by Deb Peabody
My husband recently fell seriously ill on an extended vacation to France. The hotel physician referred him to the American Hospital in Paris. She told us to get our insurance documents out and be ready to use them. I wasn’t too concerned. We had foreign travel insurance and memberships with two organizations and five credit cards with us.
During visiting hours, I spent my time away from him on the phone… mostly on hold for two and a half days with insurance companies. The business office of the hospital told me what they needed from us. The first thing was a hard copy of our certificate of insurance, showing foreign hospital coverage. All of our memberships and credit cards actually had medical evacuation benefits… but, no hospitalization! A patient can’t be placed into an air ambulance until stabilized. Many more hours on the phone proved valuable when we learned my husband’s high end Medicare supplement had eighty per cent foreign hospitalization coverage for sixty days from the time of illness.
Now, the Certificate of Insurance was within reach! More hours were spent on hold with the insurance company, using unnecessary funds to pay for a huge telephone bill. The company told me the Certificate of Insurance would be mailed to our home that day. Due to HIPPA regulations, it would be impossible to send online. They could email a letter on company letterhead, outlining our benefits. The company assured me that the letter was sufficient. I had to take what I could get.
The business office was happy to see the letter and followed up with the company. The insurer had to provide a letter of guarantee which the hospital would accept for eighty percent of our bill. The company refused to issue this guarantee, until they could verify the records. The American Hospital in Paris is the only hospital outside of the United States, certified by the Joint Commission. The Joint Commission certifies the hospitals in our country. It seemed to me that the insurance industry would give more credence to the veracity of this hospital. Not so. They just said no. I was faced with extending a hotel stay, changing flights when travel was permitted, and most of all, enough cash on hand to pay the bill, which was growing by the day… the bill which the insurance company would not pay. I checked all of our credit cards on hand, and called a good friend and attorney to find out what else I could do. He would wire money to me if necessary.
Six and a half days later, my husband was to be released. I went to the business office. They told me it was “normal” that American companies refused to issue their guarantee. The costs were more than Eleven Thousand euros. I presented my receipts to the nurses attending my husband. They gave a complete dossier to me of all that was done, drugs administered, and the results of all tests. These records were available to the insurance company, but they just said no.
This story is true. We are seasoned travelers. What if we were a couple of college kids on an inexpensive jaunt or a mission trip? Most newlyweds don’t have the knowledge or money to be able to confront the various challenges which visited us. The insurance industry in this country should be ashamed of the way it misrepresents coverage to all of us. Foreign travel insurance should be called “Medical Evacuation Insurance,” if that is what it is. Foreign hospitalization insurance should be titled clearly. It is a terrible experience to be unable to reach your insurance company without being placed on hold, sent to someone else, or being disconnected for days! Just try calling an insurance company with a question to see how they respond. What a shame. We had to go to a foreign country to learn just what misrepresentation abounds in the insurance industry. Share our story with others. Contact your legislators and senators. Insist on honesty, clarity, and regulation in our insurance corporations. Tell them you want the insurance industry to answer for the abuses they commit.
Travelers, know what coverage you have and have it with you before you leave our country. You might stay at home.
Past President of the South Carolina Medical Association Alliance
SMA Alliance Member
Reprinted with permission from Deb Peabody.