for us).

 

Hank

 

Thanks... excellent info! Hope the wife is ok now.

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Hank,

Thank you for the 1st hand telling of real life experience.

I'm sure many of us can learn something from this.

 

Hope your wife is doing well.

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My goodness, Hank.

 

This was quite an "adventure", and it sounds like it went reasonably smoothly, given the difficulties that could have ensued (and that I don't even want to think about).

 

Will you wife be okay/able to travel in the future?

 

How did you feel the ship's medical staff handled the situation while she was still a passenger?

It's the "serious stuff" that worries us... but not enough to avoid traveling, obviously.

 

Hope your wife was reasonably comfortable.

(Did the flight attendants allow her to keep the seat as "flat bed" during take-off/landing, or did they fuss about that?)

 

Thanks for sharing the details.

So glad it had a basically happy ending...!

 

GC

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Hank, thanks very much for sharing your experience. Truly hope that your wife is recovering nicely.

 

Good to hear that Chase came through after the documentation hurdles. I am guessing you have the Chase Sapphire Reserve? We've got that as well and are pleased with the benefits, but luckily as of yet have not had a need to file any travel insurance claims.

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Hank...I've been a follower of your posts for quite sometime and am truly sorry your trip had to end under such serious conditions.

 

Hoping your wife is now doing well and you two can return to your love of travel.

 

Is there anything now looking back that you would have done differently?

 

How and who helped you to decide about not using any medical in Vietnam?

 

All my best to you both and many thanks for sharing your experience.

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Very helpful information for all of us.

 

Due to our age, private insurance is very expensive compared to the cruise line insurance but we definitely want more hospital/evacuation coverage than they provide.

 

We've only had a couple of small claims over the years so I am glad to know how important it is to contact the insurance company and get receipts for everything. Did not know the ship would charge for detailed receipts but will be sure I get them if needed.

Thank you!

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Hank, I'm glad it all worked out well for you financially, and that your wife is doing well now.

 

. . .and also satisfied with Chase (although they made my life miserable for nearly 2 months).

 

Glad to see that Chase finally stepped up and honored their coverage after a couple months wait. I once had trouble with a fraudulent charge on a Chase-issued credit card. Getting it taken off my account turned into a nightmare, finally resolved when I became assertive after three months of politely playing by the rules and still going in circles. Once resolved, I closed the account and will never, ever use a card issued by Chase again. Not worth the hassle and I do not trust them. I'm really glad to see they took care of you!

 

FWIW, I do not count on any credit card for travel coverage, though I know it works for many people

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Thank you all for the nice thoughts about DW. She has completely healed (after 3 months of medical treatment and 3 trips to the operating room) and we are off to Copenhagen next week for another cruise (you cannot keep a good DW down). Her recovery was due to some good medical treatment/advice on the Golden Princess, absolutely outstanding treatment at Osaka General Medical Center and all the excellent follow-up care at home.

 

I will emphasize that we do not find fault with Chase other then delays caused by lack of communications. In fairness to Chase they do have an online tracking system (with minimal information) and always answer their phone :). The reality of having those various Chase credit cards that come with the insurance (I believe its mostly the Sapphire cards) is that its an amazing deal. Consider what you would pay for $10,000 of cancellation protection if you purchased it on a trip policy. Our insurance solution is not for everyone, but sure works for us. While purchasing trip policies for a single trip makes a lot of sense for those who take infrequent trips...looking for other options can make a lot more sense for those of us who are very frequent travelers.

 

I should have mentioned another issue which was the cost of Medical Evac. Nearly all policies (including the highly recommended Medjetassist policy requires that patients be moved from "inpatient" status. In our situation, DW was never formally admitted as an "impatient" to any hospital. All of her treatment was on an "outpatient" status on both the ship and at the Osaka Hospital. GeoBlue was still willing to pay her expensive Bus Class home which was a true compromise on their part. In my thirty plus years working in the Health Care Insurance world it is rare to find an insurer willing to compromise when that compromise specifically violates the written policy terms. In this case, the GeoBlue Case Manager made a decision that she must have thought was in the best interests of both the patient and Insurance Company. That is a decision we applaud because we believe that many other companies would have taken a different point a view.

 

Hank

Edited by Hlitner

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Thanks for posting and adding your comment about medical evac. Most people are not aware of the inpatient requirement for MedJet Assist and other evac policies. They focus on the ability to self-determine the need to evac to a home hospital. The more important consideration is the need to be in-patient. A friend of ours decided to forego an admittance to a local hospital (in UK) and wanted evac to Boston (the one in Massachusetts). Wasted valuable time while DH was in the A&E.

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I keep looking at Geoblue annual policy and have a question maybe someone can answer. I read that they only cover incidents our of the country. What would happen on a round trip to Hawaii? I assume they cover nothing in Hawaii but how about medic evacuation from the ship on the way there or back? Also, I recently visited the ship's doctor on a Princess ship. The receipt clearly stated that the Princess doctor was not registered in the US but a foreign country. Does anyone know how Geoblue would respond to that.

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Sorry to take so long to respond to your questions but I somehow missed your post until today.

 

 

[quote name='Ashland;56914164

 

]Hank...I've been a follower of your posts for quite sometime and am truly sorry your trip had to end under such serious conditions.

 

Thank you for your kind words :)

 

Hoping your wife is now doing well and you two can return to your love of travel.

 

Following 3 months of intensive medical treatment (including 2 trips to the OR) she is 95% recovered and good to go :). We are off on another cruise next week.

 

Is there anything now looking back that you would have done differently?

 

Sure' date=' somehow prevented DW from being injured. We have had a long discussion with her local surgeon and he agrees that everthing was likely done properly

 

[b']How and who helped you to decide about not using any medical in Vietnam?[/b]

 

That was mostly my call on the scene (DW agreed) based on some experience. In my prior life I was once a Paramedic and was able to deal with her initial trauma. We both had concerns about the quality of care in Vietnam and were not excited about the prospect of missing the ship and being stuck in Nha Trang. I also knew that if the ship's physician felt differently he would have had time to evacuate her to a local hospital. However, he did agree with my decision. Several days later, when her conditioned suddenly worsened, this same physician strongly recommended treatment in Osaka which resulted in immediate outpatient surgery. Two local surgeons at home felt that this treatment likely saved her leg.

 

 

Hank

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I'm glad that your wife is doing much better.

 

The only thing I would have done differently is that I would have taken photographs of all receipts/documentation as they arrived with my smartphone. That way, I have a backup copy.

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Thank you for relating your experience. You clearly have a system that suits you and it worked well when needed. I'm glad to hear that our DW is now back in the saddle (as it were).

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Thank you for sharing. This is my second year with GeoBlue. Only had one small claim, which they paid promptly without any question. We also use Chase Saphire reserve. My wife and I each have separate cards so on more expensive cruise we each pay our own half. Never filed a claim and hope not to.

 

Question, how did you get your wife to Osaka. Was that the next stop after Vietnam?

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Thank you for sharing. This is my second year with GeoBlue. Only had one small claim, which they paid promptly without any question. We also use Chase Saphire reserve. My wife and I each have separate cards so on more expensive cruise we each pay our own half. Never filed a claim and hope not to.

 

Question, how did you get your wife to Osaka. Was that the next stop after Vietnam?

 

We were on a long cruise (over a month) that went from Singapore to Vancouver. There were quite a few ports in Japan with Osaka being the first. There were actually two other ports between Nha Trang and Osaka (Hong Kong and Taipei) but DW seemed to be improving under the care of the ship's physician. We only sought medical help in Osaka after it became evident that her condition was no longer improving....and to some degree seemed to be worsening.

 

The service and care we received in Osaka was truly world-class and we could not have been more pleased. The ship arranged a private medical transfer (to and from the hospital) which had a medical team waiting to examine and treat DW. The Chief Surgeon, of this large major Teaching Hospital, paid us a personal visit (this is considered a big honor in Japan), quickly assessed the entire situation, and discussed his plan of care recommendations (the hospital provided us with an excellent translator). Although DW was able to return to the ship later that same day, it was obvious at that time that she would not be able to complete the entire cruise (which had nearly 4 weeks remaining). We did not actually evacuate the ship that day in Osaka, but disembarked two days later when we were docked in Yokohama. During that interval we had numerous discussions with the ship's physician and the Case Managers from GeoBlue (our medical insurer) trying to determine the best path. At one point I was on a 3 party phone call with the GeoBlue Case Manager and their travel agency (who booked our air home....while we were on the phone).

 

 

 

Hank

Edited by Hlitner

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We were on a long cruise (over a month) that went from Singapore to Vancouver. There were quite a few ports in Japan with Osaka being the first. There were actually two other ports between Nha Trang and Osaka (Hong Kong and Taipei) but DW seemed to be improving under the care of the ship's physician. We only sought medical help in Osaka after it became evident that her condition was no longer improving....and to some degree seemed to be worsening.

 

The service and care we received in Osaka was truly world-class and we could not have been more pleased. The ship arranged a private medical transfer (to and from the hospital) which had a medical team waiting to examine and treat DW. The Chief Surgeon, of this large major Teaching Hospital, paid us a personal visit (this is considered a big honor in Japan), quickly assessed the entire situation, and discussed his plan of care recommendations (the hospital provided us with an excellent translator). Although DW was able to return to the ship later that same day, it was obvious at that time that she would not be able to complete the entire cruise (which had nearly 4 weeks remaining). We did not actually evacuate the ship that day in Osaka, but disembarked two days later when we were docked in Yokohama. During that interval we had numerous discussions with the ship's physician and the Case Managers from GeoBlue (our medical insurer) trying to determine the best path. At one point I was on a 3 party phone call with the GeoBlue Case Manager and their travel agency (who booked our air home....while we were on the phone).

 

Hank

 

Very impressive service from Geo-Blue!

Thanks for sharing.

 

GC

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The only thing I would have done differently is that I would have taken photographs of all receipts/documentation as they arrived with my smartphone. That way' date=' I have a backup copy.[/quote']

 

That is an excellent idea, and I think some smartphones can now convert to .pdf

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That is an excellent idea, and I think some smartphones can now convert to .pdf

 

We actually did take Smartphone photos of important documents and we even have photos of her injury (which were taken in the medical center and also in the Operating Room at Osaka. When it comes to submitting complex insurance claims, having extensive documentation is king :). Our initial medical insurance claim had more then 50 pages of back-up documents. And by the way, I will repeat something I previously posted. The hospital in Osaka gave me all kinds of documentation (much of it in Japanese) including her CAT Scan pictures. At my request they also e-mailed all those documents directly to Geo-Blue. And as we were about to disembark from the Golden Princess we requested the most detailed medical records available...which actually cost us about $50 (reimbursed by our medical insurance).

 

Hank

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Thanks for the report. Glad your wife is on the mend.

 

I think everyone should be reminded that Chase does not reimburse for preexisting conditions, so that should be factored into everyone’s decision.

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Thanks for the report. Glad your wife is on the mend.

 

I think everyone should be reminded that Chase does not reimburse for preexisting conditions, so that should be factored into everyone’s decision.

 

We don't think we can count on "charge card coverage" because of the pre-existing condition restriction, especially.

Also, we almost always would go over any limits on cancellation or interruption claims.

Thus far, almost all of our claims have been for cancellation or interruption costs, and all but two very minor claims were due to medical events.

(We have no idea whether an insurer would have tried to claim that any of the medical events were related to something "pre-existing", but that's a fight we don't want to have with a major insurance company!)

 

GC

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We don't think we can count on "charge card coverage" because of the pre-existing condition restriction, especially.

Also, we almost always would go over any limits on cancellation or interruption claims.

Thus far, almost all of our claims have been for cancellation or interruption costs, and all but two very minor claims were due to medical events.

(We have no idea whether an insurer would have tried to claim that any of the medical events were related to something "pre-existing", but that's a fight we don't want to have with a major insurance company!)

 

GC

 

As I mentioned, the Chase Sapphire Card has a 60 day "look back period" for their pre-existing definition. This is pretty standard in the industry although some other policies have even further look back periods. Unless one has had an issue in that look back period or had a change in their treatment it would not be a problem. But we do agree that for many folks, it is important to get a policy with no pre-exisiting condition issues. On the other hand, if we were to purchase trip insurance for each of our trips we would be spending thousands of dollars on insurance every year. Since we do not purchase trip insurance we are over $100,000 ahead of the game by virtue of the money we have saved on premiums .

 

As we often post, each person has to examine their own circumstances and risk tolerance and act accordingly. There is no "one policy fits all" in the business. If we were paying over $30,000 for a cruise we would likely be shopping for more coverage. And the credit card coverage is certainly inadequate for somebody booking a World Cruise.. In fact, our GeoBlue medical coverage is only good for the first 70 days of any trip...so for longer trips one would have to consider other options. Because of that GeoBlue restriction (70 days per trip) we do limit our trips to 70 days :).

 

Hank

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I keep looking at Geoblue annual policy and have a question maybe someone can answer. I read that they only cover incidents our of the country. What would happen on a round trip to Hawaii? I assume they cover nothing in Hawaii but how about medic evacuation from the ship on the way there or back? Also, I recently visited the ship's doctor on a Princess ship. The receipt clearly stated that the Princess doctor was not registered in the US but a foreign country. Does anyone know how Geoblue would respond to that.

 

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

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