Insurance to cover emergency medical return flights?
September 30, 2016 7:27 AM   Subscribe

I recently suffered a detached retina in one eye. This is a condition that needs to be treated immediately or I risk blindness. There is an increased chance my other eye will suffer the same fate.

I travel internationally several times a year. If I need to get back to the United States for treatment, will the standard travel insurance after I buy my airline tickets cover it? Should I buy it? (I think the last time I bought tickets from United, the insurer was Allianz.)

Or can I rely on the airline to allow me to standby for the next plane home? If neither of these is the case, what kind of insurance should I get? Or is it better to take my chances and not buy one at all?

I’m not so worried about being on the other coast, since I could still get treated domestically, but it would be nice to know what options I have in that case too.
posted by anonymous to Health & Fitness (17 answers total) 1 user marked this as a favorite
Travel insurance covers the refunding of tickets for emergencies that happen after you have purchased the ticket. You have a current emergency and no insurance carrier will pay out on something like that.

I can't speak about each airline's policies about standby priority and how to get to the front other than being a high-mileage flyer, but standby is standby. Seats don't magically open up because you need to get home urgently.

That said, your condition is so insanely urgent that flying home for treatment will probably be moot. You will most likely be blind in one or both eyes before you land in the US.

Your only hope of saving your eyesight is to get treatment by a local ophthalmologist within the next couple of hours. Please go now.
posted by JoeZydeco at 7:44 AM on September 30, 2016 [2 favorites]

I read the question to mean that the OP had suffered a detached retina previously, and that it had been successfully treated by an ophthalmologist — not that they were currently in crisis. Certainly if they are currently suffering a detached retina, they should have it treated immediately.

That said: a detached retina is nothing to mess around with, and I would be incredibly leery about making a plan that requires you to wait 12–24 hours before treatment (the amount of time that would normally be involved in catching the next international flight and making it to a doctors' office in the US) and subjecting your eye to the pressure changes that are involved in air travel. Unless you are traveling to locations without any ophthalmologists or hospitals at all (but yet somehow have enough travel connections to get you back to the USA promptly), a better plan would probably be to get some high-quality travel medical insurance that would cover medical treatment wherever you happen to be.
posted by Johnny Assay at 7:44 AM on September 30, 2016 [2 favorites]

Keep in mind that travel insurance typically does not cover pre-existing conditions. If they can make a case for any issues you have being a result of one, good luck convincing them otherwise.

Plus, be sure to check whether they expect you to pay for treatment upfront before being reimbursed, as that is not uncommon in international insurance situations, and could factor into your assessment.

There are international insurances that aren't just for travel, but you pay for 24-7 coverage. Another issue to keep in mind is where they will expect you to get treated. Instead of flying you home they may expect you to get treated locally, even if standards of care aren't as high and hospital staff doesn't speak your language.
posted by cacao at 7:47 AM on September 30, 2016

I'm actually well-placed to answer this question, because I attended a talk given by three folks from Allianz on being more ethical when advertising their products.

Short answer is no, in general, standard travel insurance does not cover this kind of thing, because it is meant to cover only refunds when you cancel a trip due to non-preexisting conditions. It's not going to cover you if you need to unexpectedly buy a ticket back, and it's likely to deem your eye condition a preexisting condition. So for example, if you get pneumonia or your father gets pneumonia and you need to stay back to take care of him, or even if your nanny gets pneumonia and therefore you have no childcare, all of that would be covered. But if your dad is in hospital due to a heart condition, and it gets worse suddenly and you decide to stay back, they would not refund your money as you knew about the heart condition when you purchased the tickets.

As part of the talk they talked about rolling out a product that does cover preexisting conditions, because they found that a lot of people were under the impression that standard travel insurance does cover - if that applies to you it should say so before you sign up. But the general assumption is that standard travel insurance will not cover trip cancellations due to conditions you knew about when you bought the tickets. And it generally does not cover having to purchase tickets because you need to get back sooner than you expected.
posted by peacheater at 7:49 AM on September 30, 2016 [2 favorites]

Maybe find out what options there are from an outfit like Global Rescue? They may be able to connect you with appropriate local resources if a problem comes up. I agree, I wouldn't think you would want to be flying with a detached retina.
posted by BillMcMurdo at 8:08 AM on September 30, 2016 [2 favorites]

What I think you're looking for is medical evacuation travel insurance.
posted by ShooBoo at 8:10 AM on September 30, 2016 [2 favorites]

I knew someone who had a detached retina a few years ago, and as I recall he was forbidden from flying for a somewhat lengthy period of time (I want to say it was 3-4 months, but it's been ~10 years). This was tough because he was the CEO of the company I worked at at the time, and he was used to traveling constantly. As I recall he ended up having to cancel multiple important trips and ended up driving (thousands of miles) to several others. Something to keep in mind...
posted by togdon at 8:36 AM on September 30, 2016 [1 favorite]

Travel HEALTH insurance covers this, but typically only if A) the thing being treated is so expensive to treat that it's cheaper to fly you back (and let your local health insurance cover it) than to just pay to treat it where you are or B) There's some reason it cannot be treated where you are.

A detached retina can be treated anywhere, relatively inexpensively. It's a thing that happens to people all over the world. They would probably pay to fix it at your location, not fly you back to the US.

Also, in terms of pre-existing conditions, they usually cover things (with some exceptions), if they've been stable for 3 months, or 6 months. THe definition of stable (when I've bought travel health insurance) is that it has not required hospitalization during that time, and that there has not been any change in medication in that time.
posted by If only I had a penguin... at 8:44 AM on September 30, 2016 [1 favorite]

I will nth if it happens again, it should be treated wherever you are (assuming it can be treated).. A family member went blind when the second eye's retina detached (so they knew what the symptoms were) and instead of going to the local hospital for treatment, traveled 600 miles to get back home to be treated, and by then it was too late.
posted by k5.user at 8:46 AM on September 30, 2016 [3 favorites]

I think the last time I bought tickets from United, the insurer was Allianz

Oh, and you can get your insurance from any provider you like. If United has some deal that they offer Allianz insurance while you're checking out, that's convenient, but if you don't want that insurance, just call up whatever company you do want, and buy from them. I tend to buy from American Express because I already have 2 weeks of travel health coverage from them included in my card and so I can just top up for however much longer I'm staying.

If you travel that much and especially if your trips are less than 2 weeks, you should consider getting a credit card that comes with travel health insurance. My annual fee is $300, which is more than the health insurance by itself would cost me, but there are other benefits too and I think it's worthwhile.
posted by If only I had a penguin... at 8:47 AM on September 30, 2016

You should certainly check with your ophthalmologist about whether it would be okay to fly if your retina were detached; I'm not a doctor, but I'm at risk for retinal detachment myself and I would be concerned about both that and the general delay associated with international travel.

If you were cleared to fly home for treatment, though, there should be options available to you. My husband works for an insurance brokerage, and had this to say:
Anyway, the answer to their question is it can be covered by travel insurance, but not by all travel insurance. Basic plans reimburse for cancelled trips, but there are plans that provide emergency medical insurance, possibly a way back home. There may be fine print about pre-existing conditions, but who knows. So there are plans this person can get, but they should make a point to go over pre-existing conditions being covered for emergency medical abroad - they may end up paying more, but it beats paying less for something that won't do what they need.

They should also check with multiple agents - each brokerage will work with different carriers.

If there's still an unresolved medical issue, that should be addressed before travelling. If this is to have a pre-existing condition covered in case it happens again, then they can get travel insurance but they should ask a lot of questions to make sure it's covered.

Health insurance also covers emergency medical care out-of-network, but I don't know if that's the case in every state and I don't think there's an exact answer whenever I've looked into it.
posted by cellar door at 8:47 AM on September 30, 2016 [1 favorite]

What I think you're looking for is medical evacuation travel insurance.

This. But as others have said, having it treated locally is probably the better option, so restricting your travel to locations where you can get quality care in a timely manner and ensuring that you have insurance that will cover the fees and be able to arrange emergency treatments is what I would suggest.
posted by Candleman at 9:02 AM on September 30, 2016

I have a pre-existing medical condition so I can't buy regular travel insurance. You need to find a policy that specifically includes coverage for pre-existing medical conditions, and it will be more expensive, possibly better if you buy an annual policy to cover multiple trips. My area, only one provider offers this and it's about 30% more expensive but no choice. And hey, I am writing this while sick in bed on a trip where I will need to use the insurance for the first time in a decade of traveling to pay for flight rescheduling and medical bills (pneumonia).

You'd get treated locally though for a retina - the changes in air pressure from flying would mean you couldn't fly safely for a while I think.
posted by dorothyisunderwood at 12:27 PM on September 30, 2016 [2 favorites]

Your US health insurance will cover treatment overseas, especially for an emergency like a detached retina. Just about any big city hospital anywhere in the world has doctors who are perfectly capable of treating a detached retina. Flying home for treatment would be unnecessary and dangerous!
posted by monotreme at 10:50 AM on October 1, 2016

I had a detached retina. Doctor said specifically that flying was a definite no go. The pressure changes are not good. Get it treated ASAP by the best retina doc you can find locally.
posted by sarah_pdx at 11:05 PM on October 1, 2016

From the OP:
Thanks to everyone who’s answered. Sounds like a lot of people have had experience with things like this.

To be clear, I had a retinal detachment a few months ago. First I had a pneumatic retinopexy (simple gas bubble), but still more tears appeared. Then I got a vitrectomy to remove the vitreous. It’s gone well, though the bubble has been slow to dissipate. I am otherwise very healthy.

Because the vitrectomy used gas, I have not been able to fly since I got my treatment. I wondered what my options would be if my other eye was affected while overseas.

It sounds like the regular travel insurance option that appears after buying my plane ticket isn’t feasible for such an issue, and buying a year-round policy for 2-3 international trips a year would be cost-prohibitive. It seems like the best option is to make sure I have insurance that will allow me to be treated overseas, and assess my options for getting home when the time comes. Is that right?

Relatedly, flying is not an option with a gas bubble, but if I’m in Asia, or Europe, or South America, what can I do? Taking a boat would take up too much time. Does that leave as my only treatment option getting a vitrectomy with oil?
posted by taz (staff) at 7:00 AM on October 2, 2016

I had a detached retina 6 years ago while I was in South America. I was able to get back to the US for treatment, as I absolutely did not want to get surgery there and be stuck down there for weeks due to the gas bubble. I was fortunate to get back in time.

Yes, you are at elevated risk for a detachment in the other eye, but not so much that you should worry about it and let it affect your life. I've gone on several trips out of the country in the years since, and while it's always in the back of my mind, I don't let it affect my decision making.

I probably would wait a year if I were you before I started traveling internationally again. However, if it really concerns you, I think it would be worthwhile to ask the travel insurance providers what the process would be in a case of a future retinal detachment.
posted by eas98 at 6:46 AM on October 3, 2016

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