OT - travel medical insurance - some pointers if you ever have to make claims

[lisaviolet]

Hi,

I will try to make this as concise as possible. And will no doubt fail. But a heads up on your travel medical insurance choices and procedures.

A family member had a very serious health issue come to surface while on the road to Florida and had to go into the hospital while there. This was in February. I'm still dealing with it all. And it's not fun dealing with it while all your focus should be on your loved one.

Some pointers:

*give your loved ones a copy of your insurance when leaving in case you're not available to phone and for back up

*the most important issue is you must phone within 48 hours of using the insurance. (ANOTHER POSTER HAS POINTED OUT THAT THIS IS NOT TRUE FOR MOST POLICIES- CHECK YOURS). We are all told when buying but make sure there is someone who can phone and deal with it all. And make sure you phone if you are able. Your policy might go from millions to mere peanuts if you don't.

*if you phone near the end of the 48 hours do not let them try to make prior tests null and void because they weren't verified first by the insurance. Give it back to them that they know that doctors must make sure that the patient's life isn't in jeopardy.

*know that the waiting time can be extensive for calling in - fight through the deterrent if they provide that for you.

*you do not and should not answer any medical questions on the phone for your loved ones - say "I'm not a medical professional". They have access to the family doctor. You are being taped and they are looking for pre-existing signs of the illness/issue to not have to make payments. In general, watch your words.

*tell the hospital multiple times, to different shifts in case it is never documented on the chart, that no procedure/treatment can be done without checking with travel medical first. (If that is part of your policy procedure - it was clearly communicated by phone with his policy.)

*try to actually read your policy. I'm laughing because I know most of us never even glance at it. But I needed help with medical transport and got none because of wording. The insurance offers a lot but covers themselves with procedure. So know where you're at as far as coverage and procedure - if not when you buy it, then immediately when God forbid someone needs it

*on release from hospital make sure a doctor writes "stable at realease" for your protection. In case you need to get medical attention after release before leaving the country.

*know that the providers and the insurance do a dance on what each is going to do re: payment and payment levels. They are really negotiating with each other. Full payment is rarely paid. Don't let them involve you in their dance. Tell them to "talk to the insurance" or "phone the hospital" (If anyone ever goes down without insurance, DON'T of course, but if someone makes that mistake the sentence "full payment is rarely paid" is still valid. You should be negotiating costs)

*hospitals might have offshoots. Tons. For example a doctor can be working in a Florida emergency room but be paid through a provider in a totally different area of the country. A MRI can be done one place and billed in another state. So these offshoots - some will claim to not take insurance or ask for partial payment listed as "not covered by insurance". The hospitals will make comments like "oh that's not us". Ignore. Give them insurance info and send these bills to the insurance and tell them to deal with them.

*know that if you have any issues that the insurance companies have their own ombudsmen on staff and then if that doesn't alleviate any issues - provinces do as well (well Ontario works that way). I have not had to use this but I do know that it is there for the consumer.

*document conversations and dates for your own records.

*keep receipts for visiting loved ones hospitalized and on the road

*always try to be succinct in answering anything by phone or on paper. And tell your family doctor/specialists the same. Try not to give any extra information. Especially why you needed to see a medical professional. All roads will come back to those words.

*I'm sure a smaller health issue is more straightforward, and I'm hearing some very positive stories here, but it's best that we all educate ourselves for a major health issue. Your head will be in a million places, so it's best to be prepared as possible in this area.

It will probably all work out for me/my family. But it's been a frustrating experience. Hopefully no one out there on this board will ever need this information. Or has such a poor experience. But if it does help someone in need, well .

All the best,

Lisa

 

[LSmith]

Thanks very for the information. I really appreciate you taking the time to write this all out. My family travels frequently and while we are always covered, we rarely pay much attention to the details of the policy anymore. We've only had to use the insurance for minor claims.

I'm printing this out to put with our insurance policy.

Hope everything works out for you.

 

[lisaviolet]

You're welcome, LSmith. Writing it out for others made my frustration of the day dissipate. It's not a good time to be in the dark. I was very lucky as I had a good friend in insurance and another who is an EMT to guide me through some very important issues.

I am almost at the end with insurance, well wait who knows really. They told me that they settled fully about a month ago. I asked many times "FULLY?" and got "yes, fully". And then I got a payment sheet for about $500 paid. The bill would have ran close to $80 000 and that's that low because we - and the doctors there - concentrated on getting him stable for transport and having only a minimum of treatment/procedures/testing done down there.

But apparently, 75% is complete with insurance. I guess some are still doing the dance. I've heard it could take up to six months.

Thank you for your thoughts. The prognosis is dire. But I'm beyond thankful to have him home. He could have easily become trapped down there because of risks of transport in general and insurance threatening to pull out if not stable at release. But I tried to cover all my bases and we simply rolled the dice on many unknowns to meet his needs/desire to get the heck home.

 

[Disneylover99]

Thanks for posting this Lisa. Great advice! Hopefully you can put all this paperwork behind you soon. It must be so hard dealing with this and trying to meet the needs of an ill loved one.

 

[lisaviolet]

Thanks for posting this Lisa. Great advice! Hopefully you can put all this paperwork behind you soon. It must be so hard dealing with this and trying to meet the needs of an ill loved one.

I'm hopeful that we are near the end of it all. I'm not even inquiring anymore; much more peaceful.

Thank you.

 

[MedicGoofy]

May I ask what kind of health insurance you actually purchased??

I had quite the opposite experience from you, and can say that each point you made, I had no issues with.

I purchased RBC insurance. I have annual insurance, as I cross into the states almost weekly.

I had a mod medical emergency, which involved ambulance from ship, multiple tests at the ER and much treatment on the ship, as well as in the ER.

I did not phone instantly, in fact, it was well past the 48 hour mark. My insurance does NOT require that I call within 48 hours. I actually spoke to them regarding this, and they stated it is not required, but is nice to get a heads up. The whole point to the insurance, is that IF you are required to use it, you use it. Neither my insurance, my parents insurance (different company), my VISA insurance, OR my work place insurance, requires me to call within 48 hours. If you had a medical emergency in which you are not able to make any phone calls, you would not NOT be covered.

Everything was covered. I answered no questions at all when I called to tell them I was needing to file a claim when I arrived home to Canada. They asked me nothing of what happened, no medical questions. Just told me to call at my convenience upon my arrival home.

I submitted all my receipts via email, after receiving paperwork in the mail. I had payout to myself, and to the ER shortly after sending in my paperwork.

Sorry you have had such a bad experience. Many people I know who have had insurance, and had to use it (my uncle deals with directly) have had very positive experiences. Hopefully it all works out in the end for you.

 

[lisaviolet]

May I ask what kind of health insurance you actually purchased??

I had quite the opposite experience from you, and can say that each point you made, I had no issues with.

I purchased RBC insurance. I have annual insurance, as I cross into the states almost weekly.

I had a mod medical emergency, which involved ambulance from ship, multiple tests at the ER and much treatment on the ship, as well as in the ER.

I did not phone instantly, in fact, it was well past the 48 hour mark. My insurance does NOT require that I call within 48 hours. I actually spoke to them regarding this, and they stated it is not required, but is nice to get a heads up. The whole point to the insurance, is that IF you are required to use it, you use it. Neither my insurance, my parents insurance (different company), my VISA insurance, OR my work place insurance, requires me to call within 48 hours. If you had a medical emergency in which you are not able to make any phone calls, you would not NOT be covered.

Everything was covered. I answered no questions at all when I called to tell them I was needing to file a claim when I arrived home to Canada. They asked me nothing of what happened, no medical questions. Just told me to call at my convenience upon my arrival home.

I submitted all my receipts via email, after receiving paperwork in the mail. I had payout to myself, and to the ER shortly after sending in my paperwork.

Sorry you have had such a bad experience. Many people I know who have had insurance, and had to use it (my uncle deals with directly) have had very positive experiences. Hopefully it all works out in the end for you.

Sure. It was not mine, but a family member's insurance. And that was one issue. I usually know what was purchased. I had to make a blind guess and call in a time of great stress. That was on my family member (long story), but it's good that someone knows what we all purchase. It was due to great stress at the time and what ultimately was the medical issue.

TD Canada Trust was the initial provider. I do not want to list who they contract with as they are still settling.

I have a friend in insurance who actually warned me for years about some of the issues that we faced. And they have worked in claims for decades. I of course did not take him seriously until I had to face it.

I'm sure each hospital has their own ways as well. And obviously that impacts how it goes. That the dance can be different in every turn. He was in two hospitals, one for emergency - they could not deal with the severity of the issue so they transferred. Those hospitals being ones that contract out with payments - doctors, tests etc caused quite a bit of the issues. Everything was on site but billed all over the place. I had given all information to the two hospitals but they wiped their hands of offshoot billing.

So that was a one by one issue - on the phone - by the mail with bills. One does not know they exist until they all start billing. Why would you? Their hospitals say "Oh that's not us" (because they carry different names )but it is them - it's their doctors, it's their tests, it's their consulting. So that in itself caused a bunch of stress/hassle. They would bill as if my family member had no insurance because the information wasn't shared with them. One even told me that they don't deal in insurance. I mailed that bill directly to the insurance and asked them to take care of it.

So of course it could be an isolated experience, even though I was warned by someone in the industry, that certainly isn't the norm. But my points are not a bad thing to look out for in case you find yourself with these issues.

But then again insurance themselves wasn't great either. So both sides.

And they deal with original copies only, so no emailing for them.

I've always been told, when I buy my own insurance, that I have to phone in right away. I've always said back - what if I'm not able to? And they say back having someone else do it or having the card close at hand. And this specific insurance has it written right in the policy notes that you must phone in right away, before 48 hours, and they list that the amount goes from two milllion to mere thousands if you don't. And I never stated that you would NOT be covered. I stated that the policy drops from one amount to peanuts. (I've changed my wording to *might* since you've pointed this out as erroneous information).

Good to hear that RBC does not carry that stipulation or others for your family and friends. No sarcasm.

I usually purchase RBC when I'm doing yearly as well. So I will continue that choice for myself. Excellent information shared.

I'm very happy to hear that you and others have had a wonderful experience. VERY. Great to hear.

 

[lisaviolet]

Everything was covered. I answered no questions at all when I called to tell them I was needing to file a claim when I arrived home to Canada. They asked me nothing of what happened, no medical questions. Just told me to call at my convenience upon my arrival home.

I'm very pleased to hear about this part of your experience the most. The best part to hear.

Not only was I asked in multiple calls, during a very stressful time I would be phoning in about one issue and get some message that they were looking for a diagnosis etc. I also had a form that asked the exact same medical questions already asked and answered and issues that led him into the hospital. Questions about prior doctor's appointments and timing etc. All times I handled it very well, with intelligence. But it's insane to be having these conversations when your head is needed elsewhere.

Anyway, I certainly don't want to relive it all. I only wanted to warn about some issues we had.

 

[saskdw]

May I ask what kind of health insurance you actually purchased??

I had quite the opposite experience from you, and can say that each point you made, I had no issues with.

I purchased RBC insurance. I have annual insurance, as I cross into the states almost weekly.

I had a mod medical emergency, which involved ambulance from ship, multiple tests at the ER and much treatment on the ship, as well as in the ER.

I did not phone instantly, in fact, it was well past the 48 hour mark. My insurance does NOT require that I call within 48 hours. I actually spoke to them regarding this, and they stated it is not required, but is nice to get a heads up. The whole point to the insurance, is that IF you are required to use it, you use it. Neither my insurance, my parents insurance (different company), my VISA insurance, OR my work place insurance, requires me to call within 48 hours. If you had a medical emergency in which you are not able to make any phone calls, you would not NOT be covered.

Everything was covered. I answered no questions at all when I called to tell them I was needing to file a claim when I arrived home to Canada. They asked me nothing of what happened, no medical questions. Just told me to call at my convenience upon my arrival home.

I submitted all my receipts via email, after receiving paperwork in the mail. I had payout to myself, and to the ER shortly after sending in my paperwork.

Sorry you have had such a bad experience. Many people I know who have had insurance, and had to use it (my uncle deals with directly) have had very positive experiences. Hopefully it all works out in the end for you.

Same here. I have a RBC Gold Preferred VISA that I've had for 20 years, one of the perks is medical insurance. I also have Blue Cross through work. All either requires is presenting the card.

 

[lisaviolet]

Same here. I have a RBC Gold Preferred VISA that I've had for 20 years, one of the perks is medical insurance. I also have Blue Cross through work. All either requires is presenting the card.

Great information to have. Thank you. I will be working with that provider in the future, for myself. Like I've said, I've bought RBC's yearly policy twice in the past from a travel agent and will be remembering all your words with my own choices.

But then again I've never had to use it, thankfully. So I can't speak on how it would play out between the insurance/certain hospitals. Obviously probably better than this one.

My loved one's policy was both presenting the card and phoning them. My family member could do neither - long story. Nor could he properly communicate with them this entire time. His medical issue causes confusion.

 

[Sue M]

We have Blue Cross extended thru work, and buy their travel insurance. Used to get Bcaa travel insurance. But found out some Travel policies first bill MSP, then your Extended if you have it, then they pay. My extended has a lifetime limit. So conceivable it could be wiped out if I had a huge hospital bill.
Blue Cross Travel doesn't touch your Extended policy. They bill MSP then pick up the rest. I never knew some Travel insurances bill extended first. So I asked BCAA and they confirmed that they do!!

I had an incident last January while at wdw and needed medical attention. I went to the Urgent Care Facility near wdw. They even provide shuttle transportation. Only problem is that they don't bill out of country, so I had to pay the $350 then submit bill to Blue cross when we got home. Blue Cross sent me all the forms. I'm sure if I had to go to a hospital they would have billed directly!

I'm now going to check my annual policy to see about the 48 hr phone call.

Thank you for sharing what you learned.

 

[I Run Long]

Thanks for this info Sue - I was going to use BCAA but it looks as though Blue Cross would be better for our family especially as my hubby is 61. We don't have Blue Cross as our extended health that with SunLife but I still think Blue Cross is better.