Florida Medical & Travel Insurance Info B4 You Go!

FH_Brit

Insert By Martin:

Thanks so much to FH Brit, for the great insider post below, showing how travel insurance operates in one of the world's most expensive medical areas. Some great tips below.

Also check out the Cheap Travel Insurance guide for more info
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Please note - my comments are based on my Professional experiences dealing with Medical claims (and their Insurance Companies) left behind by international tourists who visited Florida. In 2009 I dealt with 40,000+ international medical claims (and probably 70%, or more were Brits - followed by Canadians).

Being an Ex-Pat Brit (formerly from Hertfordshire) working here in Florida in a job that follows all you Brits that come here and need medical treatment and then leave unpaid bills behind.

If you are going to travel to Florida you need to know a few things just in case the need arrises for medical treatment. Before you buy ANY travel insurance make sure it covers your needs.

Pre existing conditions are the biggest single reason that I have claims rejected, this may be because some of you think that you will not be covered if you tell the insurers that you have a pre existing condition (previous heart problems is a biggie) where in actual fact most insurers will cover them and may only increase the premium or excess to take account of any pre exising conditions. Sometimes they may cover you for other events but exclude the pre exist condition.

You must also consider that if you need to visit an Urgent Care Facility (sort of between a GP surgery and an Emergency Room) or to a hospital Emergency Room the medical service provider will make YOU not your insurers legally responsible for any medical debts.

Although the hospital I work for will deal with your insurance company, it is done as a courtsey to you, their customer. US and Florida State laws protect the medical facility from bad debt and when you attend the facillities you, in fact, "Sign your life away" and no matter what, you are responsible NOT THE INSURANCE COMPANY.

WHERE TO BUY INSURANCE:

Avoid buying Insurance from your Travel Agent, Teletext, and the Internet (they can sell you the cheepest and often worst coverage poicy and you won't know until you make the claim.) UNLESS YOU KNOW THE UNDERWRITERS ARE A KNOWN AND REPUTABLE INSURANCE COMPANY. you can buy very good insurance from the Post Office, insure & Go, Moneysupermarket.com, Tesco, Barclays Bank etc and you do not need to be an account holder.

Check your policy details and ask questions.

One of the UK's largest insurers has a clause that states if you are over the drink driving alcohol limit (EVEN IF YOU ARE NOT DRIVING) any accident (trip/fall etc) is considered SELF INFLICTED INJURYand will not be covered (ask the lady in Middlsex who had 3 cocktails and tripped and hit her head and ended up paying us $19,000.00+ out of her own pocket).

If you are not sure ASK the insurance company NOT the seller of the policy. (many insurance companies will have their policy "wording" available on-line so you can see before you buy).

If you need medical treatment, first consider if it is REALLY an emergency - if so go to the hospital or call 911 for an ambulance. If it is a minor condition (Sore throat, ear pain, cuts & bruise) you are better off going to an Urgent Care facility - Florida Hospital CentraCare, Solantic, and some CVS & Walgreens Pharmacies now have "In-Store Clinics" - these are often much cheeper than hospital ER's and often a lot quicker!

If you forget your Prescription Medicine's.

Try to find a (Heart or Diabetic etc) Doctor's office that will see you and give you a precription, only use the ER only if you cannot find someone else (a local Doctor's office or Urgent care facility) the Hospital will put you through a full medical before they will even consider writing you a new prescription and some insurers will not cover this as it is your negligence and/or pre existing condition).

Attending the ER for blood presure meds could end up costing YOU around £500.00! - Also other tip - before flying keep 3-4 days meds in your carry-on bag, should your aircraft be delayed or diverted, your bags may not!

DEBT COLLECTORS.

Medical providers will use debt collectors after sometimes a very short time, this is not unusual and does not neccessarilly mean that you are having legal action taken against you. - If you are contacted by a Debt Collection Agency the best you can do is contact the debt collector - NOT THE MEDICAL PROVIDER, as debt collection laws mean that the debt collector is now in charge of your debt - the hospital should refer you to the debt collector and if you ignore them, then they have the law on their side and you could find out the hard way that you should have TELEPHONED them/

E-mail often is considered unsafe as the debt collector cannot be assured that you are the person entitled to receive the Protected Health Information in your medical bill (same with fax) by telephon the debt collector will ask you if you are the debtor if you say you are, and you are not then it is you who has commited an offence and the debt collector has complied with the law. Also if you are over 18 YOU must deal with your debt not your Dad, Mum or anyone else that may have paid for the holiday or insurance policy.

In any case, you sign a consent form at the medical providers office and the bottom line is that YOU owe the money NOT your insurers. Any legal action will be taken against you not your insurance company. I have had many stuborn customer that "knows better" then call back 6 months later because they have been refused a mortguage/credit card or Car HP.

SOLICITORS.

If your insurance company deny your claim and you dissagree with their decision (or do not pay fast enough) do NOT engage a Solicitor, there are other and better ways to complain against your insurers such as the Financial Services Authority's Ombudsman Service and this consumer protection service is free to a consumer - why waste £85 - £100 per hour on a Solicitor when you get a better service from the FSA for FREE?

But remember this or any other legal action you may take, does not releive you from your responsibility to the medical provider and you should pay them straight away and then "fight" your insurance company for reimbursement.

AFTER A CLAIM IS MADE.

It is your responsibility to make sure that the insurers have actually paid the bill - some insurers tell you this and then the debt collectors start calling - Insurers have the legal responsibility to prove they have paid, not the medical provider or their agents to prove that your bill has not been paid.

You must fill in your claim forms and comply with requests from your insurers for medical records from your own GP (this is the only way a pre existing condition can be ruled out) and your insurers cannot process the claim if you have not complied. Any cost for your GP may be your responsibility also, so if you don't pay your GP then you WILL have to pay the hospital! I don't need to tell you what is the cheeper bill!

RE-ENTRY TO USA.

Many ask - will this affect their return on their next visit to the USA - Officially you must make this enquiry to the Dept. of Homeland Security (at the US Embassy in London or any US Consualte).

I have heard that yes it can affect entry to the USA - If you have holiday property here or are planning to emigrate here the immigration officers WILL do a credit check (unpaid medical bills are reported to Experian, Trans-Union & Equifax the 3 major credit reporting agencies) although I beleive that it is rare for any "2 week tourist" to be refused entry on the grounds of bad debt (I think it may differ the bigger the debt).

Remember;

A medical bill in the US can ber huge! A personal friend of mine from Hertfordshire had a twisted bowl and was hospitalized twice in 4 weeks here having 2 surgeries and her medical bill for the hospital alone was $158,000.00+ [£80,000.00]

Doctor's here bill separately and that means you may have multiple bills, just being treated at the emergency room and released (without overnight stay in hospital may result in

A bill from the Ambulance/Paramedic serrvice.
A Hospital bill.
The Emergency Room Doctor's Bill.
The Radiologist's (if you need x-rays etc).
The Pathologist (if you have blood tests etc).
A Paediatrician (if it is your child that needs treatment).

Overnight stay in the hospital can cost upwards of £600.00 per night, just for the stay (called "hotel charges") WITHOUT ANY MEDICAL TREATMENT!

etc etc etc ......

Motor vehicle accident are another subject and is complicated (as if the above is not!!!).

Although mainly Florida – a lot of the info in these postings relate to general Travel Insurance & Medical Issues – worth a read – I may be able to help.

I am an Ex-Pat Brit (Hertfordshire) living and working in Florida. I work for a major Hospital group (7 hospitals and 15 urgent care clinics around the Orlando area) dealing with all you tourists that holiday here and then go home leaving medical bills behind you unpaid.

My job is to track you down and get the bills paid and I deal with UK insurers many times each day. No matter what your horror story is, I’ve heard them all and Brits usually have the same story to tell.

I am officially a Debt Collector, and that usually scares people. Don’t be worried, it is usual business here in Florida to use debt collection agencies. If you get a letter or call from a debt collector remember DO NOT IGNORE THEM – CONTACT THEM IN THE WAY THEY ASK – don’t assume e-mail is ok the privacy laws state we have to have a verbal confirmation or “ink” signature to confirm you are the patient or other person entitled to the information. The law is on their (or their clients) side, and in ANY case YOU the patient, are responsible for your own debts NOT your insurance company.

General advice (as I cannot speak for any insurers), I am pleased to give to you if I can't help then usually I can let you know who can help/advise you regarding any insurance problems.

See link below from the UK Foreign & Commonwealth office with REALLY useful info for the traveller abroad, it has links to local Embassies/Consulate Offices around the world that will give you more local advice.
http://www.fco.gov.uk/en/travelling-and-living-overseas/

PLEASE - don't be an ignorant traveller - find out prior to travelling and not the "hard way" after an event happens. Especially here in Florida it can be very costly to YOU.

BEFORE YOU BOOK YOUR HOLIDAY -

Shop around (Martin recommendations are better than many others) and read the threads here, see who people recomend from their own experiences.

If you are travelling with others, let each (immediate) family obtain their own insurance - even families have secrets and they do not tell their family that they have any pre-existing medial conditions (PEMC) and should anything happen it may mean that you policy is voided by their unwillingness to let you know they have an PEMC. Mum, Dad & children to each policy - let your Aunt/Uncle or the Grandparents, in-laws, brothers, Sisters etc get their own policy. It does not matter who paid or organized the trip. (Like car insurance you would not put these family members on your policy (so their crash increases your premiums) so why do it with travel insurance?

Before you buy your insurance make sure that you have declaired any pre-existing medical conditions (PEMC) or other exclusions (Ski - watersport - dangerous sports etc) and if in any doubt call the insurance company and ask them, don't take anything for granted.

If you have declared a PEMC, when you get your policy make sure that the declared condition is noted and that they acknowledge you have declaired it. If it was to go that far, in court it is what is in the written contract (policy) not what you were told on the telephone.

IF YOU NEED MEDICAL TREATMENT OR MAKE ANY CLAIM -

Call your insurers at the earliest possible convenience, if non-emergency that means BEFORE you go to the hospital/medical facility, if you are admitted to an Emergency Room (ER) then ask the registration clerk at the hospital to call your insurance company's assistance service.

READ the documents supplied by the hospital - you just "signed your life away" in the admittance consent form YOU are now legally responsible for your medical bills and not your insurers. Full instructions shuold be given - here in Florida you are told (if only in the consent form) if you should contact any doctor's offices and the hospital's own billing department to make sure they have your address correct for billing and remember it is your responsibility to make sure your bills are paid (no matter who pays).

MAKE SURE YOUR INSURANCE CLAIM FORM IS COMPLETED -

This is a legal document that allows the insurance company to discuss your claim with hospital's/assistance companies/debt collectors etc, if you do not complete it (or any other documents from the insurers) then they will not process your claim until you supply the required documentation (including medical records and certificates from your GP).

You should inform your insurance company of any medical treatment - if you think that, for example, your excess will be more than your claim (you paid £20 for a prescription, and you have a £50 excess) you need to inform your insurers, as if there is another bill from the doctor that wrote the prescription or the hospital, then they will apply another excess as they do not know you have already paid some "out of pocket" expenses. Remember if in doubt CALL AND ASK - your insurers will tell you what your options are.

I won't keep on - if you have any questions - just ask!



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luci

Many thanks for your useful and informative post.

I always take my annual worldwide policy from the Nationwide. It is more expensive that I could get elsewhere, but I think it provides good cover and I hope with them being a major company that they will be reliable should I ever need to claim. Have you ever dealt with any claims via them?

FH_Brit

Luci

As I deal with "late payers" that normally means that good reputable insurers rarely get to my desk. Nationwide is one of those I rarely see, that normally means that they settle their claims promptly.

Just one point "thinking" it provides good cover can cause problems, read all your exclusions at least. It is not until you need to claim that the exclusions "come to light" and then it can prove expensive to you if cover is denied.

ellie14

I book my 85d/m with fortiss hope you dont see them on your list!!!!

luci

Sorry what I should have said is that I think it provides good cover after reading the policy. I read it every year when it comes up for renewal and there are usually subtle differences.

Did you get my PM via this site FH Brit?

julliff

Hi,

Thanks for some really useful information.

On your late payers list, do you ever see TravelInsuranceWeb?

They come out as a Which best buy so I am hoping not

FH_Brit

Ellie 14 - Fortis is one on the better companies that I deal with when I do see a Fortis policy, it usually mens that my client (the hospital or physicians office) or even the patient have missed something rather than a policy problem. I don't know where you et you policy from but for others Fortis is available from any post office.

FH_Brit

Juliff - I have dealings with Travelinsurance web but as above with Fortis few compared to others. Also although Which (The Consumers Assoc) are excelent bear in mind they do not see EVERY case and also there is no such thing as a "Perfect" policy or insurance company. A lot of the time it is picking the best to suit your particular needs.

For information purposes (cases on my desk as of now) -

AXA - 300+
Travel Insurance Web - 20
Insure & Go - 2
Fortis - 0 (zero)
Norwich Union - 0 (zero)

Bear in mind as I said before the better the company the less I see - good companies will get things cleared up very quickly and usually if I get a few cases it is usually because patients have not given information from their GP or not filled in a claim form (insurers will not process claims without a completed claim form).

Also most insurance companies will use "Assistance Companies" who sometimes don't assist very much. When an insurer seems not very good, this is usually because their assistance company are the problem not the insurance company itself. Example: EVERY X-ray taken in Florida MUST be seen by a licensed Radiographer - for speed and cost efficiency my Radiology clients have a "bank" of doctors serving many medical facilities and the hospital will take the x-rays and send over phone lines to Radiology who look and diagnose then send back to the ER/Hospital for action, this service costs just $27.00 (£13.00) I was told by an assistance company that he "did not have time to deal with little claims" after I pointed out that the patients were all reported to credit reporting agencies (Equifax, Experian etc) and that he had over 500 "little claims" outstanding, he processed and paid the claims.

FH_Brit

IMPORTANT - Ways to avoid delay or denial of your claim.

Should you need to receive medical treatment TELEPHONE YOUR INSURERS HELPLINE NUMBER at the earliest possible moment. If a minor illness or condition (cut, bruises, minor infection, insect bites etc) call before you go for treatment, often your insurers will tell you where to go as they have pre-arranged with ceertainm medical facilities to assist. If an Emergency situation then call as soon as you are fit to do so. DO NOT WAIT UNTIL YOU GET HOME, under your policy conditions this may be enought to make any claim void.

If you get a call or bill in the mail, call the person who sent it (Debt Collector. or Medical Billing company) who work for the hospital/facility - the hospital don't want to deal with billing problems they pay these agencies to collect the money for them. If you insist in sending payment to the hospital after receiving a debt collectors notice, you may find yourself facing further collection activity as to the debt collector it seem,s that you are ignoring them and avoiding your responsibilities.

Remember here in Florida, the medical service providers have the law on their side - you had the service and YOU are responsible not your insurers. Medical billers will deal with insurance comanies (as I do in most cases) but it is done as a courtsey to you and we have no legal right to pursue an insurer, we must pursue you, the customer. It is up to you to chase and make sure your insurers pay and pay promptly otherwise the facility will obtain payment from you and it is then up to you to recover any payment from your insurers.

jaffa

FH_Brit wrote: »

For information purposes (cases on my desk as of now) -

AXA - 300+
Travel Insurance Web - 20
Insure & Go - 2
Fortis - 0 (zero)
Norwich Union - 0 (zero)

Very informative and useful posting FH Brit - thankyou! Need some more advice if you can?

I was dismayed to read this post about AXA

I can only wish I had had this information before our last trip to the USA. We needed to use the ER room, before we went I contacted the medical assistance line, was at that point informed that this was AXA who gave me the ok to go to hospital and insurance/reference details to quote at the hospital. The hospital seemed happy enough with this at the time.
To cut a long story short, since our return home we have received two invoices, one from the hospital itself and one for the ER doctors services.
Contacted the claims assistance service who had reimbursed us for other expenses who advised to forward the invoices to them. Have done so in the last week, so no response from them so far
As yet no debt collectors involved as far as I know but as it is apparently AXA who are “dealing” with this I am now concerned that we are going to have a lot of hassle before this claim is settled.

Can I expect them to routinely confirm when/if they settle these invoices? Is there anything else I can do now to help the process run more smoothly??

FH_Brit

Jaffa - It sounds like you maybe a customer of mine in the near future (if the hospital was in the Orlando area! ! !

AXA Assistance in Chicago never will guarantee payment to the hospital - they will confirm coverage only - this is usual (and most insurers will) as the insurers will want to exclude any pre existing conditions after your treatment at the hospital.

You (may differ from hosp to hosp) will have signed a "Consent for Treatment" form. This is a legal, binding contract and YOU took responsibility for your debts. However AXA may (I cannot speak on their behalf) be resposible under the terms of your policy. What you HAVE to do is keep on their back. Call the Hospital and ask if your bill is paid, (get copy of final bills sent to you) and the ER Physicians.

If so, call AXA & ask if they have the final bills. - note that an insurer has 140 days to notify the hospital/physician that they are denying the claim or to pay. If they dont they are in breach of Florida Law.

Tell your insurers that you want a final decision within 30 days or you will place a complaint with the Financial Services Authority's Ombudsman Service (phone 0845 080 1800) - you must give them time for a final decision or the FSA will tell you to go away and do it then come back to them.

If your insurers have not paid within that 30 day period (ask the medical provider if they have been paid NOT your insurers) call the Ombudsman - YOU WILL GET NOWHERE IF YOU DO NOT FOLLOW THROUGH AND CALL THE FSA.

No insurance will confirm your bill is paid as routine, you may request it but they don't have to, and in any case I would ask the medical provider if they have been paid. Your insurers ask their assistance companies who tell your insurers they have paid (and they have not actually sent the check) so your insurance company tell you it's paid! Then you have debt collectors calling, or your credit report has you listed as a bad debtor, or (in some cases) a lien or court proceedings cvould be issued against you.

If you get any letters from me or any other debt collector - call them, give them all your insurance info (but bear in mind they DON NOT legally have to deal with your insurers) most will be happy to get the insurance info.

Bottom line - if you can afford to - to be safe pay the bill yourself and then submit copies of the bill and any receipts to your insurers ESPECIALY if you are emmigrating to the US or you own property here.