Medicare and Alaska Crusing

[knittinggirl]

3 hours ago, colbe said:

You still used the Doctors time.

True.  Next time I'll be asking if they have that medicine first.  Even in the states, the doctor has been known to tell me he can't do anything for me, and stick me with a charge for a doctor's visit.

 

But on Legend of the seas back in 2014, the doctor told me he didn't have the medicine, so he wasn't going to charge me.   I believe that was before Michael Bayley.

Edited October 26, 2019 by knittinggirl

[chengkp75]

12 hours ago, Billthekid said:

Holland has switch from visiting doctors on a free cruise to a medical team of full time professionals as part of the crew.  Which negates the provision that states;  Similarly, and without limitation, all spa personnel, instructors, guest lecturers, entertainers and other service personnel shall be considered independent contractors who work directly for the Guest. " 

How do you know that the medical staff are not "independent contractors"?  Being part of a ship's "crew" is not limited to being a HAL employee.  The spa personnel are all employed by the spa company, not HAL, yet part of the concession agreement allowing the spa company to operate onboard is that the spa personnel will follow all HAL rules and regulations, and follow the orders of the officers onboard the ship.  Further, each and every crew member, or person who works on the ship, signs a personal, one to one, contract between themselves and the Captain of the ship, not HAL.

 

While I have experienced the "vacationing doctor" at times, it is more the rarity than the norm, and even those doctors were not hired by HAL, but by a third party medical services provider company, and this is still the case.

 

Unfortunately, most Americans feel that their rights and privileges extend no matter where in the world they are, and this is just not correct.  Stepping on a foreign flag cruise ship puts you in a foreign country, even when cruising the Inside Passage in Alaska.  As I noted, the Medicare proviso for covering medical expenses within 6 hours of a US port is for US flag vessels.  So, yes, you need medical insurance that covers travel to a foreign country whenever you cruise.

[colbe]

8 hours ago, chengkp75 said:

Unfortunately, most Americans feel that their rights and privileges extend no matter where in the world they are, and this is just not correct.  Stepping on a foreign flag cruise ship puts you in a foreign country, even when cruising the Inside Passage in Alaska.  As I noted, the Medicare proviso for covering medical expenses within 6 hours of a US port is for US flag vessels.  So, yes, you need medical insurance that covers travel to a foreign country whenever you cruise.

Thank you for your wise and knowedgeable input chengkp75.

[Billthekid]

It sounds like to me everybody on a HAL cruise is a "contract employee" except maybe the ships officers.  All of the cabin, dining, bar personnel are on contact with who the contract is with I have no idea.  Shop, casino, and entertainers are all on contracts.  I guess the medical staff is on contact with an outside contractor.  The work crew is probably on contact along with the purser's office personnel.  So maybe 20 officers are working and being paid by HAL and the other 500-600 crew members are all contract personnel.  And as such are individually liable for their actions and not HAL.  

[3rdGenCunarder]

1 minute ago, Billthekid said:

It sounds like to me everybody on a HAL cruise is a "contract employee" except maybe the ships officers.  All of the cabin, dining, bar personnel are on contact with who the contract is with I have no idea.  Shop, casino, and entertainers are all on contracts.  I guess the medical staff is on contact with an outside contractor.  The work crew is probably on contact along with the purser's office personnel.  So maybe 20 officers are working and being paid by HAL and the other 500-600 crew members are all contract personnel.  And as such are individually liable for their actions and not HAL.  

 

I think everyone who works for a cruise line is on some kind of contract basis. Waiters, cabin stewards, bar tenders, kitchen staff are on contracts with HAL. I don't think that qualifies them as "independent contractors." It's just the way the employment is structured. 

 

Shops, casino, spa workers work for the vendors that run those locations. In-house entertainers are employed by a company that develops shows and hires the performers. One-time entertainers are probably placed by a service, as are lecturers and clergy. And it sounds like medical staff are also provided by a service. The cruise line contracts with vendors and services, not with the individuals who come to the ship. 

[chengkp75]

55 minutes ago, Billthekid said:

It sounds like to me everybody on a HAL cruise is a "contract employee" except maybe the ships officers.  All of the cabin, dining, bar personnel are on contact with who the contract is with I have no idea.  Shop, casino, and entertainers are all on contracts.  I guess the medical staff is on contact with an outside contractor.  The work crew is probably on contact along with the purser's office personnel.  So maybe 20 officers are working and being paid by HAL and the other 500-600 crew members are all contract personnel.  And as such are individually liable for their actions and not HAL.  

All merchant mariners, anywhere in the world, on any ship, are "on contract" with the Captain.  This is called "ship's articles" or the "articles of engagement".  So, even the officers are "contract workers".  The vast majority of the officers, supervisors, and crew are hired directly by HAL, and so are HAL employees.  Shop assistants, spa and casino personnel, medical staff are provided by third party companies, but sign a contract with the Captain.  Entertainers are typically independent contractors (though some lines hire their production show cast from third party entertainment firms), who also sign a contract with the Captain.  Since these people are provided by the third party companies, over which HAL has little say over which personnel are provided, they are not HAL employees, but are, as listed in the ticket contract, individual contractors.

[Billthekid]

Thanks 3rdGenCunarder and chengkp75 for the information.  I found it very interesting and educational.  Explains quite a bit.  Thanks!

[slidergirl]

Why I always buy travel insurance that has primary medical.  And, I did have to use it once - for a 10,000EU hospital bill in Italy!  I didn't have to do an "up front" payment, either.  That was was with Travel Insured.

 

I just left my job last week and my employee's medical runs out on 10/31. I leave for my vacation on 11/1.  I really did not want to do a 2 week with no insurance.  I wanted to get my Medicare all caught up for the rest of the year (never needed it).  But, the Part D (for my meds) hasn't been approved yet. So, I took out trip insurance with Travel Assured this time to cover primary medical.  I feel so much more at ease now.  As far as my meds, my NP went ahead and ordered a 3 month supply of them for me on Friday so I won't have to deal with buying more until all the Medicare is done.  

Now, I have to figure out whether to keep 'normal' Medicare and pay for Parts B&D or do Part C - it's a PIA to try to find which plan my NPs and MDs and Nutritionist work with - I'll have to go actually talk to them - even they work out of the same clinic in town, 1 MD is listed and no one else on a few of the plans - I do not want to have to drive 50 miles to see a doctor!!

[DaveOKC]

2 hours ago, slidergirl said:

Why I always buy travel insurance that has primary medical.  And, I did have to use it once - for a 10,000EU hospital bill in Italy!  I didn't have to do an "up front" payment, either.  That was was with Travel Insured.

 

I just left my job last week and my employee's medical runs out on 10/31. I leave for my vacation on 11/1.  I really did not want to do a 2 week with no insurance.  I wanted to get my Medicare all caught up for the rest of the year (never needed it).  But, the Part D (for my meds) hasn't been approved yet. So, I took out trip insurance with Travel Assured this time to cover primary medical.  I feel so much more at ease now.  As far as my meds, my NP went ahead and ordered a 3 month supply of them for me on Friday so I won't have to deal with buying more until all the Medicare is done.  

Now, I have to figure out whether to keep 'normal' Medicare and pay for Parts B&D or do Part C - it's a PIA to try to find which plan my NPs and MDs and Nutritionist work with - I'll have to go actually talk to them - even they work out of the same clinic in town, 1 MD is listed and no one else on a few of the plans - I do not want to have to drive 50 miles to see a doctor!!

I am no medicare expert, but there is LOTS of good information on the internet on this issue.

 

My understanding is that you have two options - one is Medicare (parts A, B and D) and then purchase (if you wish) a supplimental insurance that covers some costs that medicare does not - with this you can go to any doctor that accepts medicare clients (this is most doctors) while the second option (common called Medicare Advantage which does often provide wider coverage (such as some dental and optical, but you have to go to a doctor that is part of their plan, which can be limiting in some areas.