News websites and social media have been abuzz the last few weeks with the story of an Arkansas family’s harrowing ordeal trying to get their college age student emergency surgery in Mexico, after they hadn’t purchased travel insurance.
What the details point out is the importance of realizing that your U.S.-based health insurance coverage will not be accepted in most other countries, and that without sufficient credit card funds or bank balances, you could be refused treatment for relatively common emergencies.
Chase Kehler, a 22-year-old college student from Little Rock, Arkansas, was evacuated to a private, for-profit Cancun hospital when he was diagnosed by doctors on the Carnival Cruise Triumph as suffering with acute appendicitis. Left untreated, appendicitis can be life-threatening.
When the Kehlers arrived at the Amerimed private hospital in Cancun, they were told that admission cost $6,000, and if Chase Kehler needed surgery, that would cost $25,000, which are standard procedures at private Mexican hospitals.
Chase Kehler’s mother Janie told a local Fox television news station that when she informed the hospital that she could not pay $25,000, “they stopped all of Chase's treatment. They unhooked his IV, they gave him no more medicine,” and sent the family at 2 a.m. to another Cancun hospital.
The Kehler’s eventually ended up at Hospital Victoria, a private medical facility that asked for a $6,000 deposit. Chase Kehler had surgery within the hour.
Upfront medical payments for care providers abroad are common
Reviewing Newsweek’s version of the Kehler’s story, Cory Sobczyk, vice president, business development, at Arch RoamRight, told Travel Market Report: “It's very clear to me that a travel insurance policy could have solved all of [the Kehler’s] upfront issues. Their biggest issue was not having access to enough funds or a Guarantee of Payment (GOP), which is unfortunately a common occurrence for non-insured travelers visiting foreign countries,” Sobczyk.
“Many travel insurance plans, even in the mid-tiered price range, offer $50,000 or more of travel medical coverage, which would have more than covered Chase's treatment,” said Stan Sandberg, co-founder of TravelInsurance.com, an online travel insurance aggregator.
Any Arch RoamRight travel insurance policy will carry GOP through an emergency assistance provider, as part of its emergency medical and evacuation benefits, which also include access to 24/7 emergency assistance services.
“If admission to a hospital is deemed necessary by the attending physician, some companies will arrange advance payment if required, and this is contingent on the company being able to coordinate payment with the hospital,” said InsureMyTrip’s Product Expert Meghan Walch.
Then there is the issue of ensuring you are comfortable with the facility where you are going to be treated. The Kehler’s visited three hospitals in less than 12 hours, and Janie Kehler described one of them as making her feel like she was in a “third-world country.”
Typically, comprehensive travel insurance plans don't restrict where an insured can go for medical treatment, as long as they are treated by a licensed physician (as defined by the policy), said InsureMyTrip’s Walch.
Still, not all travel insurance plans offer the ability for the insured to choose where they will be treated, Sobczyk said. “Some carriers don’t offer that benefit at all; others offer it as an upgrade or include it with only select plans,” he said. “Hospital of choice coverage is not standard in the industry. If having this coverage is important to a traveler, they should closely read the details of each travel insurance policy before purchase, to ensure hospital of choice coverage is included.”
Sandberg noted that hospital of choice coverage “is generally found in the more premium travel insurance plans. But for most travelers, the standard emergency medical evacuation coverage will be more than enough.”
Arch RoamRight offers hospital of choice coverage through their Pro and Pro Plus plans, which are exclusively sold through travel agents and tour operators. It is also available as an optional medical upgrade to the Elite plan available directly to travelers on RoamRight.com. This upgrade adds both hospital of choice coverage as well as increased medical limits to the travel insurance policy, Sobczyck said.
When it comes to emergency medical evacuation, Walch at InsureMyTrip said, typically an insured would need to be hospitalized, and the attending physician along with the assistance company would need to approve and coordinate transportation from the “inadequate medical facility” to one that is better capable of treating the insured. The hospital that the insured is evacuated to is usually chosen at the discretion of the company making the arrangements, and the evacuation is contingent on the insured being medically fit for transportation, she said.
“All situations are different,” Walch advised, “so it is important to read policy documents to see what services are offered when traveling outside of the U.S., and to know what is excluded from coverage.”
“With the hospital of choice benefit, it is important that travelers understand that they must still be deemed medically fit for a medical transport by an attending physician,” Sobczyck said. “For example, if a traveler's appendix is about to burst, a medical provider will more than likely not approve the traveler for transportation, as it could put the traveler at additional harm. The hospital of choice benefit simply provides you with the comfort knowing that, when you are medically cleared for transport, that you can be moved to the hospital of your choice. In most cases, you will need to be stabilized at the nearest suitable medical facility first.”
Remote medical consultation services equally important
For travelers who don’t purchase a policy with hospital of choice coverage, it is equally as important to understand the type of emergency assistance available through the travel insurance provider, Sandberg sand.
“This means that an insured individual who is experiencing a medical emergency in a foreign country will have access to someone who understands the ‘ins-and-outs’ of that country's health care system and can help coordinate the insured's care as well as the financial and logistical sides of the traveler's care,” he said. “The last thing someone wants to do in the time of medical crisis is to figure out how to navigate a foreign country's medical system. “
Under the standard provisions of emergency medical evacuation coverage, if a hospital is not able to provide the necessary care or treatment, the plan will pay for the cost of transportation to the nearest medical facility that can provide the care or treatment, provided the insured's medical condition would allow them to be moved. “This is where having a regional expert as part of a plan's 24/7 global assistance becomes invaluable. They will know which hospitals can provide which kinds of treatment,” Sandberg said.
Arch RoamRight works with UnitedHealthcare Global and their network of doctors and medical centers to provide medical consultative services so travelers can assess the best place for emergency care. Since UnitedHealthcare Global does not maintain a financial interest in any of their providers, “all referrals are made on the objective basis of the best available care,” Sobczyck said.