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From: B Geres (no email)
Date: Mon Dec 01 2003 - 09:34:37 EST
Lisa:
If "sanctioned event" is the key, then I suspect some
companies might see to it that (for example)
participants in Steve Black's Caribbean 1500, the
Atlantic Rally for Cruisers (ARC), and the Nova Scotia
Adventure Cruising Rally, etc would find their care
excluded. In my experience (over a decade on the
underwriting and case management side of the business)
I've found companies interpret exclusion clauses quite
broadly when its to their financial advantage. You
have to remember these companies benefit financially
when they take in more premium than they pay out in
claims - its their job to see this simple equation
balance in their favor. Before you say "but if they
enforce clauses like these aggressively, their
customers will become dissatisfied and switch
companies" you need to understand that this is part of
the strategy. Insurers like nothing better than to see
sick people leave the pool.
My advice? First off, think long and hard about how
you want to see your life out. The vast majority of an
individuals medical expenses are in a subjects last
days, as they pursue extreme and in many cases
experimental therapies in an attempt to squeeze a tiny
bit more time out.
I not only have insurance experience; I've worked as a
hospital administrator. And I'll tell you quite
frankly - quality of life during the last days of
people pursuing extreme measures suck. Personally, I'd
rather just go quietly than have tubes protruding from
every orifice, pickled and wigged out on various meds.
What am I saying? Think the issues through and make
yourself up living wills (and healthcare directives)
in a form considered legal by the States/Countries in
which you intend to cruise.
Secondly, before you take your retirement or extended
holiday from work to cruise, take full advantage of
your employers group medical policy (and your cash
flow) to get yourself in tip-top condition. Have your
appendix out if its not already (even if it seems
okay). Get your lasix proceedure done. Get on blood
pressure/cholesterol meds (and/or make lifestyle
adjustments) if your numbers are even slightly
elevated. Start working out as if you were in training
(you are!). You want to go on your cruise just as
healthy as you can be.
You may want to shop for and initiate the healthcare
policy you'll use while traveling BEFORE you go -
especially if theres a pre-existing clause to deal
with. Paying premiums for coverage that's only
secondary to your employers policy is expensive, but
you may find its cheaper than dealing with
unreimbursed care while cruising.
Once "out there" you need to take on the role of
primary care coordinator. Since for someone traveling
continuity of care can be an issue, you need to be in
charge. Before you depart, get hard copies of your
medical records and carry them. Its up to you to put
them in the hands of doctors you see along the way and
inform them (in detail) as to what your care is all
about. You also need to fully inform docs that you are
transients and follow-up care might need to be
delivered in another city (or country) so get records
from that visit before you move on and add it to your
stack.
Be religious about preventive care. Most people get
into trouble because they neglect routine care (exams
or maintenence medication) and wait until a small
problem festers into a crisis. many times they do this
because they are trying to save a buck or two ("penny
wise, pound foolish"). Jump on small health problems
the same way you would hop to fix a tiny tear in your
best sail. Many cruisers take far better care of their
boats than they do themselves (just as most "dirt
people" take better care of ther cars than their
bodies.
If lack of funds stands in the way of proper care you
may find you qualify for some degree of charity care
through the network of free clinics that exist in many
medium and large cities in the States. Now I'm out of
the commercial side of healthcare I donate my time to
one such clinic locally. We see lots of transient
cruisers there. These clinics are not just funded by
churches, as one might expect... they are funded
through donations by employers who can no longer
afford medical insurance (free clinics serve the
"working poor" who fall through the gap between
Medicaid and commercial insurance)... and they are
also funded by grants from local hospitals who know
that without the clinics, these same patients would
clog their emergency room with routine care. Think you
would qualify? Look in the phone book and you'll most
likely find a free clinic.
What else might I add... well, at point of service,
brand name is still very important. Flash a Blue Cross
Blue Shield card to doctors staff and you're good as
gold. You might be surprised to find that many
physicians who say "not accepting new patients" really
mean "not accepting anything except traditional
comp/major/med funded patients, preferably BCBS).
Bring in some crappy off-brand insurance card and you
might be shown the door.
Speaking of off brand... be very careful as there are
many many people being scammed these days by fake
medical insurance they bought off the net or from a
local shiester. It looks real and the doctor might
admit you with it, but when they submit claims, only
small ones are paid and the large ones pile up (its a
Ponzi scheme). Before buying, ALWAYS check with the
department of insurance to make certain that company
exists and that your salesman is a licensed agent for
that company. Don't just say "I've heard of the
company so its okay". Scammers often create names very
similar to those of actual companies.
Sorry I rambled off a bit here... know I probably lost
a few of you early on. But hopefully there was some
useful meat in there ;-)
------------
Lisa wrote: [snip] as best as I can determine, it
appears that the operative word here is 'sanctioned".
[snip] Also, you mention having been employed in the
health insurance business in the past, what further
info can you share with the group that I may be
missing?
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