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Travel Insurance is not that Expensive

Without insurance, a medical emergency on foreign soil can put a family in a financial tailspin

Article from the Seattle Times

Like many of us who live in the Pacific Northwest, Larry Sears yearns for warmth and sun when the rainy, gray days of fall and winter set in.

For the past several years, he has left his Lincoln City, Ore., home and headed for the sun, sand and warm waters of Puerto Vallarta, on Mexico's west coast, sometimes renting an apartment from October through March.

All went well this year until Jan. 6 when Sears, 56, suffered a stroke.

Having a stroke at home is bad enough, but in a foreign country it can put the traveler and his/her family through stress and financial challenges they hadn't imagined.

A traveler's regular health insurance may not cover her or him abroad. Paying a few hundred dollars for special travel insurance before a trip may save a traveler from being saddled with thousands of dollars in debt in case of an accident or illness during a trip.

A financial nightmare

In Sears' case, the first hint of how difficult being ill in a foreign country can be came just moments after his stroke. Staff of an ambulance service in Puerto Vallarta feared they might not get paid and refused to take Sears to the hospital. His friends drove him.

That night, doctors at the private hospital wanted to operate on Sears, but they needed the approval of a relative. Sears' daughter, Danielle Parker, who lives in Bonney Lake, Pierce County, was called and gave permission.

For Danielle, that was the beginning of stress and other difficulties in arranging the best care possible for her father and getting him back to the Northwest. Today, the family's financial responsibilities continue to mount, compounded by legal complications.

And the end isn't in sight.

First, there were $300 to $400 in the initial long-distance calls between the Parker home and Mexico; then, a week later, $1,600 for airline tickets, plus other travel expenses for Danielle and her husband, Jim, to leave work, arrange care for their two small children and fly to Puerto Vallarta.

"That was tough right after Christmas when we weren't expecting those expenses," Danielle Parker said.

Then another problem. What about the hospital and other bills that would await her in Mexico?

Her dad had some money, but Danielle didn't have legal access to his accounts. An attorney in Oregon who knew Sears and his former wife came to the rescue and got a temporary court order so Danielle could get money from one of Sears' investment accounts.

In Puerto Vallarta, the staff at the private hospital insisted that Danielle take financial responsibility and presented her with a bill for $39,000.

Danielle protested, trying to sign only her initials. The paperwork wasn't clear to her. "But I had to sign my name or they were going to throw me in jail," she said.

The hospital administrators also made it clear that Sears would not be allowed to stay in that facility because his American Medicare policy would not pay the bills.

Sears had to be moved and the family decided he would be taken by ambulance to a government-operated hospital in Guadalajara and treated there until arrangements could be made to fly him back here.

Because it's a public hospital, Sears apparently owes nothing for care there, according to his daughter. However, the 260-mile ambulance ride from Puerto Vallarta to Guadalajara cost the Parkers $120.

Jim Parker said that at such government hospitals, families are expected to help care for patients 24 hours a day, bathing them and giving medications.

After his stroke, Sears was unconscious most of the time. His speech was severely restricted; he required close personal care.

While regular airlines can deal with emergencies such as transporting someone on a stretcher, space isn't always available. Because of Sears' condition at that time, the only alternative was to hire an air-ambulance service.

The Parkers flew home to make arrangements to pay the $16,000 air ambulance bill. On Feb. 4, Sears was transported here on a Lear jet specially equipped for critically ill patients.

Back in the Northwest, Sears spent several days at Good Samaritan Hospital in Puyallup where doctors tried to stabilize him. That job was made more difficult by the fact that the medical records from Mexico had not been sent along.

Today, Sears is showing some improvement. He's in a Puyallup nursing home where his speech is improving slowly and he's receiving therapy for his paralysis. He can sit up only about an hour a day, and is fed through a tube. He is slowly learning to dress himself again, but has no use of his right arm.

The Parkers continue to struggle with the financial problems of his care.

"Dad can't sign for power of attorney now because he can't hold a conversation," Danielle said. That could mean expenditures for legal fees to make Danielle his guardian.

In hindsight, Danielle wishes she had known more about Medicare coverage before her father's emergency arose.

Sears is covered by Medicare at an earlier age than most people because of injuries and disabilities he suffered in an auto accident some years ago. If he'd had a Medigap plan with travel benefits, or a special health-insurance policy geared to foreign travel, getting care would have been much easier. And it's possible the air-ambulance service would have been paid by an insurance policy.

It's not clear to Danielle whether her father understood that Medicare generally does not pay for medical services provided outside the United States.

"When I hear that people have Medicare, I assume it's an insurance benefit and that it goes wherever they go," Danielle said.

But that's not correct.

Like most young families, the Parkers are not in a position to pay thousands of dollars in medical bills hoping to be reimbursed later. Danielle is a teaching assistant at White River High School in Buckley. Jim is a bus mechanic for the Federal Way School District. The couple has two children, Caleb, 5; and Jordyn, 8.

The Parkers are receiving advice from State Health Insurance Advisors (SHIBA), a group of volunteers trained by the Washington state Office of the Insurance Commissioner to counsel consumers on health insurance, and the Health Care Financing Administration, the federal agency that oversees Medicare.

Danielle had to do some fast talking to get Sears out of Mexico without paying the $39,000 hospital bill. The hospital did charge his debit card about $1,000, and kept the card. That hospital bill still hangs over their heads.

There are other loose ends. Sears' hobby was woodworking and he had a number of tools with him in Mexico, as well as a vehicle, personal items and the motorized scooter he used because of leg injuries he suffered in the auto accident some years ago. The American Consulate there is helping the family with logistics.

The Parker family isn't unusual in believing that Medicare covers medical expenses and air evacuation for Americans traveling outside the U.S., according to Lori Shea, a nurse and medical coordinator for Air Ambulance Network of San Diego.

And families are shocked when they discover the high costs of paying for care abroad and special air transport back home.

Depending on how much advance notice an air-evacuation service receives and the care needed by the patient, Shea said airlifting someone from Guadalajara to the Pacific Northwest costs from $15,000 to $25,000. From Europe, it can be a staggering $60,000 to $100,000.

"Think of it as chartering your own Lear jet, with pilot, co-pilot, medical crew and special medical equipment," Shea said.

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