My 70 year old Aunt got sick on her Alaskan cruise. $10k so far… Norwegian(NCL) does not mess with insurance, everything is cash based.

Aunt has:
Medicare A&B
Blue Cross/Shield C

Stayed primarily in US waters, with a quick stop in Canada on the last day.

Anyone know how it works to get reimbursed for the $10k out-of-pocket so far?

Get an itemized bill and file yourself with Medicare. If it is out of US waters there would be a problem.

They sell policies for those purposes.
If you are older and/or have health problems they are worthy of consideration.
When traveling on a cruise ship, just getting any sort of care itself may be a problem too.

quote:

Anyone know how it works to get reimbursed for the $10k out-of-pocket so far?

I got sick on a cruise last year and was charged $5,600 for my time in their clinic. I had travel insurance but had to pay the bill up front. They will give her an itemized bill before she leaves the ship but she will pay the upfront costs.

In my case when I got home I submitted the bills to my insurance which is a medicare plan and they paid roughly half. I submitted the rest to the travel insurance carrier and they paid the rest.

I would never do a cruise without travel insurance just for that reason, they aren't expensive compared to the cost you may or may not get reimbursed for. Without travel insurance I doubt she will get everything back. Had I not had it I would have eaten $2,500.

Sounds like she went up to Alaska.

quote:

Sounds like she went up to Alaska.

It's in the first sentence of the OP's posting.

oldfireguy has it right. Your aunt files a claim with Medicare. File the unpaid remainder with BC/BS (however that plan works with Medicare). Whatever else isn't paid by either of them is filed with travel insurance (if that was purchased).

If there is an issue with Medicare and 'out of US waters', it is possible the BC/BS will pay some (depends on the specific plan). Travel insurance for the remainder.

Note that travel insurance goes up at age 65, at least with the ones we've done business with.

Make sure you have that itemized bill from the cruise line and maybe include a narrative/timeline of what happened.

Most part c/advantage plans now include some form of worldwide coverage. Medicare may cover something depending on the medical issue but don’t count on it. BCBS would be her primary insurer if she is on a part c plan. Contact them/submit the claims to them

OP says "Blue Cross/Shield C." If this means Medicare Part C, that is a Medicare (dis)Advantage plan, and depending on the specific plan, there might not be any coverage out of network.

My 10 year old son ate shit at the pool, busted his leg open and needed stitches.

The cruise doctor gave him stitches. No cost and a discount on a future cruise.

From the United Healthcare website: "if the ship you’re on when you receive the care is in a U.S. port or no more than 6 hours away from one when you get the services. That means the ship can be in the water, but must be within six hours of a U.S. port. Also, the doctor must be legally allowed to provide medical services on a cruise ship."

Bubbatime,
So the moral of the story is always take kid(s) with you

Outside of life-threatening issues, it would be less expensive to not use ship medical, stay in your room, and just pay for another cruise later.

UPDATE:

103+ temp…blood pressure spiking and then crashing…spent more time in sick-call than she did in her room. Everything on the ship for medical is ‘cash/credit only’. So far over $15k of medical bills in. We got off the ship today with a written letter from the doctor detailing everything he did and directions to go directly to the hospital in Seattle.

She did not get cruise medical insurance (oops)…and has been diagnosed with H1N1 (swine or bird flu). Only her.

PS:

After spending a couple of full days here before and after the cruise, Seattle is not the complete shit show that the media makes it out to be. Minneapolis is, but Seattle is not nearly as bad as we’ve been led to believe.

quote:

Originally posted by Ronin1069:
UPDATE:

103+ temp…blood pressure spiking and then crashing…spent more time in sick-call than she did in her room.

…and has been diagnosed with H1N1 (swine or bird flu). Only her.

I hope your aunt recovers quickly.

We were on the Norwegian Jewel a few weeks ago in Alaska. Tons of people coughing onboard. There were a couple of times we held our breath and/or waited before walking past where someone had been coughing. We only went to 2 evening shows in the main theater, and were surrounded by people coughing both times.

I get that it is a "trip of a lifetime" and people don't want to postpone or cancel if they're sick embarkation day, but dammit it is OUR "trip of a lifetime" too!

Sure enough on disembarkation day I had a fever. It took me a week to kick the worst of it, with the cough and fatique lingering another couple of weeks. My wife then was sick about 3 days behind me. Positive for Covid, though idk if H1N1 might also show positive.

That makes 2 cruises this year and 1 last year where one or both of us caught some form of flu or C19 onboard. Two years ago my wife caught C19 in Heathrow airport when some asshat walked past us and devolved into a total coughing fit.

If she continues to have problems have them check her for Still's Disease. Her symptoms sound a lot like my niece who was just diagnosed with this. Apparently it is quite rare and can take a long time to get a correct diagnoses.

quote:

Originally posted by Ronin1069:
UPDATE:

103+ temp…blood pressure spiking and then crashing…spent more time in sick-call than she did in her room. Everything on the ship for medical is ‘cash/credit only’. So far over $15k of medical bills in. We got off the ship today with a written letter from the doctor detailing everything he did and directions to go directly to the hospital in Seattle.

She did not get cruise medical insurance (oops)…and has been diagnosed with H1N1 (swine or bird flu). Only her.

PS:

After spending a couple of full days here before and after the cruise, Seattle is not the complete shit show that the media makes it out to be. Minneapolis is, but Seattle is not nearly as bad as we’ve been led to believe.

Do the cruise lines have some type of “temporary” health plan you can purchase? We’re taking a cruise to Alaska with Princess in July.

I don't know how the cruise ship lines work, but I can tell you we see a lot of cruise ship patients in the ER where I work in Anchorage. Most of the time if they fall seriously sick on the cruise ship they will offload in port and receive medical care there. If it's serious, they'll have medical air transport to Anchorage or Seattle. More serious cases we've had Coast Guard take them off the ship at sea by helicopter and either fly them to the closest port or to Anchorage. Medical air transport is not cheap, think $50k just to start the rotors spinning and the costs go up from there. We routinely medically transport patients by air to Seattle and the cost for that is significantly more. Once had a patient ask where they would meet the Coast Guard helicopter take them back to the ship. Um, you're not going back to the ship...

You can get insurance for emergency medical transport. I have it just because I live in Alaska and weird things happen in remote places. I think it's $125 a year.

https://www.airmedcarenetwork....1wnRyXRoC_SIQAvD_BwE

Not only is there the medical transport there's the hospital stay, cost of getting home, hotels for family members if they accompany you, etc. It's sad so many of the cruise ship patients we see were on their bucket list or trip of a lifetime and were just not healthy enough to safely travel and their dream becomes a nightmare. One chemo patient was receiving blood transfusions every other week. He planned his trip in between transfusions thinking he'd be safe. After 3 days of being on the ship and two different ports being more active than he was normally, he had completely burned out his supply of platelets and red blood cells and ended up on an air medical transport to Anchorage for transfusions. So please ask yourself or your family members if you/they are healthy enough to travel and take precautions such as travel insurance or air medical insurance if it's questionable.

And if you do end up in an ER, don't treat the staff like you're still on the cruise ship. We had one patient who experienced a COPD flareup, got offloaded in southeast Alaska and then air medical transported to us. Acted like an absolute ass, making demands of staff, cussing at nurses just miserable and hateful. He and I had a come to Jesus talk his first night there and he was fine for me the rest of the night. The next night he was even worse. Turns out his wife who he thought was flying to Anchorage commercially to be with him, stayed on the cruise ship and was probably having a great time without him. Karma can be a cold hearted bitch...

quote:

Originally posted by dry-fly:
Do the cruise lines have some type of “temporary” health plan you can purchase? We’re taking a cruise to Alaska with Princess in July.

First sentence of the third post.

quote:

Originally posted by dry-fly:
Do the cruise lines have some type of “temporary” health plan you can purchase? We’re taking a cruise to Alaska with Princess in July.

We purchase a 3rd party travel insurance that covers medical as well as evac and repatriation. If you travel outside your normal insurance coverage area more than once, an annual plan might be better than buying coverage for just the one trip. If you buy from the cruise line it will only cover that trip itinerary. If you've paid for flights separate from the cruise line then you won't have coverage for those. Make sure you're covered off the ship, especially if you are not on a cruise organized excursion.

For something like a cruise you may need to purchase cancellation coverage prior to the final payment. That would reimburse the cost of the trip if you cancel due to illness or death. That is separate from medical cost insurance during the trip, and you generally can't expect to buy it at the last minute.

If you buy a 3rd party plan be sure you read the fine print. Pre-existing conditions, excluded situations, and how much coverage you must have (e.g. at least the full cost of the trip must be purchased).

Know your coverage from your regular insurance so you know what additional coverages you need.

To get that money back, she should hit up her Medicare and Blue Cross/Shield peeps. They’ll let her know what she needs to do to file a claim since she got care while traveling.

I found out about these billing services for rheumatology that help with insurance claims, and they might have some useful tips. They make sure all the paperwork is sorted out. If her docs can hook her up with detailed billing statements, it could help speed things up with the insurance. Maybe check out those rheumatology billing solutions for similar stuff!

This message has been edited. Last edited by: Phelen_Kell,

Temporary travel insurance is a must for international travel: first for evacuation to a place with quality medical care (when in Russia, that was Finland); second to reimburse medical bills. Even countries with nationalized medicine will bill foreigners, I believe.
Our Medicare Advantage program covers out-of-area emergency care, but Medicare does NOT cover outside the US.

When I worked in Maui, Norwegian Cruise Lines would debark sick passengers who needed serious medical care to our hospital in Maui. Unfortunately, it is not uncommon for old, infirm, and very sick folks (not referring to OP's aunt, who is a lot younger than me) to want to take a trip to Hawaii as one of the last things that they do, and not infrequently it is. Families are left stuck there in any case. Not pleasant.