Re: Offshore Health Insurance


Gregory Shea
 


Hi all, 
Maybe I can inject some real world experiences into the discussion and suggest some international health insurance mistakes to avoid.
Seven years ago I was a Mediterranean neophyte with my Sharki in the marina on the Isles de Frioul off Marseille. The Tramontane had been blowing 30 knots for three days, on the beam. I wanted to double up on my bow lines and had asked the harbormaster to help me. I hurried back to the boat to ready the extra lines and non-Sharki owners may not know that the Sharki mizzen boom extends about two feet past the transom. In my haste to climb aboard, I was watching where my feet went,  not where my head was, and I ran into the mizzen boom, head first. At least that's what I think happened since my first recollection was "Why am in I this cold September water and why does my leg hurt like hell?"
To cut a long story short, fellow cruisers got me back on dry land and the paramedics called in a police patrol boat to get me back to the mainland. I was in excruciating pain and could not walk. That was when the medical mistakes started. I have Medicare C but had no idea what it said about international coverage. I had no Green Card, the passport that entitles EU residents to universal medical coverage. Without a Green Card, the ambulance folks took me to the local, indigent hospital. In Marseille, you can imagine what that was like. They X rayed my leg, announced nothing was broken and told me to buy a brace and walking stick and get lost.
I managed to get back to the boat, sailed her back to base, at the foot of the Pyrenees, buttoned her up, transited to Paris, hopped a plane home and got plugged int the US health system. This took about a month from the time of the accident, during which time I had no idea what was wrong except that I needed a wheel chair to move around.  An MRI found the problem, I had ruptured (doctor speak for snapped) my quadriceps tendon, the one on the front of your upper leg that enables you to flex your leg when walking. Apparently, my knees had folded when my head hit the boom and as I went down, the tendon stretched to its limit and then broke. I found a surgeon who was competent to make the repair, had it done and settled into a year or more of recovery.
Lessons learned, lift the mizzen boom of a Sharki before entering port, it really saves a lot of agro.
Understand what your insurance covers. I have now talked to BCBS and studied their Plan C documentation at length. It is only good in the first 60 days and only covers debilitating conditions, which they define as loss of function in critical areas such as limbs, sight, cognitive impairment etc. Coughs, colds, influenza and stubbed toes don't count as emergencies. If you are in a bad way, as I was, you qualify, but you have to know that. In retrospect, I should have insisted that the ambulance take me to one of the first rate hospitals in Marseille. Sure, I would have had to pay and claim it back, net of deductibles of course, but a local MRI would have let me know what I was dealing with. I should have produced my BCBS insurance card and demonstrated that I had insurance, if not the Green Card they expected, at least something that indicated that I was financially capable.
When these things happen you are usually disorientated because you are in a system that is not familiar to you, often with language issues. You are probably in shock and pain and the Admiral is probably no better, realizing the responsibility for the boat maybe descending on her shoulders. Confidence in your medical providers is worth its weight in gold.
My summary is that overseas Medicare medical coverage, at least under C plans, is rudimentary, at best. If the time limit has not expired, and your problem is serious, you can afford to seek good medical help, but it won't be free. Find out where you stand vis-vis your coverage and be prepared to use it. Based on my experience, the cost is well worth the peace of mind it provides.
I retrospect, I would have done a lot of things differently, had I known.
I hope that my experiences can help other sailors be prepared, in case they have the bad luck to find themselves in a similarly unfortunate situation.



Greg Shea
Sharki 133, Cap des Iles 
Preveza


From: main@AmelYachtOwners.groups.io <main@AmelYachtOwners.groups.io> on behalf of Ben Driver <bddriver@...>
Sent: Wednesday, October 21, 2020 1:42 PM
To: main@amelyachtowners.groups.io <main@amelyachtowners.groups.io>
Subject: Re: [AmelYachtOwners] Offshore Health Insurance
 
Eric
My agent says same; that is, both plan F and G will reimburse foreign medical expense. But I think I best to get another “expert” opinion and triangulate.  I don’t trust insurance companies or agents.  Also it may be insurance carrier specific; that is, not mandated.
Ben

Ben and Gayle Driver

On Oct 19, 2020, at 3:43 PM, eric freedman <kimberlite@...> wrote:



HI,

I just got off the phone with AARP. I have plan F supplemental. .

According to them it covers 100% of the bills after a $250- dollar deductible out of the USA. I must pay the bill and then submit the bills for payment.

I am just wondering if I was told the correct answer about this plan.

Fair Winds

Eric

Amel Super Maramu #376

 

 

From: main@AmelYachtOwners.groups.io [mailto:main@AmelYachtOwners.groups.io] On Behalf Of karkauai via groups.io
Sent: Thursday, October 15, 2020 9:49 PM
To: main@AmelYachtOwners.groups.io
Subject: Re: [AmelYachtOwners] Offshore Health Insurance

 

Hi all,
I'm looking at health insurance for myself again. I've been basically self-insuring for overseas care and have DAN Boaters insurance for emergency medical  repatriation. Iris has GeoBlue plus DAN.

Depending on deductible and copay, I'm looking at $ 7-8K premium, plus $3-10K deductible and $0-5K copay every year. That's a lot of money to pay when the only thing I could imagine costing that much overseas would be emergency surgery. Anything else and we would fly home to let Medicare pay for it.

I'd be interested to know what everyone else is doing.
Thanks for your thoughts.
Kent&Iris
Kristy
SM 243
Hoping to sail S again in Nov depending on COVID rules in Caribbean and beyond.

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