DIVING OVER 50 YEARS OLD

[tep]

Alternatives to DAN for evacuation...

I should have mentioned that I've been down this road. Not dive related but a decade ago my wife became VERY ill while traveling.

American Express offers Global Assist services to some (most?) card holders at no charge. Global Assist was able to completely rearrange our travel, finding flights and working directly with an airline to get us on fights within 8 hours using some interesting fare codes. I did have to pay for the new fares, but they weren't the usual 5000% markup for "I need two tickets RIGHT NOW", and they also helped coordinate getting emergency prescriptions from her doctor while we were waiting.

Being able to call a emergency travel concierge, and have them take care of the details, whether it's DAN, Global Assist, International SOS, or anyone, having someone else sort all that out you can concentrate on your family member can be really helpful.

Disclamers: I have DAN insurance, I have AMEX Global Assist and my employer uses International SOS.

 

[JamesBon92007]

giffenk, does "plain jane" travel insurance typically cover evacuation costs, such as a helicopter flight? I haven't done as much comparison as some of you participating in this thread, but I have always bought DAN insurance based on a vague presumption that DAN covers the cost of and has special expertise in arranging transportation to a facility they deem appropriate for dive accidents and then coordinating with the local medical personnel to arrange chamber treatment if necessary. Were it not for the twist of DCS being specific to our sport, and DCS treatment requiring prompt transportation to a specific type of facility, then yes, I would just go with general travel insurance. Is my ignorance showing?

I live in California. Before a recent dive trip I read my policy and basically it says I'm covered if, for some reason, it is not possible to transport me back to California for treatment. If I had the bends then they can't just put me on an airliner and hope for the best As for helicopter transportation, I suppose if I was in a life or death situation then $3000-$4000 for a helicopter ride might seam cheap. OTOH, my insurance is through the "Marketplace" which is a fiasco so I would expect that the required approvals would not flow smoothly. But as far as I could tell, it sounded like I would probably be covered for chamber treatment. They actually approved some cholesterol medicine for me that costs a small fortune because I can't tolerate all of the usual statin drugs etc.

I just got back from a week with really bad WiFi so I'm not up to date on some of the discussions, but someone said that the Nicaraguan dive OP didn't say that he was going to decline divers if they were over 50 but just wanted written proof that we are fit to dive or have insurance. My point of view was what happens if you show up without the required documents? If you are over 50 then you don't dive. So far I have never been required to bring any documents with me. One time I recall having to fill out a health questionnaire but usually they just want to know if I am qualified for a particular dive. Heck, the general attitude seems to be if I've been diving for this long and I'm still alive I'll probably make it though this dive too.

 

[KevinNM]

As for helicopter transportation, I suppose if I was in a life or death situation then $3000-$4000 for a helicopter ride might seam cheap.

Well, $3-4000 would seem cheap compared to the actual bill you will get for a helicopter flight from PHI or the other non USCG medical helo companies. I was told by some friends that they were hit for $50,000 for the flight that got their 12y/o daughter in a diabetic coma to the hospital that saved her life. The week in the ICU was "somewhat more". (She developed insulin dependent diabetes out of the blue on a cross country trip.)
http://www.nytimes.com/2015/05/06/b...ce-but-stunned-at-the-sky-high-bill.html?_r=0

 

[Lorenzoid]

As I understand it, as far as transportation, most "plain jane" travel insurance will cover no more than transportation to the nearest medical facility that's adequate for treatment. (I can see how there could be some debate there.) "Evacuation" coverage that covers transportation to a better medical facility is something else. (Does one need "evacuation" coverage to ensure transportation to a chamber that might be 500 miles away?) "Home country evacuation" coverage is something else still.

 

[DocVikingo]

No, you are correct.

However, the "clearance" is required in the event of a "yes". A "yes" does not mean you can't dive, a "yes" simply means you need ensure that you are okay to dive.

Thanks, Hawkwood. I was quite certain that was correct, but wanted to give giffenk the benefit of the doubt.

And, as you can you see by my comment in the post you cited, you & I are in full agreement on the "clearance" issue when an RTSC medical item is endorsed.

Thanks,

DocV

 

[DocVikingo]

Of course I have no idea what insurers provide giffenk's coverage or what the specifics are, but I would caution the diver relying on typical health insurance to ensure that his/her policy covers accidents that occur in foreign countries, as this is a very common exclusion. Even having primary medical insurance with very generous coverage is still often of little benefit while you're out of the country.

And even when foreign locations are covered, there is the matter that some out of country medical facilities require payment up front, or at least prior authorization from your insurance company or other proof of ability to pay (e.g., an American Express card with no stated spending limit), before you are admitted to or discharged from the hospital, or even allowed to leave the country. DAN is on top of this, but most general medical and some travel policies will not provide such, or will do so only with considerable foot-dragging (and of course many dive accidents, such as DCS, do not "keep" particularly well).

Relatedly, all medical air evacuation services, as far as I am aware, absolutely require payment in advance or for solid verification of guarantee of payment. I would mention in passing that I was a personal party (thankfully not the injured diver) to a necessary low-altitude stateside evacuation from a remote location that ran to about $275,000, and that was many years ago. This is beyond the stated limits of most routine medical coverage or "plain Jane" travel insurance policies of which I am aware if. And even when the money is there, the primary medical or travel insurer is highly unlikely to agreeably move you farther than the nearest location that in their (often scuba ignorant) estimation can, as Lorenzoid said, provide "adequate" treatment.

Then there is the topic of co-payments, deductibles, and other out-of-pocket medical costs which are almost always characteristic of primary health insurance, and can add up to a tidy number. With a policy such as those offered by DAN, these are covered as a matter of course.

Admittedly this can be complicated business, and little can be definitively stated without reading the specific policies under discussion. However, it can be definitively stated that if you are going to eschew a secondary dive accident policy and rely solely on your primary medical insurance and some sort of travel policy to cover all dive accident-related costs where ever they may occur, it is advisable that you do your homework very, very diligently.

Regards,

DocVikingo

 

[JamesBon92007]

Well, $3-4000 would seem cheap compared to the actual bill you will get for a helicopter flight from PHI or the other non USCG medical helo companies. I was told by some friends that they were hit for $50,000 for the flight that got their 12y/o daughter in a diabetic coma to the hospital that saved her life. The week in the ICU was "somewhat more". (She developed insulin dependent diabetes out of the blue on a cross country trip.)
http://www.nytimes.com/2015/05/06/b...ce-but-stunned-at-the-sky-high-bill.html?_r=0

The $3000-4000 was what I thought I'd read in one of these threads about helicopter flights. Apparently I misread something. Hundreds of thousands of dollars for a helicopter flight seems like a lot. Why the astronomical fees?

 

[KevinNM]

Part of it is that they are trying to make money, part is that they are expensive to operate. They have crew ready to go 24 hours a day, so you have a lot of people being paid good money to crew one helicopter, and you need multiple helicopters to provide 24/7 availability due to the required maintenance, They also are expensive to buy, expensive to fly, and they require a lot of maintenance, so you also have a team of mechanics and constant expensive parts. A new PHI Eurocopter AS350 B3 was destroyed in a crash followed by a fire on our roof a few years ago. That was as it took off after delivering it's first patient ever, everyone survived the crash. I have no idea what it cost, but looking around I see them for sale used for $2 million. Another provider lost another aircraft (and crew) a few months later.

 

[Centrals]

I was planning to dive in Spain and found out medical clearance is necessary regardless of age, well at least in places that I had made enquiry.
I have two insurances, Blue Cross(30m max) and DAN Preferred Plan(no depth limited as long as I have the training and using the right equipment).

 

[tep]

Here's one data sample on medivac costs, just in CONUS: When the Only Ambulance Is a Helicopter

That's costs where there's lots of support for the business (airports, local housing for staff, navigation, repair facilities). Add much more for operators in out of the way places where maybe the only maintenance available for the bird is 500 or even 1000 miles away, parts are 5 days away, etc.