Dialysis Cruises

In article , Marsha wrote:

If you are covered by Medicare and are visiting another country and had
a heart attack, would Medicare pay for it? If so, then their rule about
dialysis is stupid. If not, then at least they are consistent, although
wrong IMO. What is it about being in another country that changes
coverage?

Medicare A or B won't cover you out of the country. However you may and
many do because it is prudent to do so, purchase supplemental Medigap
policies from a private insurance company. Some of them will cover
emergencies out of the country. I would say they would consider a heart
attack is an emergency but dialysis is not.

--
Charles

"Marsha" wrote in message ...
Kent Billeau wrote:
That seems silly. Just because you're on dialysis, you can't go out of
the country if you want Medicare to pay for it?

Marsha

Its precisely this logic that dooms O'bamas socialist plans for medicine.
Yup, just keep running up the bill on the taxpayers, after all, it's only
fair.

Kent

Please don't mistake me for an Obama fan - gag. I just don't understand
how an established dialysis patient is costing you more in tax dollars if
he goes on cruise, if that ship has the capability for dialysis. Would you
explain that to me?

Marsha

It probably wouldn't cost more to do treatments elsewhere but consider that
most private insurance companies normally don't pay the cost of a shipboard
doctor visit either. If I visit the ship's doctor I have to take the paid
receipt and fill out the paperwork for my insurance at home and hope that
they pay the bill.

Most ships would not have the machinery or supplies to do a dialysis.

Peritoneal dialysis is more popular and less restricting for people that do
not have "advanced" kidney disease. As the article I have posted the link
to: http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/ says there are
two types of peritoneal dialysis. One generally can be performed by the
patient themselves and requires no machine to perform. The issue with this
is getting the fluids and tubing, etc. on the ship. Each bag of dialysis
solution comes in 1.5-, 2-, 2.5-, or 3-liter bags. The patient will
generally need 3 to 4 bags per day and some method of warming the bags to
body temperature prior to use. Disposing of the biohazard material (the used
equipment) may also be an issue. It can't just be put in the trash.

However for those that do have advanced renal failure hemodialysis is the
only alternative. http://kidney.niddk.nih.gov/Kudiseas.../hemodialysis/.
Expensive, fairly large machinery and quite a lot of training to operate it.

A dialysis patient is pretty much tied to their location in most instances,
depending on the type of dialysis that needs to be performed, because of the
need to warm and change bags or the machinery involved. I have been inside
the ship's hospitals on a number of ships while doing ship inspections and
in a lot of instances they just aren't equipped to handle this type of
person or emergency if the patient does not comply with their doctor's
orders for the dialysis. The ship's hospital could not possibly store the
supplies for dialysis needed for a continuous stream of patients if they
relaxed their standards about pre-existing medical problems.

Princess cruises (and most other lines have similar wording) contract of
carriage states: "in the sole opinion of Carrier, the Captain or any Doctor,
You or any minor or other person in Your care during the Cruise are unfit
for any reason for the Cruise, or Your presence might be detrimental to Your
health, comfort or safety or that of any other person, or in the judgment of
the Captain is advisable for any reason. Carrier reserves the right to
request a letter from Your physician attesting to Your fitness to travel,
but by requesting such letter does not waive its right to disembark or
refuse to embark You as set forth in this Section."

It further states later "You agree that You or Your travel agent must, at
the time You book Your Cruise, inform Carrier in writing of any special need
or other condition for which You or any other person in Your care may
require medical attention or accommodation during the Cruise."

What happens here is that the passenger notifies the line, the line talks to
their doctors and the line then says, no, you can't come due to the
pre-existing condition that we can't handle if something happens to you.

: All this conversation means nothing. The insurance which you buy for
the cruise w9would cover hospitalization, etc. Not Dialysis though
).i'm not sure about this)


Marsha wrote:

Jack Hamilton wrote:

On Sun, 13 Sep 2009 11:34:48 -0700, MelB wrote:

My wife and I would like to take a cruisb. The problem is that I
need dialysis 3 times per week. Where can I get info on cruises
that provide dialysis services?

Also, does Medicare pay for part or all of the dialysis? What about
additional medications, such as Epogen?

According to http://emerginghorizons.com/expert/index.php?id=125:

"Furthermore, Medicare will not pay for on-board dialysis treatments
on any cruise ship. Some private insurance policies will pay for up to
80% of the dialysis treatments though, so you might want to shop
around for additional coverage. Additionally, if you can arrange for
treatments in US ports in Medicare-approved facilities, Medicare will
cover that. Medicare will not cover routine dialysis treatments in
foreign ports."

That seems silly. Just because you're on dialysis, you can't go out
of the country if you want Medicare to pay for it?

Medicare is a US based insurance company. I had medical coverage
through the State of Maryland (my employer) and they wouldn't cover me
if I even went out of the state. That's the rule. Medicare's rule
is that they only cover you in the US. If you go retire in Belize,
you are not covered.

My husband had a heart attack in the Bahamas and Medicare paid for his
hospitalization in the US, but not the ER visit or the ICU or the
doctors in the Bahamas and they didn't pay for the transportation
back to the US.


If you are covered by Medicare and are visiting another country and had
a heart attack, would Medicare pay for it? If so, then their rule about
dialysis is stupid. If not, then at least they are consistent, although
wrong IMO. What is it about being in another country that changes
coverage?

Marsha

In article , Rosaly Z. Greenberger
wrote:

All this conversation means nothing. The insurance which you buy for
the cruise w9would cover hospitalization, etc. Not Dialysis though
(i'm not sure about this)

I don't think anyone has thought that insurance bought for the cruise
would cover Dialysis. The question was about Medicare. But as I
understand Dialysis I don't think any US private insurance policy that
anyone has would cover it on a cruise or in a foreign country. Even the
policies that have coverage when out of the US......I doubt they would
cover that if it is pre-existing and you go on a trip.

--
Charles

Marsha wrote:

My husband had a heart attack in the Bahamas and Medicare paid for his
hospitalization in the US, but not the ER visit or the ICU or the
doctors in the Bahamas and they didn't pay for the transportation
back to the US.

If you are covered by Medicare and are visiting another country and had
a heart attack, would Medicare pay for it? If so, then their rule about
dialysis is stupid. If not, then at least they are consistent, although
wrong IMO. What is it about being in another country that changes
coverage?

I just said that Medicare would NOT cover a heart attack if you had a
heart attack outside of the USA. If you can get back to the US from
the foreign country (which the Bahamas is), you will be treated under
Medicare after you get back, but the doctors, and hospital in the
foreign country are not covered, nor is transportation back to the US.
Fortunately, we had supplemental insurance which paid 80% of the costs
in the Bahamas, but we had to pay up front and then get reimbursed.
..

On 9/13/2009 10:24 PM, Kent Billeau wrote:

Its precisely this logic that dooms O'bamas socialist plans for
medicine. Yup, just keep running up the bill on the taxpayers, after
all, it's only fair.

All this socialist talk is such BS. By definition stuff like
Medicare and Medicaid is taxpayers paying for the needs of
others. Why hasn't anyone been yelling about them all this time?

Sorry for continuing this off-topic portion of the thread.

Bill

In article , Bill
wrote:

All this socialist talk is such BS. By definition stuff like
Medicare and Medicaid is taxpayers paying for the needs of
others. Why hasn't anyone been yelling about them all this time?

They don't want to get those seniors upset and against them do
they........so they BS the seniors and the public.

McGovern had an op ed in the Times the other day on a simple way to
provide universal health care to all US citizens. Extend Medicare to
everyone. Why should it only cover those over 65?

--
Charles

In article , Marsha wrote:

Why do you call it excess medical expenses? Dialysis is dialysis. He
would need it no matter where he was. If a dialysis center is available
on board a ship, why should someone be denied travel out of the country
because of an already established need for dialysis?

Dialysis centers are specialized entities that treat hundreds, if
not thousands, of patients daily. Thus, they have all sorts of economies
of scale that kick in that you wouldn't get in a one-on-one situation.
Besides MCare pays for NOTHING outside the US, it isn't limited to
just dialysis.

--
"Politics should be limited in its scope to war,
protection of property, and the occasional
precautionary beheading of a member of the ruling class."
-P.J. O'Rourke

On Sep 13, 10:53*pm, "Rosaly Z. Greenberger" wrote:
: *All this conversation means nothing. The insurance which you buy for
the * cruise w9would cover hospitalization, etc. Not Dialysis though
).i'm not sure about this)

Rosaly,

I'm sure you know this, but to clarify your remarks for folks new to
cruising and/or travel insurance, if you or your traveling companion
(or a none-traveling loved one) has a pre-existing condition, then you
need to examine closely and ask whether "the insurance which you buy
for the cruise" would cover hospitalization, other medical care or
trip cancellation/interruption for pre-existing conditions.

Generally, the insurance sold by the cruise line does NOT cover pre-
existing conditions. And generally, the cruise line's definition of
pre-existing condition is going to be far more expansive than yours,
i.e., if you look at the policy definition of pre-existing and begin
reciting reasons why it won't apply to one or more health situations,
understand that the insurance company will have its own list of
reasons why the basis for any claim is a pre-existing condition--you
should simply follow the advice to buy a policy that covers pre-
existing conditions.

An experienced cruise travel agent will be able to assist on this
point. A terrific site for comparing policy provisions, and
specifically how an insurer handles pre-existing conditions, is
www.insuremytrip.com. The only trick to getting pre-existing
conditions covered is timing your purchase of insurance to your first
trip deposit (usually must buy insurance within 7-14 days of initial
deposit) or your final trip payment (usually must buy insurance within
24 hours of final payment).

Diana Ball
Austin, TX

Diana: Thanks for ypur reply. I know only too well the pitfalls of
buying the insurance from
a travel agent. I lost thousands of dollars when I canceled a cruise
right after 9/ll as I didn't want to upset my husband with the fuss at
the airports at that time. Unfortunately, he had Dementia and had it for
l0 years and we sailed every year (with insurance) but the bottom line
was that they called that a pre=exsting condition and wouldn't refund my
money. I was furious as we had sailed many times before

and the thing that made me most angry was that my cousin who was going
with us had insured through Celebrity and they gave her a credit for a
future cruise of 75% which I would gladly accepted.

At any rate, I don't think people should travel without insurance.

rosaly

Rosaly,

I'm sure you know this, but to clarify your remarks for folks new to
cruising and/or travel insurance, if you or your traveling companion
(or a none-traveling loved one) has a pre-existing condition, then you
need to examine closely and ask whether "the insurance which you buy
for the cruise" would cover hospitalization, other medical care or
trip cancellation/interruption for pre-existing conditions.

Generally, the insurance sold by the cruise line does NOT cover pre-
existing conditions. And generally, the cruise line's definition of
pre-existing condition is going to be far more expansive than yours,
i.e., if you look at the policy definition of pre-existing and begin
reciting reasons why it won't apply to one or more health situations,
understand that the insurance company will have its own list of
reasons why the basis for any claim is a pre-existing condition--you
should simply follow the advice to buy a policy that covers pre-
existing conditions.

An experienced cruise travel agent will be able to assist on this
point. A terrific site for comparing policy provisions, and
specifically how an insurer handles pre-existing conditions, is
www.insuremytrip.com. The only trick to getting pre-existing
conditions covered is timing your purchase of insurance to your first
trip deposit (usually must buy insurance within 7-14 days of initial
deposit) or your final trip payment (usually must buy insurance within
24 hours of final payment).

Diana Ball
Austin, TX