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Titanic-sized medical bill surprises cruising couple

Posted by Anita Dunham-Potter On April - 18 - 2011

Susan and Larry Smith were looking forward to their first-ever Cunard cruise across the Atlantic onboard the fabulous Queen Mary 2. But the fun stopped for the New York City couple the moment Larry had chest pains along with gastrointestinal malaise.

The Smiths immediately sought treatment at the ship’s infirmary, where the ship’s doctor ran an EKG and some tests. Fortunately Larry’s heart checked out okay, but he was dehydrated and was given intravenous fluids and was kept in the infirmary for an hour of observation. Larry’s tests ruled out any infection, but the doctor couldn’t figure out why Larry had become so dehydrated. Therefore, no definitive diagnosis was reached. The next morning Larry felt much better and the cruise continued. A few days after the visit to the infirmary, the Smiths got another unpleasant surprise: a bill for medical services totaling $1,200. The amount was immediately charged to their shipboard account.

The Smiths were shocked. “It didn’t seem like a lot of treatment for $1,200. It was as much as my cruise fare,” said Susan Smith. Even worse the couple foolishly believed that their health insurance would be accepted onboard the ship. It wasn’t. Fortunately they did have travel insurance (purchased through the cruise line) that covered medical issues.

Insurance doesn’t travel well
What many people don’t realize is that all cruise ships of foreign registry are considered to be entities operating outside the United States. And, as the Smiths discovered, domestic medical insurance coverage doesn’t travel the same way aboard ship as it does within the United States. Sometimes, coverage doesn’t extend to foreign travel at all; other times it just works differently. For example, co-payments may be higher than usual or your reimbursement may be limited.

Even with complete medical coverage, you can’t just hand the cruise line your insurance card. You will usually have to pay your treatment costs up front and file for reimbursement after you return home. That’s what the Smiths did. Their insurer accepted the claim but explained it could take up to three months to receive reimbursement. The Smiths were relieved to be covered at all.

Could the Smiths have avoided the $1,200 out-of-pocket expense? Maybe. If they had purchased third-party travel insurance, they could have received upfront financial assistance and they might have gotten their money back more quickly.

Third-party insurers usually provide primary coverage, i.e., the insurance company pays the traveler directly for any medical claim. Most cruise lines also sell insurance policies, but these usually provide secondary coverage, which means that you must file your claims through your regular medical insurance carrier, then seek reimbursement from the cruise line’s insurance company.

Cover the gaps
Medicare beneficiaries should always purchase travel insurance when they cruise, because they do not have Medicare coverage outside the country. Another very big gap is medical evacuation and transportation services, which are seldom covered by medical insurance policies. According to Medjet Assist, an Alabama-based evacuation operation, domestic air medical evacuation services average $10,000 to $20,000, while international transports can exceed $75,000. If you travel more than once a year, consider buying an annual policy; both MedjetAssist and Travel Guard offer this kind of policy, which can be purchased for as little as $185 a year.

Cruising is exciting, but it can turn into more of an adventure than you planned if you discover that you aren’t covered for the unexpected. So check your insurance policies and fill in the gaps with supplemental coverage.

By Anita Dunham-Potter (editor@www.expertcruiser.com)

© www.expertcruiser.comYour online consumer guide for cruise travel and information.

18 Responses to “Titanic-sized medical bill surprises cruising couple”

  1. im a bit shocked at the bill amount..
    1200 $ ???
    its too much..

  2. Johan Roode says:

    When I hear stories like this I don’t think I would want to take a cruise on a boat. $1200 for treatment? That’s way to much!

  3. wow that is way too much… $1200 for medical treatment?

  4. common sense says:

    how is that too much? if you went to a hospital in the US without insurance…saw a doctor, had and ekg, and an iv…the cost would be WAY more than $1200!! Besides the fact they happened to provide this service in the middle of the ocean! So if the ekg had indicated he was in fact having a heart attack…would the price be worth it then? Get real people!

  5. erin says:

    Oh my goodness, 1200 to be looked over by a doctor. Thats ridiculous and their insurance wouldn’t cover it? Thats shocking.

  6. When I hear stories like this I don’t think I would want to take a cruise on a boat. $1200 for treatment? That’s way to much!.

  7. Simon says:

    WOW! That’s alot for a doctors consultation – however, if he was having a heart attack………It may seem cheap. What can you say……you are certainly ‘captive’ when in the middle of the ocean.

  8. DaveJ says:

    I think it was pretty cheap, actually. Apparently you haven’t been in a hospital recently. That’s emergency medicine by any definitiion. And as for being held captive, do you check the price at the emergency room before you go there? And walk out if it is too much? Insurance not paying? Read your contract. If you don’t know what is covered and not covered, shame on you.


  9. Sylvia says:

    I know exactly how this couple felt. November 2009 my family and I went on a Victory cruise, on which my son got sick. A visit to the infirmary, some cough medication, and a bottle of acitaminophen cost us $320.

    It was ridiculous!

  10. Flights says:

    When it comes to health insurance coverage, never assume anything.

    Few domestic plans cover foreign travel, and when they do it is often just a fraction of the actual cost.

    Travel insurance is well worth the few extra dollars for peace of mind.

  11. Aleksander says:

    $1200 for treatment? That’s way to much!.

  12. wow that is way too much… $1200 for medical treatment?

  13. Suka Gadget says:

    Oh my goodness, 1200 to be looked over by a doctor. Thats ridiculous and their insurance wouldn’t cover it? Thats shocking.

  14. Ya as we all know that how much expensive is the medical test,s now a days so its not big deal for $1200 for the medical treatment…

  15. I remember when my father had a heart attack at sea right in the middle of their once in a lifetime cruise. Thankfully the travel insurance he organized before he left covered all but $200 of the expenses, which included a helicopter trip off the ship and flights home from Spain

  16. Uli says:

    $1200 for that kind of treatment sounds to me like robbery, but there’s nothing you can do, except next time check your insurance coverage more carefully

  17. 1200 $ is way too much for this. Thanks for charing this story

  18. Jenifer Casale says:

    I am an ER nurse. This bill does not shock me at all. This was EMERGENCY SERVICES. chest pain! ekg, and other tests done, as well as IV’s for dehyrdration….had this been on land in a medical center…it would be much higher. It is not the ship’s fault that health insurance does not cover these services. but looking at what the treatment was….EKG and IV alone, and chest pain…would result in an ER visit for ACLS–you are looking at a minimum of 5K to start


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