Medical Evacuation insurance?

We always carry year around medical evac insurance. If we are more than 50 miles from home, they will bring us home. We use Emergency Assistance Plus. Have no idea of they are any good since we have never had to use them. I guess time will tell. About $200/year.

In the US private insurance (unless its specifically excluded) covers ambulance transfer, and this includes medically necessary air ambulance. In the case above, the transfer was within WA, so should have been covered. Medicare is the same. Once you are out of the US Medicare has no coverage, many health plans have limitations. I buy comprehensive insurance as you do. I'm not traveling enough out of the US to justify an annual policy, but you should run the numbers if you are.

I'm late to the game on insurance - I'm not a big purchaser of insurance if I can avoid it. My current coverage covers me all over the world with in-contract hospitals that get me the benefit of negotiated rates and so I don't worry too much about that. I did just purchase evacuation coverage for the very first time for our trip to China and I will do the same for Egypt in January. I roughed out the cost difference for the annual policy and, in the end, just went for the minimal period of time.

One thing to keep in mind - everyone - is that in January a lot of the policies are becoming more closed provider networks and that means your travel coverage will be more limited. I, for one, have always carried a multi-state policy that has lots of in-network providers in the distant state where my daughter attends college. Most of those plans (at least for Washington residents) are disappearing in January.

For me, this means that I will likely buy both evacuation and care coverage for my January trip. Even in a closed network, a single emergency is covered - like the "emergency room service" according to the Premera plan I just randomly checked. But that leaves a lot of uncovered costs where you wouldn't even get the benefit of the discounted negotiated rates between providers and insurance companies.

For you, Lola, Premera's policy covers most of the I-5 Washington corridor and not much else. It's pretty mind-boggling to think of the limitations inherent there, given how much people travel.

We belong to an HMO ( affiliated with Kaiser) and it provides out-of-area medical coverage up to $2500. (So our two ER visits were covered, as was a previous torn ligament when I was skiing in Utah). Beyond that, we are supposed to come home to get treatment, and I never thought to check if they cover the transport. I will go and do that now. But somehow I feel like they would not cover a $21,000 airlift.

We are often on islands near here that have no ferry service in the middle of the night---so an air ambulance would be the only option in a dire emergency. And one of our favorite places to go is a remote wilderness lodge in Alaska---hours and hours from the nearest hospital by road, so a plane is the only fast way to get help. Or backpacking in the wilderness, two days' hike in from the road. But maybe some of these situations might involve Search and Rescue as the first step, and I know at least the MedJetAssist plan does not cover SAR.

Locally here in the NW, a good deal is to sign up with one of the Air Ambulance companies such as Life Flight/MedStar, etc. for around $60/year. Often being a member of one of those groups will cover you when you are out of your service area. That does not cover internationally.

Before I retired I was a hospital social worker, working ICU, Progressive Care and occasionally ER. The prices for air transport, either helicopter or fixed wing are jaw dropping. There is a base rate and it increases if you need a higher level of care. From this area, Level 1 trauma is often airlifted to Seattle so $21,000 would not even begin to touch this bill. My ball park guess would be $100,000 for a transport with anything critical going on.

I have a friend who also has a policy thru Divers Network for med-evac. You do not have to be a diver but they are ready to go in to some off the beaten path destinations. It does cover internationally.

I went with MedJet Assist because I am a suspicious and doubting creature by nature. Divers Alert allows transport to the "nearest suitable hospital". MedJet Assist allows transport to the "hospital of the member's choice". I really like to be my own decision maker when I can.

Lola,

The fee that you mentioned for an air transfer is obscene! I can't imagine how they justify charging that much for a relatively short trip. Seeing reports like this makes me very relieved that I live here, as the charges are much more reasonable..... http://www.bcehs.ca/about/billing/fees

The aspect of medical care during travels is something I had to deal with this year, so it's a topic that's still fresh in my memory. I might consider something like MedJet Assist for a future trip.

If you go with MedJetAssist, there is a discount through AARP.

Thanks for the tip on MedJet discount for AARP, Bets. Looks like a full year plan is about the same as a 30-day plan for just our next trip.

We always get medical evacuation insurance when we travel out of the country .

However we dont worry about it within our cou try as its a non issue. My mom was helicoptered off our island for heart surgery, cost us 150 bucks. Sorry, socialized medicine is great that way.

There are two rates for travel medical insurance , one for any travel to the States , and one for the rest of the world . I will let you guess which one is most expensive.

pat,

The cost for your Mom's air transport may have cost considerably more in other provinces in Canada, regardless of socialized medicine. Here are a couple of examples....

• https://www.thestar.com/news/canada/2015/08/06/mother-left-with-30000-bill-for-air-ambulance.html
• http://www.cbc.ca/news/health/ambulance-fees-a-roadblock-for-many-who-need-care-1.2946576

The reason we get such a deal here in B.C. can be explained by the link in my earlier post. The ambulance service we have in B.C. is somewhat unique and is a benefit that came about due to the Dave Barrett NDP government in 1974. I used to work for BCAS so I'm very familiar with the service.

Wow so glad I live in BC! Secretly always thought it was the best province ! Lol

Interesting! Would the cost of air transport also be low for a non-Canadian visiting BC? I know we would pay for emergency medical care there, but if I had to be helicoptered off an island would it be $150?

Bets---how much is the AARP discount? I have never joined, but maybe I should. . .

I Googled and found this:

Discounted Medjet rates for AARP Members Up to Age 75
•Individual Annual Membership: $235 (normally $270)
• Family Annual Membership: $345 (normally $395)
• Short-Term Membership: Starting at $80 (normally $99)

Medjet covers older folks as well.

As a non-car owner (and thus non-member of AAA), I like having access to AARP hotel discounts. I don't think I've ever used any other AARP discounts, but some folks might find the car-rental discount(s) useful. Here's the discount webpage.

We always carry a family membership to Divers Alert Network. You do not have to be a diver to use it.

It costs about $55 a year for the two of us, and provides emergency evacuation and other services any time we are more than 50 miles away from home. We have never had to use it but the friend who recommended it (and her husband) were evac'd from Switzerland back to Denver with a broken leg without any hassle or extra charges.

Sasha ,no I doubt very much a non resident would pay the same , we are covered under our provincial plan , which i imagine covers most of the real cost .

Divers Alert Network---are you satisfied that the coverage is as good as the more expensive plans?

I will have to look closely at the AARP discount on MedJet Assist. I wonder if the Family rate discount would apply if only one of us (me but not my husband) were to join. We do have AAA for hotel discounts, so have not felt any need for AARP. ( I know they also have a discount on British Airways flights, but we always use miles for those.)

And I will also call my HMO and ask about their air ambulance benefit. The policy says they provide that when medically necessary, subject to a 20% co-pay---but does that apply world-wide? Hopefully the person I talk to will know the right answer.

As I said, I've never had to use it, but our friends gave DAN a glowing recommendation. With a $55/annual family membership you get $100,000 evacuation insurance plus other benefits. It gives us peace of mind.

sasha,

No, the cost would not be the same. Non-residents (those not on B.C. Medical and not having a Care Card) pay more, but it's still much cheaper than the exorbitant rates mentioned by Lola. As shown in the B.C. Ambulance link I posted earlier (re-posted here), the "Non M.S.P. Beneficiaries" section shows the rates charged for non-residents. From what I remember, this is basically done on a "cost recovery" basis and I don't believe the intent is to make a profit.

Keith,

YES, basically the charges will be different for ambulance services in Ottawa than in Calgary, or anywhere else in Canada. Although we have a "single payer" health care system in Canada administered by the Federal government, health care and ambulance fees are administered by each province so there are differences in cost across the country. For the same reason, it's a good idea for Canadians to take out travel medical insurance when travelling from one province to another. Using a B.C. resident travelling in Ontario as an example, if he/she were to be injured in Ontario, B.C. Medical would only pay the same amounts as they would pay here for whatever procedures were necessary. If the rates for that procedure were higher in Ontario, the patient is "on the hook" for the balance in charges. I know this to be true as I know someone here that fell and fractured her hip when visiting Ontario. There was a "rude awakening" when the bill arrived, but it had to be paid. The surgeon made a very interesting remark to her - he said, "this would have been cheaper for you if it happened in the U.S.". I was shocked when I heard that!

I'm not sure whether THIS VIDEO can be viewed in all areas, but it provides an revealing look at the situation. It's interesting to note that the woman profiled in this story who had a sick child, faced crippling bills for ambulance services in the province she was living at the time. She has dealt with that situation by moving to B.C. where costs are considerably more reasonable.

To expand on what I mentioned earlier, I believe we're the only province in Canada to have a fully provincial ambulance service, which provides integrated coverage between ground / air / marine transport. In most smaller communities, "primary care" Paramedics are normally used, but in larger centres advanced life support Paramedics are available. If ALS skills are needed on a call and a crew is available in that locale, they can be sent to assist the PCP crew. We also have a specialized Infant Transport Team that can go anywhere in the province to deal with critically ill infants. I've worked with them and their skills are exceptional.

BCAS is a crown corporation (owned by the provincial government), the largest service in Canada and one of the largest in North America, serving an area of about one million square km and with about 3600 employees. As defined in legislation, BCAS is the only EMS provider in the province (except for a couple of private transfer services). Fire departments can provide "first response" for emergencies but they have a lower level of training and can't transport.

To answer your question, NO you don't have to pay here before you're transported. The ambulance crews are only concerned with providing patients with the best possible care using whatever resources are necessary under the circumstances. Billing is handled separately. I'm very proud of B.C.A.S. and my time working for them (25 years +).

I believe BC and Quebec have the best Medicare in the country, at least that is what I have been told by medical profession people. I do know that my husband in his final 18 months was transported to hospital 6 times by ambulance, and spent the final 6 weeks of his life being cared for in the best hospital in the city, and it all came under Medicare. Of course, we are taxed for this wonderful service ...... the money doesn't fall from the sky.

Norma,

Most of us don't mind paying taxes for medical care, and that's also common in many European countries. As Mr. Spock so eloquently put it, “Logic clearly dictates that the needs of the many outweigh the needs of the few.”

Ken, I have never, ever, heard a Canadian complain about being taxed fir Medicare. Today I went for my free 'flu shot, just one more perk of our system.

Norma,

I also got my "free" Flu shot recently, but wasn't entirely happy about it. I had hoped to get one of the high dose versions that are proven to be more effective for us old guys, but after two weeks of E-mails, phone calls, etc. I couldn't find anyone in this area that was stocking the high dose versions. One of the pharmacies said they could get them but were unwilling to order a box of 10 for one person. The high dose versions are not completely covered by the medical system here, so I would have had to pay an extra $70, but that's not a problem and I was willing to pay it.

I'll start earlier on my quest next year and hopefully I can find someone that's willing to stock the high dose versions. I'll fly to Vancouver if necessary, but given my current condition I couldn't do that this year.

For Lola -- AARP lets you add your spouse to membership for no additional cost. I added my husband so we could get a discount on cell phone service (which is in his name -- ah, the joys of late-in-life marriage)

It turns out the Divers Alert Network insurance is not available for residents of Washington State (or NY, IN, and FL).

I assume something about it does not meet our Insurance Commissioner's requirements. WA is very strict about protecting consumers---I have seen other travel insurance that was not offered here as well.

Lola, the information you found out about the DAN insurance is interesting and slightly unnerving.

I did not intend it to be unnerving---just an explanation of why the attractively-priced DAN insurance is not an option for me.

Washington does have some stringent requirements for insurance plans which some companies choose not to try to meet. I cannot name the specifics; I just know that some companies offer policies which cannot be bought in WA.

You know the pop-up offer of travel insurance that sometimes appears when you are booking a flight? One time I was curious what they offered and clicked on it. The company was Allianz, and as soon as I indicated I live in WA, I was told the coverage was not available. Yet I believe I have seen Allianz among the various offerings when I search for general travel insurance on InsureMyTrip, which starts out with the question regarding our state of residence. So the exclusion must be policy-specific, not company-wide, and not an indication of the quality of the company.

I just returned from a trip downtown to talk to representatives of my HMO about travel benefits and medical evacuation. The answer is that emergency medical care is not limited by the $2500 "travel benefit"; that is for routine care while out of our area. For life-threatening emergencies they pay the full amount and/or transport us home to get care here. So we are good there. But we would end up paying 20% of air evacuation expenses, which can be considerable. So we will go ahead and get the annual coverage with MedJet or a similar company---and hope we never need it.

I am glad to have had the opportunity to discuss this with people here!

It turns out the Divers Alert Network insurance is not available for residents of Washington State

Really? Then I need to call them from my home in Seattle and ask for my money back for the many years we have paid for their insurance.

Me and my wife are scuba divers. We sometimes go to extremely remote corners of the world, then get on a tiny speedboat and roar off for 4 or 5 hours, and finally step off on some tiny fly-speck island that nobody here has ever heard of, where there's no facilities for anything other than diving, sleeping and eating meals, and we engage in (what some might consider) risky adventure activities (5 deep dives a day, with sharks, stinging corals, strong currents, etc.) for a week. I'm talking really remote. We've been DAN members for years and have always bought their "gold plated" insurance plan. I've only had to use it once, for a very minor dive "injury" my wife sustained, in this case I just had to call their 24-hour medical hotline in Durham, to confirm what I thought I knew about my wife's condition (for this one, we were on Bali, so getting to a phone was't difficult - and the DAN specialist I spoke with confirmed my wife's condition was temporary, cosmetic - thankfully - and she would quickly heal up completely - it gave us peace of mind).

Note that DAN is primarily set up for divers. I guess they also sell plain old "travel insurance" - maybe that's the one with state exclusions. We have their Dive Accident Insurance plan, which does cover emergency medical expenses and evacuation (plus dive-specific things like getting put in a hyperbaric chamber - something you really don't ever want to have to go through). It may be that the more expensive plans for divers (I always get the most expensive plan available) don't have exclusions but the non-diving plans do. Might be worth learning to dive just for the insurance? :) I'll leave that up to you...but I think the statement that "Divers Alert Network insurance is not available for residents of Washington State" is not completely accurate. I live in WA and have their insurance (this is a good reminder - time for me to renew our annual policy...).

I use Divers Alert Network insurance, too (not a diver). It has some unique features that, as a solo traveler much of the time, appeal to me. For example, they will cover flying someone to be with you if you could not be flown home immediately. I don't have any concerns about it being inadequate coverage.

David --- all I know is I looked at the website, clicked on Travel Insurance, and saw that it is not available in four states, including Washington.

Perhaps as a diver you can access other coverage through them. My husband is a scuba diver but has not done it for years. But my eyesight is so bad I have never considered getting certified--although I paid to get both my sons certified through PADI ith classes on Bainbridge Island. It just would not work for me. And once I saw on the website that travel Insurance coverage is not available for us in our state, that was the end of the inquiry for me. I have too many years working in the courts, dealing with insurance cases, to try to work around things.

My newest credit card, Chase Sapphire Reserve, says it has med-evac insurance. Has anyone else looked at this?

Keith,

You're very welcome! Here's another related item on one the challenges we're currently facing with the health care system.....

• http://www.cbc.ca/news/opinion/two-tiered-health-1.3848228

Laura B,
Someone much wiser than I once said "The devil is in the details." Please read the details in depth. You may have to make strong demands to actually get to see all the details. My experience with all things offered as an adjunct to a credit card is that there are plenty of ifs, ands, buts, conditions, and restrictions on the so called benefit. What they are offering may very well suite your needs, but maybe not. The biggest "misunderstanding" with most medical evacuation insurance is that most will only evacuate you to the nearest place you can get adequate care --- not back to your home area.

Thanks for the response, TC. I am reviewing the many pages of small print in the card's benefits booklet.