By Carmen Heredia Rodriguez, Kaiser Health News It was evident that the fever, nausea and loss of appetite Vlastimil Gajdoš felt on his wedding day was not a mere case of cold feet.
Gajdoš, 65, fell ill in Honolulu in March after arriving with his bride-to-be from the Czech Republic. He and Sylva Di Sandro, 58, intended to marry and honeymoon on the island.
While they did tie the knot, they also engaged in serious battle with the novel coronavirus. He was in the hospital for two weeks, some of it in intensive care, on a ventilator. Like many visitors to the U.S., who are aware that health care prices here can be higher than back home, Gajdoš purchased a travel insurance plan that covered up to $300,000 in medical expenses.
But after Gajdoš was diagnosed with COVID-19 and his wife called to check whether his care would be covered, the newlyweds discovered a catch: The insurer said it wouldn’t pay upfront. And it would consider reimbursing the couple only after Gajdoš was released from the hospital.
“I was really afraid that they [doctors] would not give him any assistance if they were not sure that this would not be covered,” said Di Sandro, who had only a mild case and was not hospitalized.
The coronavirus pandemic has wreaked havoc on the travel industry — including insurance companies. Even beyond the current crisis, travelers should pay careful attention to the fine print on coverage policies.
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Many plans offer health care coverage in case a person needs medical attention during a trip. But policies vary tremendously by company ― containing limits on payouts, copayments and circumstances, such as whether they cover an evacuation.
Most travel insurance plans contain exclusions for known or “foreseen events,” said Kasara Barto, a spokesperson for Squaremouth, an online service that allows travelers to compare insurance options.
In some situations, a traveler can anticipate the risk of visiting a destination. A regular insurance policy might not cover a mountaineering accident while climbing Everest, for example.
Also common is the pandemic exclusion, in which the insurer will not pay for a traveler’s medical expenses if they are related to an outbreak such as the coronavirus.
“It’s definitely something that they should be aware of, that not having coverage to cover [medical care] could lead to such a financial loss,” Barto said.
Language on exclusions can be vague, which could make it difficult for travelers to decipher whether their policy will pay for care related to COVID-19, industry experts said. To make matters worse, some policies don’t specifically name a pandemic as a circumstance that is covered or excluded — and how they count the start and end of a pandemic period.
The World Health Organization declared the spread of the coronavirus a worldwide outbreak on March 11. Travelers who purchased plans after that date should take extra care to make sure they have medical coverage for COVID-19, said Christopher Mosley, a lawyer who specializes in insurance litigation at the law firm Sherman & Howard.
However, that cutoff date might be earlier in some policies. Some insurers considered COVID-19 a risk in certain areas as early as January, Mosley added.
“There’s not a one-size-fits-all” coverage, said Mark Friedlander, director of corporate communications for the Insurance Information Institute, a research organization supported by the insurance industry.
The risk is perhaps highest for foreigners visiting the U.S., which has the highest health care costs in the developed world. Many of the national health systems in European countries will treat foreigners at no charge or for much lower rates.
Foreign embassies are stepping in to help their citizens in the U.S. decipher insurance policies. In a notice, the Slovenian Embassy in Washington, D.C., specifically mentioned the high cost of health care when advising citizens traveling in the U.S. to check whether their insurance covers pandemics. Officials at the Spanish Embassy also said insurance is an issue that has come up in conversations with its citizens here.
The Czech Republic intervened in Gajdoš’ case and at least one other time recently on behalf of citizens with health insurance problems, said Zdeněk Beránek, the deputy head of mission for the Czech Embassy in Washington, D.C.
“This is not the cheapest country in the world when it comes to health care,” Beránek said, “so you better be careful.”
Given the chaos of the pandemic, some insurers are choosing to stop selling travel insurance policies altogether — including LV, a company based in the United Kingdom.
But others, such as Allianz, are expanding benefits to include care for COVID-19. The company announced it will accept some trip cancellation and medical claims related to the virus that aren’t typically covered in their plans, according to a press release.
“This is kind of uncharted territory for every insurance company that’s in this market,” said Don Van Scyoc, vice president of individual sales at the travel insurer GeoBlue. The company sells plans for Americans going overseas and foreign nationals who are away from their homelands for extended periods. Their policies cover COVID-19 care, he said.
Gajdoš and Di Sandro reached out to the embassy and his employer for help after his travel insurer denied him coverage. The employer pledged to help him if his plan did not cover his hospital stay, he said, but the government intervention worked. The insurer ultimately agreed to cover Gajdoš’ expenses.
The couple would not disclose the final tally for Gajdoš’ hospital stay, but a typical 10-day course of treatment in an intensive care unit can run into several hundreds of thousands of dollars.
He was discharged from the Queen’s Medical Center on April 8, grateful for the care. Gajdoš said his insurer’s actions caught him off guard. He intentionally purchased a more expensive policy with the expectation that they would receive help, not pushback, from the plan.
“You don’t have the energy,” Gajdoš said. “You are oriented on fighting for your life.”
From:: KHN Insurance