Medical coverage from GeoBlue, cc and another policy

[dcl999]

We have medical coverage through GeoBlue. There is also some from our cc. Our cruise/tour also provides some. If needed, who do I call first? Who do I file with first?

Edited July 27, 2022 by dcl999
Duplicate post changed

[Jersey42]

It depends on what you have.  Assuming you have GeoBlue Trekker, then the simple answer is to file with GeoBlue  The only downside to this is the $100 or $200 annual deductible if you don't use a network provider.

 

All cc medical insurance that I have seen pays secondary, so you have to file with other insurance first.  Plus, the cc's don't cover pre-existing conditions and the medical limit is usually tiny.  If you don't have a pre-existing condition, then you may still need to provide old medical records to prove it.  So don't file with the CC.

 

Take a look at your cruise/tour coverage.  Does it pay primary or secondary?  Most are secondary. If yours is too, then file with GeoBlue.  If it pays primary, does it cover pre-existing conditions?  If it does, and there is no deductible, and medical charges are less than the coverage maximum, then you might want to file with the cruise/tour insurance to save the GeoBlue deductible. If it does not cover pre-existing conditions and you might have one, then file with GeoBlue. If it does not cover pre-existing conditions and you do not have one, then file with GeoBlue to save the hassles of proving you have no pre-existing condition, OR file with the cruise/tour insurance to save the GeoBlue deductible.

 

If you use a GeoBlue network provider, then ignore all of the scenarios and just file with GeoBlue.

 

[Hlitner]

When we had a similar situation (about 4 years ago) the answer (from Geoblue) was that their policy was primary.  We filed with Geoblue, they paid all of our medical and medical evacuation claim, and life went on :).  At the time we also had some CC coverage and Medicare Advantage Plan coverage, but never involved them in the medical and evacuation issues.  We did file with our CC for trip interruption, and they paid most of that claim.

 

My advice to the OP is that if you do ultimately need to file a claim (we should all hope this does not happen) than file with GeoBlue and their claims processing folks tell you if there is any kind of claims coordination issues.  I would also advise that if you do get into a situation that would result in filing a claim, you immediately telephone or e-mail Geoblue and get them involved at the earliest possible time.

You also need to be careful to document everything, even if it means paying some money to get detailed medical records to support any claim.

 

Hank

[CHEZMARYLOU]

@Jersey42 & @Hlitner We have travel insurance through the cruise line to cover the cost of the trip, (Suites are too expensive to absorb the cost should we have to cancel) and want to purchase GeoBlue for medical/evacuation coverage, and we have a medicare advantage plan.  I'm assuming if it is a medical issue GeoBlue would be the 1st company we would file with. If we cancel prior to the cruise for a covered reason then Celebrity's insurance would be our go to to recover the cost of the cruise.

[Hlitner]

15 minutes ago, CHEZMARYLOU said:

@Jersey42 & @Hlitner We have travel insurance through the cruise line to cover the cost of the trip, (Suites are too expensive to absorb the cost should we have to cancel) and want to purchase GeoBlue for medical/evacuation coverage, and we have a medicare advantage plan.  I'm assuming if it is a medical issue GeoBlue would be the 1st company we would file with. If we cancel prior to the cruise for a covered reason then Celebrity's insurance would be our go to to recover the cost of the cruise.

When you use GeoBlue (which only works when you travel outside the USA) the GeoBlue policy is "primary" for claims.  Like you, we live in PA and have a Medicare Advantage Plan (Aetna).  When we had a major medical emergency (in Asia) we only needed to deal with GeoBlue (we never submitted anything to Aetna) who reimbursed us for all the medical bills (on the ship and in Japan) and also arranged/paid for emergency air evacuation to get us back to the USA.  That air evac was interesting (I posted here at the time) since DW had the medical necessity for a lay flat seat which mean Business Class.  Geoblue actually got us on a 3 person phone call (us, GeoBlue's case manager, and GeoBlues preferred travel agency) and quickly arranged a last minute Delta Airlines Business Class seat (which cost about $10,000) for DW (Tokyo to the USA).  I chose to book my own Business Class seat (to be near DW) rather than let GeoBlue book me (since they would have only booked me in the lowest price economy seat), but that was my choice.   If Delta had refused to fly DW (this can happen with medical evacs) than GeoBlue would have needed to arrange for a medical evac flight.

 

If you also have Celebrity's Travel Insurance, that also includes some Medical and Evacuation coverage.  While GeoBlue took the primary position when all we had was Medicare, I do not know whether they would do the same with Celebrity's Insurance or whether they would get involved in some type of claims coordination scheme.  Claims Coordination between insurance companies can be done between the insurance companies (which is almost blind to the claimant) or they can ask the claimant to submit claims to both insurers (much more complicated).   Because you do plan on having the Celebrity Insurance I think it might be wise for you to call Steve (tripinsurancestore.com) or one of his staff and ask about this issue.  His company also handles Geoblue so they could even set that up if you find that desirable.   If you do not want to deal with Steve (or another broker) than an alternative would be to call GeoBlue and ask them the same question.

 

Hank

[Jersey42]

1 hour ago, CHEZMARYLOU said:

I'm assuming if it is a medical issue GeoBlue would be the 1st company we would file with. If we cancel prior to the cruise for a covered reason then Celebrity's insurance would be our go to to recover the cost of the cruise.

Yes, you are correct on both accounts. 

 

@Hlitner's advice is all spot on.  I will add the following for a medical claim:

• If you have GeoBlue, Medicare Advantage and Celebrity Cruise Care you file with GeoBlue and they will take care of all (covered) expenses - less the deductible if applicable.  Celebrity is secondary coverage, so the best you could reasonably expect from them is the GeoBlue deductible.  I guess if GeoBlue denies coverage for a portion of the claim or they pay a reduced amount, you could file with Celebrity for the balance. But I would not expect anything more than the deductible.
• Medicare Advantage (MA) plans are all different.  I assume if you are purchasing a GeoBlue plan, your MA plan does not give you complete or good foreign travel coverage.  So you will probably never need to file anything with them.
• From GeoBlue: "The GeoBlue Trekker plans are secondary insurance. However, GeoBlue will process and pay overseas claims as a primary payor and reserves the right, where applicable, to contact your primary insurance company to coordinate benefits."  While GoBlue could contact your MA plan for coordination of benefits, Steve at TripInsuranceStore (highly recommended) confirmed recently that he has never seen this happen with any of his customers.  

Edited August 27, 2022 by Jersey42

[CHEZMARYLOU]

Thanks, we're only keeping the Celebrity coverage in case we have to cancel for a covered reason after final payment. 

[Hlitner]

31 minutes ago, Jersey42 said:

Yes, you are correct on both accounts. 

 

@Hlitner's advice is all spot on.  I will add the following for a medical claim:

• If you have GeoBlue, Medicare Advantage and Celebrity Cruise Care you file with GeoBlue and they will take care of all (covered) expenses - less the deductible if applicable.  Celebrity is secondary coverage, so the best you could reasonably expect from them is the GeoBlue deductible.  I guess if GeoBlue denies coverage for a portion of the claim or they pay a reduced amount, you could file with Celebrity for the balance. But I would not expect anything more than the deductible.
• Medicare Advantage (MA) plans are all different.  I assume if you are purchasing a GeoBlue plan, your MA plan does not give you complete or good foreign travel coverage.  So you will probably never need to file anything with them.
• From GeoBlue: "The GeoBlue Trekker plans are secondary insurance. However, GeoBlue will process and pay overseas claims as a primary payor and reserves the right, where applicable, to contact your primary insurance company to coordinate benefits."  While GoBlue could contact your MA plan for coordination of benefits, Steve at TripInsuranceStore (highly recommended) confirmed recently that he has never seen this happen with any of his customers.  

Our own experience, which happened in 2018, was that Geoblue wanted no part of our Medicare Advantage Plan.  Our plan does cover foreign emergency and urgent care (DW's injury would have fallen under both of those categories) and as part of the Geoblue enrollment process we did fully disclose this Medicare Advantage information (GeoBlue requires that you have other coverage as part of their eligibility process).  When we were dealing with the GeoBlue Case Manager and filing our claim info I did ask about filing a claim with the Medicare Advantage Plan and GeoBlue simply told me they (GeoBlue) was primary and we only needed to file with them (and they reimbursed us 100% of the medical bills less the small deductable).   Whether GeoBlue than goes through a claims coordination process with Aetna (the Medicare insurance carrier) is unknown to me.  Having worked in the medical insurance industry for over 35 years I do know that it would be possible for them to work with Aetna, but have no idea if this is part of their internal process.  Since we never received any kind of Explanation of Benefits (EOB) from Aetna, my best guess is that Geoblue simply covered the entire claim.

 

I should mention that we also had other secondary insurance through our Chase credit card.  We never filed anything with Chase for Medical or Evacuation coverage since it was covered by our primary insurance (Geoblue).  We did file with Chase for their Trip Interruption benefit for which they did reimburse most of our pro-rated loss.  This is why there are quite a few posters here on CC who talk about using a combination of good travel medical insurance and credit card cancellation/interruption insurance.  The higher end credit cards such as AMEX Platinum and Chase Sapphire Reserve do include some insurance although they have very restrictive terms so are not suitable for everyone.

 

Hank

[Jersey42]

27 minutes ago, CHEZMARYLOU said:

Thanks, we're only keeping the Celebrity coverage in case we have to cancel for a covered reason after final payment. 

In this case, if you have a medical claim you must first file with your Medicare Advantage plan.  If it does not pay everything, then you can file with Celebrity.  Celebrity's plan pays a maximum of $25K for medical.  If your MA plan offers some foreign travel coverage with an out-of-pocket maximum of less than $25K, a GeoBlue plan would not have provided you with any significant benefit.   

[CHEZMARYLOU]

1 hour ago, Jersey42 said:

In this case, if you have a medical claim you must first file with your Medicare Advantage plan.  If it does not pay everything, then you can file with Celebrity.  Celebrity's plan pays a maximum of $25K for medical.  If your MA plan offers some foreign travel coverage with an out-of-pocket maximum of less than $25K, a GeoBlue plan would not have provided you with any significant benefit.   

I think I am more concerned about medical evacuation, if needed.  We will only be cruising in the Caribbean.

[Hlitner]

On 8/27/2022 at 12:54 PM, CHEZMARYLOU said:

I think I am more concerned about medical evacuation, if needed.  We will only be cruising in the Caribbean.

So, you can't get sick or have an accident in the Caribbean?   The reality is that evacuation from the Caribbean is a lot cheaper than medical evacuation from South America, Africa, Asia, etc.  But if you are hospitalized for a major medical problem in the Caribbean (or anywhere else) you can quickly rack up 10s of thousands of dollars in medical bills.  

 

And there is a myth about medical evac.  All medical evac policies require that you be an inpatient and have the medical need and ability to be transferred.  This latter provision generally means you need to approval of the attending physician, a receiving physician, and the insurance companies own medical staff, before you can be evacuated.  If you have a serious illness or accident, you may not be able to get transferred for days or weeks until your condition has stabilized.   And many evacuations are only going to get you to the nearest decent medical facility which is not necessarily home.  Have a major accident on Anguilla and you might find yourself evacuated to nearby St Maarten.  Have an accident in Limon, Costa Rica and you might find yourself evacuated to San Jose.  The option to get evacuated back to the USA might not be practical because of your medical condition and lack of approval from your insurance company.

 

Hank

[CHEZMARYLOU]

@HlitnerI know it is just as possible to get sick or injured in the Caribbean. My point was that we would not be halfway around the world if something happened. 

[Hlitner]

Just now, CHEZMARYLOU said:

@HlitnerI know it is just as possible to get sick or injured in the Caribbean. My point was that we would not be halfway around the world if something happened. 

True.  But you only get medical evacuation for a serious problem that gets you hospitalized.   

[Babr]

22 minutes ago, Hlitner said:

True.  But you only get medical evacuation for a serious problem that gets you hospitalized.   

And as you pointed out earlier, it still may not get you back to the US but to a higher level of care in country that is deemed appropriate by the parties making the decision.

 

If that is the goal, ChezMary may consider a separate evacuation-specific  policy like MedJet. It still requires hospitalization, but it does give you a voice in the decision once you are able to be transferred.

Edited August 31, 2022 by Babr