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Cologne, an Injury, Medicare and Travel Insurance Part 1

In January 2025, in Cologne, on the first night of our planned 19 day tour of Germany, my wife tripped on a section of raised pavement on a darkened street near the Hauptbahnhof. She was told in the ER that she had a fracture of the bone in the floor of her eye socket, and hospitalized overnight. The next day she was seen at the Uniklinik Köln Hospital in Cologne and told that she could not fly home until after surgery because she would be at risk of serious eye injury if she were to fly. She was told that the surgery would be done early the following week. The next week, when we heard nothing from the hospital, we sent an email to the “International Office” of the hospital. The reply stated that Medicare was not accepted and that we would need to make a 13,000 euro deposit in order for the surgery to be scheduled and hospitalization provided.
We were fortunate to be able to transfer the deposit the next day. But the surgery occurred not 5 days, but 15 days after her fall. On the day of her operation she was told that she would have to wait another 2 weeks before she could fly home.
The travel insurance we included in our Expedia flight reservation included Medical Assistance. Within a few days of my wife’s injury I filed a claim with the insurance company. The response was quick. Because it points out some of the documentation requirements we needed as we sought reimbursement once we got home, This is a portion of the initial email we received upon filing a claim.
“Below is a summary of what documents we would require, and our process should adjustments need to be made for your travel home due to the medical issue.
1. Completed and signed Release of Information Form from patient (blank form included)
2. Copy of the original flight / travel itinerary
3. Copy of the information page of all passports of the individuals needing help with travel
4. Copy of the medical reports from the treating physician
5. Completed Fit to Fly Form from the treating physician no sooner than 3-4 days before the patient is cleared to travel (blank form included)
Once we have these documents, they will be reviewed by our medical staff to put in travel recommendations. Once that is confirmed we can then work with claims to confirm how coverage applies under the policy for these costs and if they are anything we can prepay or if it is something you would initially pay for upfront and then submit to claims for reimbursement once you get back home.”

As we only were traveling with an Apple iPad, completing the release of information and printing out the Fit to Fly forms for the hospital was especially challenging. The insurance medical unit contacted me daily for updates on my wife and to offer assistance.

On the initial phone contact with the insurance company we were given instructions on how to submit documentation of expenses, documents and bills to the insurance company’s website. In most cases, we submitted them on the day we received them. Despite this, when we got home the claims-processing part of the company said that they did not have access to these documents, so we had to submit them again. Similarly, after getting several emails saying that we needed to fill out claims forms, we realized that our initial claim had not been forwarded. The forms were not included in the emails requesting completion, and we finally realized we needed to request them.

After the initial Uniklinik appointment we stayed in a hotel near the train station for a couple of nights, but it quickly became clear that we would need to stay in Cologne near the hospital for an indeterminate length of time-not only until the surgery, but also until the last post surgery appointment and clearance to fly home. We were able to find an AirBNB a few blocks from the hospital. Because of the surgery delays the initial apartment reservation ran out. Then we moved to another AirBNB where we stayed until the final post-surgical appointment.

Posted by
2960 posts

I hope your wife’s eyesight is not impacted about this because I know that would be incredibly scary. Hopefully she’s making a full recovery

I know it’s going to be a pain to deal with the travel insurance, but as you can see from Medicare‘s response, this is why if you were on traditional Medicare, you should never leave the country without travel insurance. Yes, travel insurance can be difficult to deal with but it’s better than not having any insurance at all to cover this.

Posted by
9978 posts

The reply stated that Medicare was not accepted and that we would need to make a 13,000 euro deposit in order for the surgery to be scheduled and hospitalization provided.

Even though the hospital did not accept Medicare (which does not surprise me), you should still be able to submit a claim to Medicare for reimbursement IF you have a Medigap plan. I believe there is a lifetime coverage of up to $50,000 using Medicare. I don't think Medicare Advantage plans cover medical emergencies overseas.

Have you called a Medicare rep to ask? Usually the Medicare plan would be the primary coverage and the travel insurance secondary, although it depends on the policy.

Regardless, I am sorry about the accident and all the issues involved. That must have been very scary and also very frustrating.

Posted by
423 posts

So sorry about your wife's injury. What a scary time. And thank you so much for sharing this information with us all. As another poster says, this is an excellent example of why travel insurance is so critical to have. Sending best wishes for your wife's total recovery, as well as reimbursement for all your expenses.

Posted by
1674 posts

I believe there is a lifetime coverage of up to $50,000 using Medicare. I don't think Medicare Advantage plans cover medical emergencies overseas.

The $50k lifetime coverage is available from at least some Medigap supplemental policies - not Medicare itself.

And some Medicare Advantage plans do include foreign travel coverage - others have mentioned this in the past on the forum.

Emergency medical evacuation coverage is a different matter - and this may cover the largest financial hit if you need it and don't have it.

Posted by
319 posts

I'm so sorry to hear about your wife's accident, the insurance hassles and the loss of your vacation! I do really appreciate your post. It caused me to print out and read the (55 page!) insurance policy we have for our upcoming trip. Wishing you both the very best outcome!

Posted by
1412 posts

Hi there, SO sorry to hear about this accident and all that it entails - While it's technically correct no overseas hospital 'accepts Medicare', it doesn't mean you don't have coverage. If you have a Medicare provider such as Kaiser, or whatever provider you use, call them, not medicare You can look up the number on their website. (And if you don't have international data on your phone, download ViberOut, it's unbelievably cheap to make international calls.) I know I've called Kaiser several times to reassure myself that the Kaiser Advantage Plan coverage includes international medical emergencies.

Usually the policy would cover up to $50,000 lifetime reimbursement. They will be able to help you with gathering the necessary paperwork for reimbursement. AND I know from a friend, the sooner you call the better! They need to know about the accident.

Agree with last poster, really a good idea to download, read your medical insurance policy details, I have the telephone numbers and policy printed out and carry it whenever I travel. I hope that's helpful... it all sounds utterly exhausting, wishing your wife a speedy recovery.

Posted by
9364 posts

Someone correct me if I am wrong. Regular Medicare (as primary insurer) does not provide any coverage for overseas care. Like many people, I have a secondary private insurance plan (from former employer) that does cover international medical costs, but as a reimbursement. Not to generalize, but no foreign country's medical providers are required to work with or have a reporting relationship with US insurers.

Medi-gap and Medicare advantage plans are private insurance policies that work with Medicare for domestic services, and may cover international care if it is in the specific policy that you have.

Posted by
8422 posts

The last time I had Travel Insurance, they demanded a "denied Medicare claim" before they would consider paying out. Both parties know that Medicare does not cover me abroad, but this is another helpful (to them) obstacle to discourage payouts! You can be sure there will be a battle between Expedia and Medigap over who has to pay first ...