# Catastrophic health insurance?



## utchuckd (Apr 4, 2010)

From what I've seen so far, health care isn't that big of an issue day-to-day as a cruiser in general. Most small issues seem to be reasonably affordable if you need something taken care of, and the lifestyle itself can lead to being healthier overall. But what about major events? What if you happen to develop an illness or condition that forces you to seek lots of medical attention back in the USA? If you are a cruiser abroad, but have to return home to get treated for something, can you get some sort of major medical/catastrophic type policy that maybe doesn't cover you abroad, but does if you have to return for treatment?


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## travlin-easy (Dec 24, 2010)

I'm sure you could obtain that type of coverage. Of course, you would have to have money to burn. Keep in mind that in the U.S., and many other nations, you cannot, by law, by turned down for treatment in any hospital.

Instead of shelling out a huge, monthly premium, why not just put about $5,000 in a special, interest bearing, checking account, one that you could access from anywhere in the world and use the money for transportation back to the U.S., or another part of the world where you feel comfortable with their health care.

Another thing that you should think about is health care limits. Most insurance companies, including Blue-Cross/Blue-Sheild place strict limits as to how much they'll shell out for catastrophic health care. More often than not, those procedures are already covered by your standard, health-care policies. 

Good Luck,

Gary


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## ottos (Aug 12, 2008)

I don't have any personal experience with this, but have seen other threads where people discuss using DAN (Divers Alert Network) to get that type of insurance. And I don't think that it mattered that they weren't 'divers'.


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## nekha123 (May 9, 2012)

travlineasy said:


> Instead of shelling out a huge, monthly premium, why not just put about $5,000 in a special, interest bearing, checking account, one that you could access from anywhere in the world and use the money for transportation back to the U.S., or another part of the world where you feel comfortable with their health care.


I would second this idea. Instead of paying huge monthly premium, it is better to keep some reasonable amount for emergency cases that should be accessible from anywhere. As he stated an interest bearing, it'll be keep on accumulating interest as long as you keep it their and also you could easily withdraw when required. No dirty procedures.


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## mdi (Jan 15, 2009)

The OP asked about "Catastrophic" insurance. I do not know about other countries but $5K would be gone in a moment of tests and evaluations in one day in an average US hospital. Maybe you guys have never gotten seriously ill or had a serious injury. If you are able to get the type of insurance mentioned above that would be the wise move to me.


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## travlin-easy (Dec 24, 2010)

MDI, I have been seriously Ill, spent two months in the hospital paralyzed from the waist down, and I worked in cardio-pulmonary medicine for 15 years. Believe me I know how ridiculously high hospital costs are in the U.S.. If you'll notice, at the past part of my post I said "More often than not, those procedures are already covered by your standard, health-care policies." I didn't recommend dropping his standard, health-care policy. I just don't recommend adding a very expensive catastrophic policy that would likely not be recognized in most countries other than the one where it was originally purchased. Also, keep in mind that in many, many nations of the world, the cost of health-care is miniscule when compared to the U.S.--even catastrophic care requiring surgery and extended hospitalization.

I agree, that $5,000 wouldn't cover a single MRI or Cardiac Catheterization procedure in the U.S., which when you think about it, is ridiculous in itself. I just got out of a dentist chair and we talked about implants, which are nothing more than tiny, titanium pins screwed into the jawbone. The cost, $3,000 each and at least 4 are recommended. The same procedure in many other nations would be a fraction of that.

That $5,000 I talked about, however, would probably cover transportation costs back to the U.S. from just about anyplace in the world. Getting the boat back home would likely cost a lot more.

Cheers,

Gary


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## ebs001 (May 8, 2006)

I think this is what the o/p is looking for: Emergency Medical Evacuation Insurance


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## Cruisingdad (Jul 21, 2006)

I remember this discussion coming up before. Seems like one of the key issues in the policy was the transport back costs. Now, if you are wel enough to hop a plane, the 10k method would be fine. But if you have to be medically evac'd back to th US seems the costs were incredible. 

A lot of people I know carry a "10k policy". That is insurance does not pay anything until their out of pocket is 10k. I suppose it is all a matter of the risk you are willing to tak in life.

Brian


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## sailpower (Jun 28, 2008)

travlineasy said:


> If you'll notice, at the past part of my post I said "More often than not, those procedures are already covered by your standard, health-care policies." I didn't recommend dropping his standard, health-care policy. I just don't recommend adding a very expensive catastrophic policy that would likely not be recognized in most countries other than the one where it was originally purchased.
> Cheers,
> 
> Gary


Sounded to me like the OP was NOT going to have "regular" coverage, just the catastrophic?


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## mdi (Jan 15, 2009)

travlineasy said:


> I didn't recommend dropping his standard, health-care policy. I just don't recommend adding a very expensive catastrophic policy that would likely not be recognized in most countries other than the one where it was originally purchased. Also, keep in mind that in many, many nations of the world, the cost of health-care is miniscule when compared to the U.S.--even catastrophic care requiring surgery and extended hospitalization.
> 
> I agree, that $5,000 wouldn't cover a single MRI or Cardiac Catheterization procedure in the U.S., which when you think about it, is ridiculous in itself. I just got out of a dentist chair and we talked about implants, which are nothing more than tiny, titanium pins screwed into the jawbone. The cost, $3,000 each and at least 4 are recommended. The same procedure in many other nations would be a fraction of that.
> 
> ...


obviously Gary I agree with you. I thought the OP was saying this would be the only policy he would have, the catastrophic, nothing else. In that case I did not think 5k would go very far  I think the debate over health care is interesting since some South Pacific countries will not even let you in without health care insurance that is documented.


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## utchuckd (Apr 4, 2010)

I guess I wasn't very clear with my post. I guess what I'm asking is if I'm cruising abroad, can I still have an insurance policy back in the US if I have to come back here for any issues. My current policy is an HSA with a major medical policy (low premium, high deductible). Could I just keep that going while I'm away and then use it should I have to come back for any major treatments? Sorry if I used the wrong or confusing terminology.


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## ebs001 (May 8, 2006)

utchuckd said:


> I guess I wasn't very clear with my post. I guess what I'm asking is if I'm cruising abroad, can I still have an insurance policy back in the US if I have to come back here for any issues. My current policy is an HSA with a major medical policy (low premium, high deductible). Could I just keep that going while I'm away and then use it should I have to come back for any major treatments? Sorry if I used the wrong or confusing terminology.


If you want this question answered the only place to ask is your insurance company. I would hardly want to bet the bank on peoples opinions on a forum.


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## mdi (Jan 15, 2009)

ebs001 said:


> If you want this question answered the only place to ask is your insurance company. I would hardly want to bet the bank on peoples opinions on a forum.


Ah Yes, ask the company "where you are NOT Covered"; but the short answer, you'll love this, depends on where you are going and what policy you have and who you have it with. So you gotta ask the insurance company and if you are going out of country you gotta find out to some extent what the host country will accept.


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## utchuckd (Apr 4, 2010)

Yeah I plan on figuring all that out with the insurance company, but as I'm in the middle of moving and almost, but not quite, ready to change my insurance I thought I'd ask and see if anyone knew.


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## mdi (Jan 15, 2009)

utchuckd said:


> Yeah I plan on figuring all that out with the insurance company, but as I'm in the middle of moving and almost, but not quite, ready to change my insurance I thought I'd ask and see if anyone knew.


I don't know what your options are, for example can you keep the old policy or you need to switch for one reason or another. If you have the option of either policy I would check with them both before I switched or changed policies.

A good example of this for me is that I, like everyone else, gets offered Accidental Death policies. But I ride motorcycles and some AD policies do not cover motorcycles, so you have to look at the fine fine print 

I am a believer if you have it - You do not need it, its only when you don't


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## Jane.Joy (Aug 17, 2011)

I did a bit of research before we started cruising - this is the company we got a quote from:

Worldwide Travel Insurance | Seven Corners

It was about $5000 a year for a late-forties couple, as I recall. Catastrophic, high deductible (5000, I think). The cruisers that we know either have DAN, or they have no health insurance, or they use one of the catastrophic plans like the one I cited above and they pay all medical expenses out-of-pocket. We decided against getting the insurance (big chunk of change!) but we're uneasy with the decision, so probably will revisit at some point. Would be interested to hear what other full-time cruisers have decided.

(apologies for posting twice - I was looking at two threads and posted to the wrong one  )


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## ebs001 (May 8, 2006)

mdi said:


> Ah Yes, ask the company "where you are NOT Covered"; but the short answer, you'll love this, depends on where you are going and what policy you have and who you have it with. So you gotta ask the insurance company and if you are going out of country you gotta find out to some extent what the host country will accept.


The o/p wants to know if he can keep his US policy in force while he is out of the country (USA) so that if he comes back for treatment he will still have coverage in the US. There is no host country involvement here. Since insurance companies make their own rules there is no definitive answer and they and they alone can answer his querie.


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## Aces (May 13, 2012)

The best thing and the right step to do is contact your insurance provider regarding this matter if they will still cover you or not.


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## dongreerps (May 14, 2007)

This thread raises and discusses a very complex set of issues. They all arise from the supposition someone gets seriously ill while abroad. Issues include where to get care, when to be evacuated home, how to be evacuated home, how to pay for the trip home, medical insurance coverage when you do get home, and where to get treated in the US. 

The first choice for treatment is in the local area if expert local care is available. The problem is knowing if there are really skilled medical help available locally. To find that out may take some blunt questioning. (How many of these have you seen this week, month, year. What is your success ratio?) If you have Divers Alert Network coverage, the MD answering the DAN phone back in the states will be able to help you determine if local treatment is acceptable, or evacuation to home is advisable. This access to medical advise over the phone is a very valuable part of the service provided by DAN.

In many parts of the world medical/surgical care is every bit as good as that available in the US. 

The second question is medical evacuation. If the patient can get onto a commercial carrier, pay for the first class ticket, the care that goes along with it, and get home. Of an air ambulance is necessary, realistically you must have evacuation insurance. I know of two sources: DAN, and AKC. DAN is least expensive, and provides good service. American Kennel Club charges $109 annually for member and family coverage. 
They claim this coverage includes caring for your pet, and getting him back home if necessary. I have no experience with them, but just getting a pet shipped home is expensive. If I were traveling with a pet, I would sure investigate AKC coverage. They also claim expert medical advise.

This leaves the question of the medical insurance coverage if the patient has to be evacuated back to the states. A high deductable/low premium policy or "catastrophic coverage" is what most would arrange for. I would get as much coverage as possible. My own son was in an accident in 1985. The bill from the 1st hospital was slightly less than $250,000. (Insurance paid). He was then medically uninsurable, but we got him covered with a medical policy with a $25,000 deductable. Annual premium was about $250.00. Those numbers are from the mid 80's. Today they would be much scarier.

If evacuation is medically necessary, be prepared to intelligently choose where to go. If I am sick sick sick, and trying real hard to die right now, I would want to go to a major hospital known for it's expertise in what ever I am suffering from. More than that, if there are two hospitals side by side, one staffed by the professors, and the other the professors teaching hospital, I want to go to the teaching hospital. 

I hope this clarifies some thinking.


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## Luisa Hilburn (Jul 27, 2019)

If you need medical attention, catastrophic health insurance can become very costly due to the high deductible. For example, if you have one medical emergency, it would not be covered by the three initial primary-care visits. Then, if your total cost was less than $7,900 that entire amount would have to be paid for without the help of the insurance company.

Another example where catastrophic health insurance can become costly is if you currently have a large family with multiple children. In this scenario, your family may require several different health services throughout the year. This could include annual checkups, getting diagnosed, seeking treatment for an illness or any primary-care visit. Since the catastrophic health insurance deductible is set at a very high level, you would be required to pay a large amount of money out-of-pocket until the deductible of $7,900 has been met. Instead, a silver or gold plan with a lower deductible amount would provide better financial coverage.


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