Health Insurance While Cruising?

[thomaswaier]

All Hail,

We are making plans to cruise the Caribbean for the next few winters. Health insurance while cruising is a big question mark. I would appreciate any advice from cruisers on health insurance options. I will be on Medicare, but it does not cover you out of the country. My wife, being younger, will need insurance. Our plan is to be in the Caribbean for 5 or 6 months during the winter.
Also I have heard that some cruisers buy a type of "travel insurance" that pays to fly them back to an area with health care or coverage. Any info on that program?
Not sure that I am comfortable with just going bare without insurance. The probable outcomes of dying or going broke is not a choice that I want to make.
Thanks in advance for any advice.

Skipper Tom

[John A]

I believe that US Medicare is valid in Puerto Rico which is a commonwealth of the US, also maybe the US Virgins.
All of the Islands have government supported health care, and I can only give an example of my experiences.
I mangled my foot in the electric anchor windless and when I reached Bequia it was swollen and infected. Daily visits as an outpatient, in what passed for a hospital, for over two weeks corrected the problem and the care was provided free. I donated $300 to the hospital.
I had offshore insurance coverage from a US company, which shall remain nameless.
While in Trinidad in 2004 I had to undergo surgery for what turned out to be a spot of cancer in the bladder.
The doctor claimed that total cost would be under $6000 US. My Insurance premium, at the time, was about $4000 US a year. I contacted my insurance and received prior approval for the surgery.
Three days in a private room, surgery, anesthesiology, drugs, everything, total cost was $5400 US. I sent all the receipts to the insurance company and received $1800.
I didn't renew the insurance. It was cheaper to pay cash for health care than pay insurance premiums, and who knows what the air med-evac would have cost, back to the billing practices of the US.
Annualy explortory surgery as an outpatient was about $1900 US. A two pass very complete cat-scan was $385, office visits were $30. Compare that to the US!

Negitive can be a very beautiful word.

Please don't use this post, or this thread to debate about health care.
reguards John

[maxingout]

We were paying State Farm a premium of about $10,000 for health insurance with a $5,000 deductible for myself and my wife while cruising. I never used the insurance. It was way too much money with too high of a deductible. We paid our premiums since a single illness could wipe us out in the US health care system.

I am a physician, and I am ashamed of the cost of healthcare here in America. It is prohibitively expensive unless you have a job. One of the reasons I returned to work was to get health insurance through my employer. I am too young for medicare.

Healthcare in New Zealand and Australia was excellent and affordable when I was cruising there. Down in the Caribbean, things will be much less expensive, but somewhat hit and miss. For common things like infections and minor surgery, it will be quite affordable. If you have a major problem and have to return to the USA, it could bankrupt you.

Under the present situation, cruising without health insurance is like playing Russian Roulette. You could do very well if you are lucky. But if you are unlucky, you are toast.

I would not cruise without insurance for catastrophic illness. It just costs a lot of money. If you get sick, you end up with a preexisting illness and getting insurance will be impossible.

I don't get easily depressed, but this is depressing. It makes me wish I had taken Kiwi or Ozzie nationality when I was living and cruising down under.

[ksalt]

While it's not a substitute for actual medical insurance, DAN (Divers Alert Network) membership includes up to $100k medical evacuation coverage, even for non-diving medical emergencies. It's a great benefit considering the membership dues are only $70. They also have some additional accident insurance policies for additional cost.

Of course depending on the emergency and where you are, you may be better off paying the local heath care costs out of pocket than returning to the US. (I had 10 stitches to a cut thumb at a US emergency room recently, total time in the ER was maybe 60 minutes. They billed my insurance over $4k.)

[s/v Moondancer]

We have a high deductable, but very comprehensive, US based insurance which we maintain to avoid the pre-existing illness problem, evacuation insurance and DAN dive insurance.

Today I had a skin biopsy in Trinidad; doctor, hospital, histology etc...total cost $300. Many of the Trinidad doctors are UK trained, as I am myself.

The UK insurance company BUPA also provides excellent cover at a reasonable cost providing you do not want coverage in the USA.
International healthcare plans - Bupa Intl

[TabbyCat]

thomaswaier,
There are two types of health insurance for cruisers to consider.
1) International Health care coverage that pays the bills for when you are hospitalized overseas. This is available for quite low rates for cruisers who are out of the US for 6 months or more per year.
2) Evacuation insurance. This pays for your to be evacuated back to the USA for treatment. If you're a SCUBA diver and a member of DAN, they can get you this coverage.

We also offer both types of insurance through our website - go to IMIS Online Services and click on the links for International Healthcare and Global Emergency Assistance.

~ Susan

[Brent Swain]

Steer clear of Travel Underwirters, Worldwide Mediclaim. I made a claim with them and they refused to pay , because I didn't have a credit card for them to put my expenses on. My brother also had many problems with them. Their main priority seems to be finding a way to weasel out of paying any claim.
Brent

[osirissail]

- -To clarify some things about medical insurance. There are two basic types - Travelers Insurance is for tourists visiting outside the USA (for instance) and is time limited. It expires in a month or two or three. Then there is full medical insurance for long term cruisers - available from many sources such as IMIS (who I use) and European agencies. You choose the deductible and range of coverages. There are normally 3 to 5 different versions of each companies policies. It does take some serious sweat and eye-strain to ferret out what each is covering and when. Be prepared to do some in depth studying.
All of them normally have two premiums per version of their policies - one for anywhere in the world and one for excluding the USA (and sometimes Canada). The difference in premiums is in the 200% to 300% range (e.g. US$1500/year excluding USA & Canada, and US$6000/year including the USA & Canada for my policy). Since I have Medicare/etc. I bought only the "excluding USA/Canada policy".
If you are not a USA or Canadian citizen then you have to realistically determine whether your home country will cover you inside these two countries or not. It was suggested to me that it would be wise to buy the "outside" policy and then if you determined you want to visit the USA/Canada you get a "rider" for the time you will be there.
I look at the outside policy as "major medical" only, as the normal fees in 3rd world countries are on average about 10% of the USA costs. Paying cash is viable as pointed out above.
Final wrinkle, for those requiring Visa's for French or some other islands, you must have medical insurance with "repatriation" coverage - so having a policy is mandatory unless you plan to skip those islands.

[Brent Swain]

Don't know why they would unclude Canada in that higher price. I once had an accident in the US, and Canadian health care paid what it would have cost to deal with in Canada, 1/10th of what the US bill was.
If they told me they wanted to charge the same rate in Canada as for the US, I'd tell them to shove it,and learn a bit of grade three geography.
Brent