cslasor

Me (66F) and my husband (74M) will be going to our first, and probably only, trip to Hawaii in January. We're planning to fly from Florida to Oahu, spend a couple of days with family, then do the 7 night NCL cruise around the islands, spend a few more days on Oahu with family, then fly home to Florida. I've got refundable fares for the cruise and we'll fly out there anyway even if the cruise is cancelled, so I'm not too worried about trip cancellation insurance. But what about medical? Yes, I know it's not a foreign country, but is it still likely that medical evacuation might be needed if we have a problem? It's a mighty long way from Hawaii to Florida and I'm sure evacuation would be pricey.

Does anybody have any experience with medical issues while visiting Hawaii? Is it basically the same you'd expect as having issues in the continental US? Is medical/evacuation trip insurance still recommended?

Thanks!

thursdaysd

I always buy Medical and Medical Evacuation/Repatriation insurance if I'm going to Europe. Presumably my Medicare plus Medigap coverage would still work in Hawaii, but I think I would want the Evacuation/Repatriation. I buy mine from Seven Corners - you can insure just a couple of thousand in actual expenses and then add the medical coverage quite cheaply.

PrairieHikerI

Well, if neither of you has any major medical issues, I don't see the need for insurance. The probability of a reasonably healthy, cautious person having an accident (car or fall) or incident like a heart attack is low. Maybe 1 in 1,000. The Queen's Medical Center in Honolulu is one of the top hospitals in the world. But to be safe you can get travel insurance from World Nomads Travel Insurance for as little as $131.

J62

If you do buy insurance, be sure you know exactly what you are buying.

Medical evacuation insurance doesn't necessarily mean they will fly you back to a hospital near your home... It could simply cover getting you to the nearest qualified facility.

Repatriation insurance often just covers repatriation of remains, should you die while on a trip.

Christina

I wouldn't buy it for medical, presumably you have insurance in the US, don't you? So Hawaii is no different than if you were traveling to a state next door to yours. In fact, HI has better medical cost regulation than a lot of states.

Evacuation is another issue, what do you plan on doing in HI? ONly sitting on a boat mostly? If you are diving or hiking on clifftops in dangerous areas, or doing some risky sport, I could see it. BUt otherwise, why would you need to be evacuated? The only reason would be if you have a known medical condition that you think could strike and cause that, I would say. So you would have to decide that.

ok, of course you could get hit by a car in a crosswalk if walking in a city, this does happen (in fact, it happened to the sister of a friend of mine in Paris, luckily she wasn't hurt too badly and didn't spend that long in a hospital). I don't insure when I travel in the US as I don't insure against really rare things like that. If I had to pay for it, I could, also. I don't do base jumping or anything like that, or free climbing and I don't hike in dangerous difficult areas.

It's really your call, I would imagine evacuation alone wouldn't be that expensive, why not price it out. I don't know why it would b e "needed", HI has excellent medical care, It would be because you wanted it. So you would need a policy that was "on demand", which most are only in case of necessity.

I think it costs about $100 for short-term medical evacuation only policies at the member's discretion. So you just have to decide, if it makes you feel better, that's not too bad. Medjet Assist Short Term is the policy to look at. But due to it being Hawaii, it's a different price of course than continental US, probably more like $150. Might be cheaper for a family, though (I mean cheaper than $300).

Seamus

Please pay heed to J62's mention that medical evacuation usually does not mean transporting you to your home, rather to the closest facility capable of treating your condition. So if you were to experience a problem in Hawaii the closest facility would very likely be right there in Hawaii, which does have some great hospitals.

tomfuller

I agree. Do not doubt the quality of medical care you or anyone else will get on any of the Hawaiian Islands. The Queens Medical Center also has several satellite hospitals on Oahu. My daughter (RN) works in the one near Ewa Beach. If anything bad happens while you are on the ship, the medical staff will see to it that the patient makes it to a hospital on land.

thursdaysd

Which is why I recommended Evacuation/Repatriation. The issue is not the immediate treatment of a problem, which can undoubtedly be handled on Hawaii, but the aftermath. Anyone can have an accident - I broke my wrist in Switzerland (not skiing), and a friend broke her hip in Portugal. Depending on the situation, getting home can be a significant expense.

suze

Why wouldn't you just go to a hosital in Hawaii?

thursdaysd

You would, but American hospitals (or the insurance companies) want you out of the hospital as soon as possible if not sooner. Wouldn't you rather go into a rehab/nursing home AT home? And what about new plane tickets (assuming you can actually sit in a plane seat) for you and any companion(s)? And living expenses for said companion(s) while you are in hospital?

And what if you get Covid and need to quarantine?

cslasor

Thanks for all the info and advice. I think I’ll skip the insurance for this trip. I don’t usually get it, but we are getting older and my husband did have a heart attack a few years ago. And I’m adventurous but terribly uncoordinated. So you never know.

I’ll just count on my Medicare Advantage plan and the really good odds that nothing too exciting will happen.

thursdaysd

What does your MA plan say about out of network treatment?

suze

You can check about medical clinics in Hawaii. My plan is thru Kaiser Permanente here in Seattle and I did look before my last trip and they have facilities in Honolulu.

jamie99

Check with your Medicare Advantage plan and find out which doctors and hospitals are "in network" or if they have an online directory, check there and then I would cross check Yelp reviews.
I do know my Medicare Advantage plan does not cover medical expenses out of the country (with rare exceptions) so when I go to Mexico I buy trip insurance including medivac, but would not bother with Hawaii.

aliced

My husband and I are each older than each of you, but no, we never buy insurance for domestic travel, including Hawaii, where we were this past December in Maui. Why would you want to be evacuated to FL anyway in an emergency? Unless your doctors feel something stands a likely chance to occur, the HI hospitals accept your insurance. We are not even taking medical evacuation for this month's trip to western Europe. It depends on what happens, of course, but the chances of something grievous just arent that high. I feel alot more comfortable having something occur in HI than in most of the Caribbean islands, that's for sure, but then of course, it's a quick flight home.

Our inlaws were visiting their daughter in Lugano Switzerland probably 10 yrs ago when she had something occur, dont remember what, was in a Swiss hospital for a good week, for which all expenses had to be put on their credit card, before their medical insurance (not sure she was on Medicare yet) fully reimbursed them for upon their return.

mlgb

World Nomads won't issue a policy for over 70. Seven Corners will.

I'd check your existing coverage to see if it covers expense should you need treatment onboard the ship. It can be $$$$. People do on occasion have injuries or medical incidents on board as well as on land. Don't assume you are covered on the ship.

thursdaysd

The point of insurance is to cover you for events you do not expect, but that would be expensive if they occurred. You don't expect your house to catch fire, right? Do you not carry insurance in case it does?

You buy insurance hoping you won't need it, but are glad to have it when you do need it. Right now, aside from accidents, or unexpected medical crises like heart attacks or strokes, there is the possibility of Covid, and you are both old enough to be at high risk. If you are on a cruise an outbreak is more likely than not.

mlgb

I agree, I think a lot of posters are missing the cruise part or are not familiar with how cruise ship sickbays charge out the wazoo. A friend needed treatment on a cruise and her supposedly good insurance didn't cover it. You will get charged to your shipboard account and then will have to seek reimbursement.

Outside of Oahu, I'm not sure you can say the same about the availability of facilities on the other islands.

Seven Corners does have COVID coverage on some of their policies. In addition to possibly catching the 'Rona on the cruise, there are also risks on the long flight over to Hawaii. Just ask suze who thinks she caught it on a much shorter flight.

Another insurance option is to see what NCL offers to cover medical treatment onboard and costs of evacuation from the ship to the nearest hospital in Hawaii.

wtm003

Last year we were planning a trip to Maui. I buy an annual Medical Evacuation policy that covers us anywhere. I usually buy a medical only policy if I'm traveling outside of the US and would need to use an out-of-network provider because my deductible is extremely high. When I started looking at hospitals on Maui, it didn't appear that any were in network. I looked at buying a medical only policy and nothing was available. We ended up cancelling that trip for a variety of reasons, but any future trips to Hawaii will include a phone call to my insurance company to verity my coverage. I may need to buy a comprehensive travel policy that would cover my medical deductible.

J62

Good reminder about the cruise. I have relatively recent, first hand experience dealing with cruise insurance reimbursement on a major US cruise line.

An elderlay (80's) relative of mine became ill while on a cruise outside the US and required emergency treatment on the ship, as well as on land in a foreign country. They have medicare advantage (MA), and also purchased travel/medical insurance offered by the cruise line. Thankfully....

A few takeaways.
The travel insurance offered by the cruise line was well worth it, in the end, but the process of getting reimbursed was slow and painful. They don't make it easy for you...

The travel insurance was secondary, meaning that every claim had to be submitted through the MA primary, get rejected, then resubmitted through the cruise line's insurance with all of the primary EOBs. That process alone was laborious, and required a lot of follow up contact & discussion with the travel insurance company to explain the paperwork to match up line items. I had to create a ~100 line spreadsheet to match up the hospital bills to the ~EOBs from the MA, including foreign exchange conversion. Back and forth with the cruise line insurance to clarify line items dragged the process out for several quarters. Careful record keeping is a must. Diligence is even more critical.

Medicare does not pay for medical expenses outside the US. I don't recall if their MA plan covered some, but if it did, it was not much. If I recall correctly, the MA would have paid for cruise ship medical expenses in US waters, at out of network rates, and would have made the cruise insurance mostly off the hook. Check with your own plan to be sure you know what they cover.

Total bills were "only" ~$30 to $40k, which included one night in the ship infirmary under emergency care, and a week or so in a foreign hospital / ICU. Thankfully they were in a country that had both good medical care and at very resonable total cost. In the end, we paid very little out of pocket, but there was a cap on the $ the travel insurance would have paid. Onboard ship expenses were line for line, far more expensive than the foreign hospital. The cruise line did charge immediately for on-ship medical expenses.

We also had to pay the hospital out of pocket, but that was NOT required before discharge. That total bill may be a stretch to pay for some. Our cc has the credit line, and I was able to get cc rewards points out of it.... I'm guessing we could have paid on a payment plan if we didn't have the credit line.