Medical Evacuation costs - anyone have first-hand knowledge?

[erdoran]

Been in an interesting discussion on the NCL boards about Geoblue Trekker and Medicare coverage of medical bills & emergencies in US waters - e.g. sailing from NYC to Port Canaveral and there’s a medical emergency during that trip.  Turns out Medicare would probably cover the medical portion (depending on the individual’s plan of course).  However, it’s unclear about medical evacuation coverage, since my understanding Geoblue would only cover outside the US.

 

Anyway, one of the posters who has worked in the cruise industry 40 years or so said that air/boat evacuation from a cruise ship is done by US Coast Guard or equivalent in US, Mexico, and Caribbean and at no charge...

 

So that got me thinking...there is common wisdom that older cruisers need a substantial amount of medical evacuation coverage, over and above medical bill coverage, and costs are thrown around about $50k, $100k, etc, etc...but...this must be a wildly profitable product for insurance companies, along the lines of collision damage waivers & other insurances for rental car industry.

 

Does anyone have any first-hand knowledge of someone who has been medically evacuated from a cruise ship, and a ballpark of cost, if any, JUST for the evacuation from the ship to land or a hospital?  Steve @iamtrustworthy your insight is especially welcome if you have helped customers with claims for this.  

 

My instinct is that these high numbers are legit, but based on what was said I’m wondering where these high medevac costs are incurred.

 

TIA

Edited January 4, 2020 by erdoran

[Babr]

OK. I don’t have first hand experience, but I think I can clarify what the evacuation covers so that you know where the expense comes from. No, a private company does not rescue you from a ship at sea. Indeed, that portion of getting you to the hospital is done by the equivalent of the Coast Guard or appropriate military branch.

 

Insurance covers the cost of getting you from that initial point of treatment to a facility that can treat your condition if it is beyond the capabilities of the local hospital. You must be stable enough to transport, and the insurance company doctors must consult with the local doctors in order to approve the evacuation to the nearest appropriate facility.  

 

The cost  doesn’t necessarily reach the limits offered, and the insurance companies know that. Fifty to even one hundred thousand is often recommended, but much higher limits are a likely a selling point that offers reassurance to the purchaser.

 

The evacuation coverage alone is not a big moneymaker. A policy that has a high limit for evacuation generally has better coverage for medical as well, along with other improved coverage, thus the higher cost.

 

As a side note, there are companies like MedJet Assist that will transport you to the facility of your choice, but that is a stand- alone policy, not general travel insurance.  

[iamtrustworthy]

21 hours ago, erdoran said:

Been in an interesting discussion on the NCL boards about Geoblue Trekker and Medicare coverage of medical bills & emergencies in US waters - e.g. sailing from NYC to Port Canaveral and there’s a medical emergency during that trip.  Turns out Medicare would probably cover the medical portion (depending on the individual’s plan of course).  However, it’s unclear about medical evacuation coverage, since my understanding Geoblue would only cover outside the US.

 

Anyway, one of the posters who has worked in the cruise industry 40 years or so said that air/boat evacuation from a cruise ship is done by US Coast Guard or equivalent in US, Mexico, and Caribbean and at no charge...

 

So that got me thinking...there is common wisdom that older cruisers need a substantial amount of medical evacuation coverage, over and above medical bill coverage, and costs are thrown around about $50k, $100k, etc, etc...but...this must be a wildly profitable product for insurance companies, along the lines of collision damage waivers & other insurances for rental car industry.

 

Does anyone have any first-hand knowledge of someone who has been medically evacuated from a cruise ship, and a ballpark of cost, if any, JUST for the evacuation from the ship to land or a hospital?  Steve @iamtrustworthy your insight is especially welcome if you have helped customers with claims for this.  

 

My instinct is that these high numbers are legit, but based on what was said I’m wondering where these high medevac costs are incurred.

 

TIA

Hi Erdoran,

 

I've never had a customer who was transported off a ship by the Coast Guard, but I have a customer who is in the Coast Guard tell me one would be free (no cost).

 

The most expensive transport I have been involved with is $126,000 from South Africa to the Mayo Clinic in Minnesota.

 

It's a lot less from Cental or South America. Two years ago I had a customer that was transported from Panama City to Georgia for just under $40,000.

 

What travelers mostly don't know is that insurance companies as well as the Medical Transportation membership plans all have authorized affiliates that provide access to medically equipped aircraft as well utilizing commercial airlines with medical escorts.

 

> this must be a wildly profitable product for insurance companies

 

I wouldn't say the Medical Transportation / Evacuation coverage adds much profit to a Trip Cancellation plan or for a GeoBlue plan. There are so few transports and the majority of medical transports are done on commercial airlines with medical escorts, that the cost of the Medical Transportation / Evacuation coverage is a relatively small part of the policy's cost.

 

I hope this helps,

 

Steve

[erdoran]

Thanks.  Quite helpful!

[sultan_sfo]

Normally, I avoid responses. So I will just write this one post only. I do not wish to debate.

 

In April 2019, I was disembarked at Guadalope on day 90 of a 111 days cruise. I had Platinum Princess Vacation Plan (PVP) with an evacuation coverage of $50K.

 

The final evacuation was to be to my city of residence -- SFO. Fortunately, the French Hospital in Guadalope to which I was disembarked and admitted was able to correctly diagnose my problem (not a pre-existing) which the ship doctor was not able to do. After 6 days, the Guadalope hospital doctor cleared me to be transported but I was still on IV because of a secondary infection.

 

The PVP coordinator was great. I learned through the hospital via the PVP coordinator,

that because of being on IV, I could NOT use commercial airline even accompanied by an RN. So the evacuation to a US hospital (where I would be medically covered) had to be using an Air Ambulance. Evacuation directly to SFO would have exceeded $50K but luckily the coordinator was able to locate an Air Ambulance going to FLL. So I was evacuated  to FLL by Air Ambulance with 2 medical attendants. After a short stay in FLL hospital, I was off IV and PVP arranged to fly me commercial First Class accompanied by an RN to SFO and admitted to a PT hospital in SFO . Air Ambulance was around $24K and the flight FLL/SFO may have been around $5K. These are real evacuation numbers.

 

IMO, the assumption that  an evacuation during a transatlantic cruise by helicopter / coast guard to the nearest (US or non-US) hospital would be compliments of US govt. is doubtful.

 

BTW, the best source is Steve whose experience and knowledge IMO can be completely trusted.

Now I get xtra coverage over and above PVP through him.

 

 

Edited January 7, 2020 by sultan_sfo

[erdoran]

Thank you sultan for sharing your experience.  This had been an excellent education for me, and I’d think for other cruisers reading this thread.  I guess I always assumed that medevac coverage was ship to first shore hospital, and it would then be dubious whether the standard trip insurance would cover a flight from the shore hospital to your preferrred home hospital, unless there was something massively wrong or the shore hospital was totally inadequate.  My takeaway is that I was wrong and that the primary trip insurance or trip medical plan will most likely cover both, up to policy limits, and the 500k-$1 million evac limits are really unnecessary; a $250k medevac is more than sufficient for most ordinary cruising.

[Babr]

Not meant as debate - just a couple of observations.

 

Years ago, we were on a cruise somewhere off the coast of California returning from Mexico when a young girl on board suffered an attack of appendicitis.  Since we were hours from port, and -as luck would have it - the USS Ronald Reagan was within range, a helicopter was dispatched to evacuate her.  The captain updated us later to say that she was transported back to the Reagan where she received an emergency appendectomy. I suppose it was closer than land, and time was of the essence. As it turned out,  she got transportation, treatment, and a great story to tell courtesy of the US government. 
 

That is not to say that one can expect the same on a transatlantic even in a dire emergency. Sometimes it just isn’t possible. That is why there is a morgue on board. On our last transatlantic, when we reached the Azores, there were a number of ambulances lined up to transport ill passengers to the hospital. I suppose those people had been stabilized and tended to in the infirmary until we arrived at the first place they could be disembarked. 
 

The point is that rescues at sea are pretty rare. That is not what evacuation insurance is for.

 

 

[fasmustang]

FIrst, we had Princess Platinum insurance. We were disembarked in Dominica Dec. 2019 for my hubbys severe back pain, because they said he needed a CT scan, which the Princess ship didn't have in the medical unit. Had to pay the $4k ship medical bill (overnight in sick bay, no tests) before we got off the ship & were transported to what they called a hospital. Got hold of AON & got evac'd to FLL the next day by AirEvac at a cost of 23K. Insurance covered that. After 8 weeks in 3 different hospitals in FL we were medically evac'd (he was intubated) to a hospital in OKC, our home state. Had to argue with AON because they tried to tell me we only had $25k coverage - but I had read policy that said $50K. They finally agreed that we had coverage for a second flight. ($23k to fly to Oklahoma hospital) Still fighting with them to receive any reimbursement for the medical bills. They keep sending letters asking for something new. Have sent BCBS EOB's, hospital/dr bills, medicare secondary EOB's, cc statements showing payments, etc. Their latest request is for charts & dr's notes, and proof that he was treated by licensed MD's. Since when are major FL hospitals not using MD's? I'll never use a company underwritten by AON again if I can help it. I've sent over $100k worth of unpaid bills to them, & can't even seem to receive the $10k reimbursement in coverage we had.

[erdoran]

9 hours ago, fasmustang said:

FIrst, we had Princess Platinum insurance. We were disembarked in Dominica Dec. 2019 for my hubbys severe back pain, because they said he needed a CT scan, which the Princess ship didn't have in the medical unit. Had to pay the $4k ship medical bill (overnight in sick bay, no tests) before we got off the ship & were transported to what they called a hospital. Got hold of AON & got evac'd to FLL the next day by AirEvac at a cost of 23K. Insurance covered that. After 8 weeks in 3 different hospitals in FL we were medically evac'd (he was intubated) to a hospital in OKC, our home state. Had to argue with AON because they tried to tell me we only had $25k coverage - but I had read policy that said $50K. They finally agreed that we had coverage for a second flight. ($23k to fly to Oklahoma hospital) Still fighting with them to receive any reimbursement for the medical bills. They keep sending letters asking for something new. Have sent BCBS EOB's, hospital/dr bills, medicare secondary EOB's, cc statements showing payments, etc. Their latest request is for charts & dr's notes, and proof that he was treated by licensed MD's. Since when are major FL hospitals not using MD's? I'll never use a company underwritten by AON again if I can help it. I've sent over $100k worth of unpaid bills to them, & can't even seem to receive the $10k reimbursement in coverage we had.

First and foremost, is hubby OK?

 

And a question - I’m assuming the $100k in bills are from FL - why wouldn’t Medicare & secondary pay them?  I think a lot of us on Medicare would want to know that.  My (naive?) assumption is if we are in the US then Medicare and secondary cover everything legit.

[D & S]

Sultan mentioned he gets his insurance thru Steve. What insurance company is Steve associated with?

[Babr]

Steve is a broker whose agency TripInsuranceStore.com is often mentioned here. He represents several companies he has determined to be trustworthy.

 

He has a sub-forum on the home page of this forum. Hit the back button and scroll to the top.  You can go to his web page for lots of information or call for personal help.

[doctork]

Erdoran, I am so sorry about what you and your husband are going through.  Sadly, sometimes the battle with insurance is almost as bad as the illness or injury itself.

 

I wonder if your state Insurance Commissioner office could help you out with your insurance problems.  The IC may not have much sway with international companies and medical bills, but if you bought the insurance in Oklahoma, the company that sold it to you is probably licensed in OK and must follow OK state laws, which require that the insurer deliver what you have bought and paid for.  AON is usually a broker of insurance, not the actual underwriter, so the policy is possibly/probably underwritten by another company - check the fine print on the policy to be certain.

 

And if it is Medicare causing some of the trouble, your Senator or Congressional Representative's office should help you.  They employ staffers with expertise in health care matters to help their constituents with Medicare problems.