Onboard Health Insurance

The ins and outs of onboard medical care and insurance coverage on cruise ships

By: By Marilyn Green

Recently, someone asked me if, when a passenger gets medical treatment onboard a cruise ship, it is covered by health insurance. I didn’t know the answer but, after some investigation, it turns out to be fairly complicated.

Cruise line charges for onboard medical care are generally similar across the industry, with office visits running $35-40, electrocardiagrams priced at $100 and emergency medical evacuations with a doctor starting at $900 or more.

However, conventional health insurance may or may not cover any charges onboard. Most cruise lines are registered outside of North America. Bruce Good, director of public relations for the Yachts of Seabourn, pointed out that Seabourn’s yachts, for instance, are registered in the Bahamas, and the line’s doctors are licensed in the United Kingdom. Therefore, they do not use the same procedure codes as are common in North America, so insurance carriers will process claims from onboard as Foreign Claims.

“Medicare does not apply and Blue Cross/Blue Shield does not cover foreign medical care,” Good said. “Some others, such as United Healthcare, do. Travelers should check with their providers. The medical office onboard can supply a detailed bill for submission, but without the codes.”

Tim Rubacky, senior director of corporate communications for Prestige Cruise Holdings, said that if you or your clients has emergency medical coverage in a travel insurance policy, onboard care should be covered.

“You have to choose a plan that contains emergency medical coverage and/or medi-evac,” Rubacky said. “Then, the costs are covered, so that you can get reimbursed, but you must pay up front and then submit for reimbursement.”

Tom Baker, president of CruiseCenter in Houston, agreed.

“We sell Trip Insurance.com from MH Ross,” he said. “We have had numerous claims for onboard treatments both for pre-existing and new health issues. The claim must first be processed by the clients’ personal health care. If it is declined, which is likely since it is offshore, the insurance pays for it — at least ours does.”

Agents also mentioned CSA, which covers onboard care with all policies except one that is just for domestic air, and Travel Insured International, which has a number of policies covering onboard care, including a Gold policy that takes over as a primary insurer. In this way, passengers go directly to them and they don’t have to worry about their home health insurance.

Baker and other agents have said they do not use vendor insurance because many do not cover this important piece.

“It takes a lot of questioning before one finds the right company and insurance to offer. It is tricky and the rules are all over the place with most carriers,” he said.

Other agents pointed out that pre-existing and psychiatric conditions may be excluded from some policies, and nearly all policies exclude complications for elective procedures. So, if a client has a cosmetic procedure in a ship spa and something goes wrong, there is no coverage.

The bottom line? Clients must read the fine print very carefully before they buy a policy and before they set sail.

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