He Fell Ill on a Cruise. Before He Boarded the Rescue Boat, They Handed Him the Bill. – KFF Health News

Vincent Vasani and his fiancée, Sarah Eberlein, had never been to sea. He had never even sat on an aeroplane. But when they bought their first home in Saginaw, Michigan, in 2018, their real estate agent gifted them tickets for a Royal Caribbean cruise.

They are slated to depart in December 2022, after a two-year delay due to the coronavirus pandemic.

The couple chose a cruise to the Bahamas because it included a visit to CocoCay, a private island accessible to Royal Caribbean passengers that included excursions to a water park, balloon rides and swimming with pigs.

It was that day at Kokoke when Wasni, 31, started feeling depressed, he said.

The next morning, as the couple made plans in their cabin for the last full day of the trip, Wasni let out a pained cry. Eberlein found him having a seizure in bed, bleeding from his mouth from biting his tongue. He opened his door to get help and then noticed another guest, who woke up his wife, an emergency room physician.

Vasani was able to board a wheelchair brought by the ship’s medical team and be taken to a medical facility, where he was given anticonvulsants and fluids and monitored before being released.

Wasni had suffered seizures before, starting about 10 years ago, but it had been a long time since the last one. Imaging at the time showed no tumor, he said, and doctors concluded she may have epilepsy. He initially took the drug, but after two years without any seizures, his doctors stopped taking the drug to avoid liver damage.

Wasni suffered a second seizure a few hours later in his cabin on the ship. This time she stopped breathing, and Eberlein remembered that her lips were so purple they looked almost black. Then, she ran to find help, but in her haste she locked herself in. By the time the ship’s medical team reached the cabin, Wasni was breathing again, but blood vessels on his chest and neck were broken, which he later said resembled the stripes of a tiger.

Vasani was in the ship’s medical center when he suffered a third seizure – a grand mal, which typically causes loss of consciousness and violent muscle contractions. By then, the ship was so close to port that Wasni could be rescued by a rescue boat. He was placed on a stretcher to be lowered by ropes from the side of the ship, Eberlein climbing down a rope ladder to join him.

But before they could disembark, the bill arrived.

Patient: Vincent Wasney, 31, who was uninsured at the time.

medical services: Fees for general and advanced observation, a blood test, preventive medication, and services performed outside the medical facility.

Service provider: Freedom of the Seas Medical Center, on-ship medical facility Cruise ships operated by Royal Caribbean International,

Total Bill: $2,500.22.

What gave: As Part of Royal Caribbean’s Guest Termscruise passengers “agree to pay in full” all expenses incurred on board until the end of the cruise, including expenses related to medical care. In addition, Royal Caribbean does not accept “Land-based” health insurance plans.

Wasni said she was surprised to learn that Royal Caribbean was requiring her to pay her medical bills before she could leave the ship, along with other charges such as wireless internet — even though she was being evacuated immediately.

“Are we being held hostage right now?” Eberlein remembered asking. “Because, obviously, if he has three seizures in 10 hours, that’s an issue.”

Wasni said he remembered little of his stay on the ship after his first seizure – seizures often left victims drowsy and disoriented for a few hours.

But he certainly remembers being shown a bill while waiting for the rescue boat, the bulk of which was $2,500.22 in medical fees.

Wasni, still feeling nervous, explained that he could not afford that much and a cruise employee responded: “How much can you pay?”

He drained his bank accounts, including money saved for his next house payment, and maxed out Wasni’s credit card, but was still about $1,000 short, he said.

Eventually he was allowed to leave by ship. He told that later he came to know that his card was overdrafted to make up the shortfall of money.

Royal Caribbean International did not respond to multiple inquiries from KFF Health News.

Once on the ground, in Florida, Wasney was taken by ambulance to the emergency room at Broward Health Medical Center in Fort Lauderdale, where he incurred thousands of dollars more in medical expenses.

He is still not entirely sure what is causing the seizures.

On the ship he was told it could be extreme dehydration — and he said he remembers being extra thirsty on CocoCay. He also considered whether trying escargot for the first time the night before could have played a role. That said, Eberlein’s mother is convinced the issue was related to swimming with pigs. And don’t despair, Eberlein accidentally broke a pocket mirror three days before his trip.

Wasni, who works in a stone shop, was uninsured when they left. He said that a month before starting his trip, he finally felt he could afford a health plan offered through his employer and signed up, but the plan wouldn’t start until January 2023, after he returned. Hui.

They also lacked travel insurance. As inexperienced travelers, Wasani said, they thought it was for lost luggage and canceled trips, not unexpected medical expenses. And because the cruise was a gift, they were never prompted to purchase coverage, which often happens when buying tickets.

Resolution: Wasni said the couple returned to Saginaw with no money in their bank account, several thousand dollars in medical debt, and no idea how they would cover their mortgage payments. Because she was uninsured at the time of the cruise, Wasni did not attempt to collect reimbursement for the cruise bill from her new health plan when her coverage began weeks later.

The couple set up payment plans to cover medical bills for Vasni’s care after abandoning the ship: one with two doctors they saw at Broward Health, who billed the hospital separately, and one with the ambulance company. with. He also paid a bill with Broward Health. Interest is not charged on those schemes.

But Broward Health said Wasney did not make two payments to the hospital, and that bill was eventually sent to collections.

Broward Health spokeswoman Nina Levin said in a statement that Wasni’s bill decreased by 73% because he was uninsured.

“We do everything in our power to provide the best care with minimal financial impact, but take advantage of private and Affordable Care Act health insurance plans as well as travel insurance to minimize the risks associated with unplanned Cannot emphasize enough the importance of. Medical issues,” she said.

The couple were able to pay off their home with $2,690 they raised through a GoFundMe campaign Which was established by Vasani. Wasni said he got a lot of help from family as well as friends he met playing disc golf, a sport he picked up during the pandemic.

“A group of people came for us,” Wasni said, still moved to tears by the generosity. “But the hospital bill is still due.”

Takeaway: Billing practices vary by cruise line, but joe scottThe chairman of the cruise ship medicine section of the American College of Emergency Physicians said medical charges are usually added to the cruise passenger’s onboard account, which must be paid before leaving the ship. Individuals can then submit receipts to their insurers for possible reimbursement.

He suggested that those planning to purchase a cruise purchase travel insurance that specifically covers their trips. “If they charged a fee it would facilitate reimbursement and potentially cover costly medical evacuations if necessary,” Scott said.

Royal Caribbean It turns out that Passengers who receive care onboard submit their paid bills to their health insurer for possible reimbursement. multiple health plans Medical services are not included However, it is obtained on cruise ships. Medicare will sometimes cover Medically necessary health care services on cruise ships, but not when the ship is more than six hours away from a U.S. port.

Travel insurance can be designed to address Too many accidents outside the citySuch as lost luggage or even transportation and accommodation to visit a loved one if a traveller is hospitalised.

Travel medical insurance, as well as plans that offer “emergency evacuation and repatriation,” are two types that can particularly assist in medical emergencies. Such plans can be purchased individually. Credit cards may also offer travel medical insurance along with their benefits.

But travel insurance plans have their limitations. For example, they may not cover care related to pre-existing conditions or plans that cover “risky” activities, such as rock climbing. Some plans also require that travelers first file with their primary health insurance before seeking reimbursement from travel insurance.

As with other insurance, be sure to read the fine print and understand how reimbursement works.

Wasni said they plan to do the same before their next Royal Caribbean cruise. He said, he would like to go back to the Bahamas on basically the same trip – there is so much about CocoCay that he didn’t get to explore.

Bill of the Month is a crowdsourced investigation kff health news And npr Who analyzes and interprets medical bills. Do you have any interesting medical bills you want to share with us? tell us about it,