Our experience with the onboard Medical Clinic

[Hlitner]

2 hours ago, Jake Martin said:

If you are over 65 from the US and carry a supplemental Medicare policy, Plans F and G do cover up to $50,000 of foreign medical care.

They are the most expensive plans, but worth it.

Virtually all cruise ships are flagged in Bahamas, Panama, not the US.

That is limited to emergency and urgent care (with most plans).  Like most foreign coverage, the patient will need to pay their own bills (generally prior to discharge) and later seek reimbursement.  Patients (and their representatives) need to be very careful to seek the maximum available documents prior to leaving a facility.  When DW was treated in Japan, we left with nearly 50 pages of documentation including x-rays. CT Scans, photos, etc.  All this was very helpful when we later submitted our claims (in our case GeoBlue was Primary and we never used our Medicare Advantage coverage).

 

Hank

[Heidi13]

6 hours ago, Jake Martin said:

If you are over 65 from the US and carry a supplemental Medicare policy, Plans F and G do cover up to $50,000 of foreign medical care.

They are the most expensive plans, but worth it.

Virtually all cruise ships are flagged in Bahamas, Panama, not the US.

 

Bahamas may be the largest register of cruise ship tonnage, but I certainly wouldn't say virtually all cruise ships are registered in Bahamas or Panama.

 

This is the HAL Board and all their ships (11) are registered in The Netherlands. The entire Viking Ocean & Expedition fleet (12) are registered in Norway. P&O UK, P&O Aus, Princess and Cunard (29) are registered in UK or Bermuda. Aida Cruises (11) are registered in italy and Costa (10) are also Italian. Celestyal Cruises (2) are registered in Malta and Azamara (4) are also registered in Malta.

[Toad]

On 4/21/2023 at 12:14 PM, Guest ldtr said:

Have not seen a Medicare advantage plan that covers outside the US. There are still a couple of Medicare supplement plans that provide coverage, but the level of coverage is extremely limited.

 

We use an annual policy for about 350 per year with 1000 deductible that will cover any trips in that year, up to a max individual trip length of 70 days. You can do multiple long trips, just not over 70 day on any one trip.

I like the idea of an annual policy, may I ask where one gets it or is that not allowed?

[Shmoo here]

47 minutes ago, Toad said:

I like the idea of an annual policy, may I ask where one gets it or is that not allowed?

I did a search on one of the travel insurance comparisons websites when we were looking for one.  

[0106]

The Cruise and Travel Insurance Forum may help some of you. https://boards.cruisecritic.com/forum/2648-qa-cruise-insurance-with-steve-dasseos-of-the-tripinsurancestorecom-summer-2023/

[aliaschief]

As retired military with Tri Care For Life we actually received compensation for over a $1,200 charge from some medical clinic visits onboard.  Took some time but eventually we were reimbursed. First problem insurance paid Hal when we had already been charged in OBC.

We were not aware this was feasible to a fellow retiree living in Brazil part time told us. I believe we used DD form 2642 to make a claim.

Edited November 26, 2023 by aliaschief

[aliaschief]

22 minutes ago, aliaschief said:

As retired military with Tri Care For Life we actually received compensation for over a $1,200 charge from some medical clinic visits onboard.  Took some time but eventually we were reimbursed. First problem insurance paid Hal when we had already been charged in OBC.

We were not aware this was feasible to a fellow retiree living in Brazil part time told us. I believe we used DD form 2642 to make a claim.

Just an add this visit occurred in Norway.

[Jake Martin]

On 4/22/2023 at 8:20 AM, Hlitner said:

We often discuss these kinds of insurance issues on the CC/Cruise discussion topics/ trip cruise insurance board.  And by the way, some (not all) Medicare Advantage Plans do include some out of the country coverage for Emergency/Urgent Care.  
 

Folks need to be aware that nearly all out of country coverage will require you to pay the bills and later seek reimbursement.  
 

Hank

 

[Jake Martin]

Couple amplifications

 

Even though Medicare Plans F (grandfathered) and G - Supplemental to Medicare OG, cover up to $50K, that is eventual reimbursement. You’d likely have to front payment, then get reimbursed (like Rx insurance in 80s and 90s)

 

A vessel may be registered in Holland, but it is likely “flagged” in another country. As a lawyer, this is done so ship operators can take advantage of more corporate friendly laws.

 

Many non cruise ships are registered in Monrovia, Liberia!

[crystalspin]

3 hours ago, Toad said:

I like the idea of an annual policy, may I ask where one gets it or is that not allowed?

Deanna at the TripInsuranceStore (Steve Dasseos writes the Q&A answers on the CC Insurance Board) sent me the link to GeoBlue's annual Trekker policies (two levels are available). We are comfortable with GeoBlue (the "Blue" is from Blue-Cross-Blue-Shield). The cost is the same to the customer using their link. TripInsuranceStore does not broker Allianz so you will have to go somewhere else if you want to comparison shop.

[crystalspin]

2 hours ago, Jake Martin said:

A vessel may be registered in Holland, but it is likely “flagged” in another country. As a lawyer, this is done so ship operators can take advantage of more corporate friendly laws.

Welcome to Cruise Critic. It is a great place to learn about cruising.

 

Google is another: "Cruise ships fly flags of the countries they are registered in."

 

ETA: Holland is not synonymous with The Netherlands. 

 

Edited November 26, 2023 by crystalspin

[Jake Martin]

I stand corrected about its home port.

it is flagged in the Netherlands, often called Holland, although that is technically the name of a couple provinces (“north and south”)

 

Most cruise ships (and other large vessels) fly under flags like Bahamas (Queen Mary 2 which I arrived in Europe on in October) or Panama to take advantage of more favorable maritime law.

 

Very few cruise ships fly the US flag because of an early 19th Century law called the “Jones Act,” which requires, among other things, that almost all of a US flagged vessel has to be built in the U.S.

[Toad]

7 hours ago, crystalspin said:

Deanna at the TripInsuranceStore (Steve Dasseos writes the Q&A answers on the CC Insurance Board) sent me the link to GeoBlue's annual Trekker policies (two levels are available). We are comfortable with GeoBlue (the "Blue" is from Blue-Cross-Blue-Shield). The cost is the same to the customer using their link. TripInsuranceStore does not broker Allianz so you will have to go somewhere else if you want to comparison shop.

I looked up GeoBlue last night and that looks pretty good to me!  I feel comfortable with BC/BS.  Thx

[ottahand7]

@Jake Martin were you on the Volendam Grand South America.   I think I remember you from our Deck 6 hall party and for the rest of the voyage.   

[VMax1700]

9 hours ago, Jake Martin said:

Very few cruise ships fly the US flag because of an early 19th Century law called the “Jones Act,” which requires, among other things, that almost all of a US flagged vessel has to be built in the U.S.

The 'Jones Act' actually titled the Merchant Marine Act 1920 refers to carriage of goods/cargo (clue in the title of the act)  and does not have any bearing on the cruise industry. 

The cruise industry and Passenger vessels in general are covered by the Passenger Vessel Service Act 1886. 

 

[Heidi13]

12 hours ago, Jake Martin said:

 

A vessel may be registered in Holland, but it is likely “flagged” in another country. As a lawyer, this is done so ship operators can take advantage of more corporate friendly laws.

 

Many non cruise ships are registered in Monrovia, Liberia!

 

The Cruise Line may be registered in a different country from their tonnage, so they can receive advantage from corporate friendly laws, but ships must display the Ensign of their Flag State. Every ship's Flag State is where the ship is registered. I may not be a Lawyer, but with almost 30 yrs as a ship's Master, I learned and experienced significant parts of the very specialised area of Maritime and Admiralty Law. This included an annual presentation of the Certificate of Registry to the attending Flag State Inspector/Class Surveyor.

 

When a cruise line selects a Flag State for new tonnage, upon application, the ship is added to the Flag State's Registry. The ship is issued with a Certificate of Registry, which resides with the Master. Once added to a Flag State's Register, the Master must fly the Ensign of that country.

 

New builds are different in that the shipyard owns the vessel until she completes sea trials and is accepted by, and then delivered to the owners. When owned by the shipyard, ships built by Fincantieri use the Italian ensign, then when delivered, the vessel is reflagged to the owners preference.

[Heidi13]

10 hours ago, Jake Martin said:

I stand corrected about its home port.

it is flagged in the Netherlands, often called Holland, although that is technically the name of a couple provinces (“north and south”)

 

Most cruise ships (and other large vessels) fly under flags like Bahamas (Queen Mary 2 which I arrived in Europe on in October) or Panama to take advantage of more favorable maritime law.

 

Very few cruise ships fly the US flag because of an early 19th Century law called the “Jones Act,” which requires, among other things, that almost all of a US flagged vessel has to be built in the U.S.

 

The Queen Mary 2 was initially registered and flagged in UK (Southampton), but about 10- 12 years ago she was reflagged to Bermuda, which uses the same Red or Blue Ensign as UK Flagged tonnage. I believe the change from UK to Bermuda is due to the Master of a UK Flagged ship is not authorised to facilitate weddings, whereas the Master of a Bermuda ship is authorised. The QM2 is NOT registered and flagged in Bahamas.

 

The collective name for the alternative ship registries is Flag of Convenience. Yes, they are less rigurous, but if signatory to IMO their Shipping Act & Regulations must meet the minimum IMO requirements.

 

The "Jones Act" is a US Cabotage Act that only refers to the shipment of goods. It does not include passengers, which are covered by the Passenger Vessel Services Act, often known as PVSA. These Cabotage Acts, also require vessels to be crewed by Americans and the ships maintained in the US.

Edited November 26, 2023 by Heidi13

[leerathje]

I have a slightly different story, but a positive one, nonetheless.

 

My father was cruising with us on an 11 day South Caribbean late this past winter.  We had our own room, and he had an accessible room.  He had rented a scooter for use on board, and after going through the door with his scooter, he scraped his arm quite badly on the door jamb.  The door is harder to get through with a scooter, and a passerby or room steward helped him get in his room more than once.  He takes blood thinners, and the bleeding wasn't stopping.  He went to the infirmary, and the doctor examined him, put on a pressure bandage and dressed his scrape. Although my dad had travel medical, we were never presented with a bill, and it wasn't on his final invoice either!

 

Not sure if he wasn't charged because my dad scraped his arm on the door jamb, or if they just forgot. (I highly doubt that!!) I did put a comment on the email after the cruise saying that I thought the accessible rooms should have push-button doors.  If you are in a scooter, it is quite difficult getting through the door.

 

Leanne

 

 

[floridababa]

On 4/21/2023 at 12:14 PM, Guest ldtr said:

Have not seen a Medicare advantage plan that covers outside the US. There are still a couple of Medicare supplement plans that provide coverage, but the level of coverage is extremely limited.

 

We use an annual policy for about 350 per year with 1000 deductible that will cover any trips in that year, up to a max individual trip length of 70 days. You can do multiple long trips, just not over 70 day on any one trip.

What company?

[floridababa]

On 11/25/2023 at 12:17 PM, Jake Martin said:

If you are over 65 from the US and carry a supplemental Medicare policy, Plans F and G do cover up to $50,000 of foreign medical care.

They are the most expensive plans, but worth it.

Virtually all cruise ships are flagged in Bahamas, Panama, not the US.

Do they pay after your travel insurance or before? What type of medical care?

[GeezerCouple]

14 hours ago, Jake Martin said:

I stand corrected about its home port.

it is flagged in the Netherlands, often called Holland, although that is technically the name of a couple provinces (“north and south”)

 

Most cruise ships (and other large vessels) fly under flags like Bahamas (Queen Mary 2 which I arrived in Europe on in October) or Panama to take advantage of more favorable maritime law.

 

Very few cruise ships fly the US flag because of an early 19th Century law called the “Jones Act,” which requires, among other things, that almost all of a US flagged vessel has to be built in the U.S.

 

Welcome to CruiseCritic!

And thanks for your input.

 

However, the "Jones Act" does not cover passenger vessels.

The similar, but separate, Passenger Vessel Services Act (PVSA) covers, yes, passenger vessels.

 

And more important, in terms of actual sailing, than the just what flag is flown/etc., is the effect of that on what routes are allowed, especially for USA ports.  This is what is behind the requirements for some cruises that taking passengers between two USA ports is prohibited for foreign-flagged vessels... why a near or distant port of call is required if the itinerary starts and ends in the USA, etc., depending upon the specific itinerary.

 

Here is more information in case you are interested:

https://help.cbp.gov/s/article/Article-23?language=en_US

 

GC

[albingirl]

I asked for something simple, but no, it was costly like a professional would determine your needs. Let's just say, a band aid was going to break the bank. 

[TiogaCruiser]

On 11/26/2023 at 12:26 AM, Jake Martin said:

I stand corrected about its home port.

it is flagged in the Netherlands, often called Holland, although that is technically the name of a couple provinces (“north and south”)

 

Most cruise ships (and other large vessels) fly under flags like Bahamas (Queen Mary 2 which I arrived in Europe on in October) or Panama to take advantage of more favorable maritime law.

 

Very few cruise ships fly the US flag because of an early 19th Century law called the “Jones Act,” which requires, among other things, that almost all of a US flagged vessel has to be built in the U.S.

Missed a few. A bit more about the “other bits” of The Netherlands.

 

 

 

[OBX-Cruisers]

I think "shocked" might be the appropriate word when it comes to copays and other costs with many/most "Advantage" plans.  They are cheaper but often you get what you paid for and end up paying the difference when you actually need the care away from the home PPO/HMO docs.