Medical insurance for Mexico

[DrSteve]

This may be a dumb question but...is it necessary to get medical insurance if you already have a good US-based policy? I'm assuming DAN is highly recommended no matter what.
Thanks
Steve

 

[5615mike]

Yes, DAN is highly rec if your going to be diving but especially if your diving in an environment like Coz where you are doing multi level dives, ususally deep, repeatidly for days on end.

 

[Cudabait]

Not a dumb question, Steve.

I have had two occasions in the past year to get medical treatment while on diving trips. I have good based US insurance and DAN. I can't say enought good th9ings about DAN. I experienced what could have been a fatal barracuda attack while on a night dive in Honduras last Febreuary. DAN doctors, multi-lingual were constantly on the phone with the locals. I reccomend their premium insurance. It covers other than strickly divng accidents. DAN paid airfare for wife & self to be medivaced to Houston. They have picked up every penny my primary insurance did not cover. I'm sur for those who do not have primary insurance, they will live up to their policy obligation. CUDOS for DAN!!

You also may wish to check if your US policy will pay for hyperbaric treatment and all the other complications that can accompany barotrauma.

fregards,

 

[chuckrt]

I would suggest checking with your policy holder as most will not cover out of the US except Canada, at least here in the northeast. If you booked your trip with an agency they shouuld have travel ins. for purchase but it will probably not cover diving. This is a very strong argument for DAN's policy. Also alot of places will require cash to even see/treat you. I don't no how Mexico works but even in Europe cash talks.

chuckrt

 

[DocVikingo]

The following may help you with your decision. It's based on an article I wrote for "Undercurrent" http://www.undercurrent.org & also can be found by a search of the board archives:

"ARE YOU DIVING NAKED?

'American Express. Don’t leave home without it?' Piffle. A far more reckless action would be leaving for a scuba trip without adequately insuring against dive injuries and related costs.

I recently saw a bill from a hyperbaric facility on Cozumel for the treatment of unexpected, uncomplicated DCS sustained in Oct 2000. La cuenta? Two Table 6, two Table 5 treatments plus related expenses=US$14,050.10. Had this hapless diver sustained injuries so severe that they couldn’t be addressed on island and required air evacuation to Mercy Hospital in Miami, transportation alone would have cost from $10,000 to $20,000 depending on logistics.

Also in Oct 2000, after a week of diving on Provo a physician with over 200 dives suffered an unexpected case of the bends on her last day. She quickly underwent a Table 6 treatment, followed by 3 more over the next 3 days. Her return trip was on a private charter, pressurized Lear Jet to Ft. Lauderdale, a flight of about 600 miles. The damage? $7,200 for hyperbaric services & $4,600 for the ride.

An acquaintance of mine needed evacuation from a live-aboard off Panama to Miami following unexpected DCI sustained in August 2000. The air service secured a charge of $20,000 against his credit card before rolling the craft onto the tarmac.

Had any of these divers been stricken in remote Indonesia, the cost of air evacuation could easily have hit $35,000. Dan Nord, Director of DAN Medical Services, told “Undercurrent” of an $80,000 tab for an emergency evacuation from Southern Africa.

Do I have your attention? Good.

Getting Covered

Let me suggest that prudent divers will purchase dive insurance and view it as supplementary to their general health coverage, as a hedge against services that primary medical policies deem outside their obligations. Be aware that some standard health policies contain exclusions for diving related accidents, including chamber treatment, not to mention exclusions/limitations for injuries sustained outside of the country.

The first step in assessing the adequacy of protection is to review your primary health insurance coverage. In particular, look into dive-related hyperbaric chamber treatment and emergency air evacuation, both at home and abroad.

Even when a primary health policy does generously insure against dive-related injuries away from home, some foreign countries want payment or credible proof of payment before you are admitted to or discharged from the hospital, or allowed to leave the country. It is a near certainty that your general health insurer will not advance any monies or make any pre-authorizations for such contingencies. A dive insurance plan will almost always serve far better in this regard. Diver protection plans are often recognized, particularly in foreign countries, as reliable sources of payment, and in some cases may even provide cash advances or assurances of coverage. With chamber treatment alone running from $4000-$1,000 per hour, depending on facility, number of personnel involved and other factors, costs can mount rapidly.

Don’t, however, be lulled into a false sense of security by a dive insurance policy. In addition to the folly of not having strong standard health coverage, the fact is even the most benevolent dive insurance may not defray all eventual medical expenses. The long-term costs of treating such events as Type II DCS with permanent neurological impairment or severe pulmonary barotrauma can be extraordinary.

There are a number of agencies which offer dive insurance, including DAN, PADI and DiveSafe. Let’s have an in-depth look at the offerings & workings of the most widely recognized and comprehensive plans, those of DAN & PADI.

DAN

While this not for profit agency did not reveal to “Undercurrent” the number of policies currently in force, it has about 200,000 members and reports that a majority of them subscribe to one of its plans.

DAN diver policies are not standard across its 5 international regions. The largest region, DAN America, encompasses the US, Canada & Caribbean basin. DAN America-Mexico, currently operating under the aegis of DAN America, is on the way to becoming independent. The remaining regions are DAN Europe, Japan, South East Asia-Pacific (SEAP) & Southern Africa. While these regions work closely together and share some resources, they remain independently owned & operated. They are free to formulate their own dive insurance policies and select their own underwriters. DAN America dive policies are underwritten by United States Life.

Policies offered by DAN Dive America are the Standard ($54), Master ($64) and Preferred ($99). Various family plans can also be purchased. All policies include up to $100,000 in TravelAssist coverage, the DAN membership fee of $29, a subscription to “Alert Diver” magazine & access to medical information services. Do be aware the Standard plan covers only Decompression Illness (DCI). Many divers, myself among them, would consider this inadequate protection given the range of possible dive-related accidents. DAN’s two top plans provide more substantial medical dive accident coverage (up to $250,00 per incident per insured with the Preferred Plan), and incorporate death/dismemberment/disability and reimbursement benefits for dive gear lost as a result of dive injury.

The Preferred Plan has some exclusive benefits, such as a $10,000 lifetime maximum benefit (with a $250 deductible) for medical non-dive accidents occurring outside of the country of permanent residence. There is also trip cancellation/interruption coverage for many of the losses incurred when an insured’s ability to dive becomes substantially limited due to personal sickness or injury.

Nice as this is, the feature should not be confused with a formal vacation cancellation policy and there is a related $250 deductible. Vacation cancellation insurance, in addition to coverage of personal illness/injury cancellation losses, provides much broader protection that may incorporate losses due to strikes on common carriers, natural disasters, bad weather and terrorism.

Okay, what is the insured diver to do when an injury is sustained? If at all possible, the first thing is to contact DAN. In an emergency, DAN can be called at 1-919-684-8111, or 1-919-684-4326 (collect). This is a hotline staffed 24 hours, 365 days per year, by personnel from the Departments of Hyperbaric Medicine and Anesthesiology at the Duke University Medical Center. Although not a requirement of DAN policies that the diver alert the agency prior to receiving covered medical services, DAN personnel can provide expert medical advice & assistance in negotiating care systems.

As regards financial matters, DAN is able to supply hospital admittance/discharge deposit advances of up to $5,000 when provided with an acceptable guarantee of reimbursement for any non-covered services. This guarantee typically comes from the primary health insurer or the diver himself. According to Mr. Nord, diver sureties would include such vehicles as a personal credit card, or the card of a family member or other individual who agrees to participate. DAN’s TravelAssist claims & payments coordinator, National Baromedical Services, Inc., can arrange for other guarantees of payment of certain costs on a case by case basis.

Based on the need to maintain acceptable standards of practice & technology, and due to past abuses of its chamber coverage, DAN has instituted controls on services. Specifically, cases of DCI requiring hyperbaric treatment are referred to a member of its Diving Preferred Provider Network (DPPN). These are chambers that meet standards of service in a cost-effective manner. Currently there are about 40 such facilities in the DPPN, all located within the US. Renee Westerfield, DAN Communications Director, told “Undercurrent” that a diver needing emergency chamber treatment will be referred to the nearest facility, whether or not it is a member of the Network. However, in nonemergency situations, DAN makes every effort to use a DPPN facility.

Regarding those staggering medical transportation figures presented earlier, all policies provide up to $100,000 DAN TravelAssist evacuation and repatriation benefits. This includes covered medical and visitor transportation for injuries incurred at least 50 miles from the insured’s permanent residence. One thing to keep in mind is that all such travel must be coordinated in advance through TravelAssist [1-800-326-3822/1-215-245-2461 (collect)]. If you make any travel arrangements on your own, DAN will not reimburse you. Through its subcontractor, International SOS Assistance, Inc., TravelAssist will make the necessary arrangements and provide a Letter of Assurance of payment. This in hand, emergency air service companies feel comfortable in waking crews from their naps.

Ancillary TravelAssist benefits are extensive. These include continued medical monitoring of the injured diver, legal assistance including bail bonds, repatriation of traveling companions & dependent children, return of a rental vehicle, cash advances of up to $250 for medical emergencies, help in the recovery of lost or stolen belongings, and a range of personal services such as contacting relatives & employers. They will even send a needed prescription you left behind.

An important consideration in deciding on a particular DAN policy is depth limit restrictions. While both the Preferred & Master Plans have no depth limit, the Standard has a 130’ restriction--it does not cover dive-related injuries occurring below this level. This may prompt the diver not planning to dive below 130’ to purchase the minimum plan thinking he is saving money. There is certainly nothing wrong with frugality. However, recreational divers must appreciate they can unintentionally violate this restriction for a number of reasons. Rescuing a buddy, nitrogen narcosis, chasing a dropped camera or that once in a lifetime photo, or even the accident itself may result in exceeding this limit. With a no depth limit policy, there is no wrangling over your "real" dive plan or "intent" when it comes time to settle, as can be the case with policies containing such limits.

PADI

PADI offers a much broader range of dive-related insurance, including property and liability coverage for dive boats, operations, shops & resorts, personal liability coverage for PADI facility affiliated dive training staff and sponsored workers compensation and liability insurance. Laurie Vicencia Painter, Manager of the PADI Diver Protection Program, told “Undercurrent” the program has about 16,000 diver plans currently in force. All policies are sold and administered by Vicencia & Buckley Insurance Services, Inc. of Cerritos, CA, and underwritten by American National Insurance.

PADI diver protection plans include the Silver ($40), Gold ($60) & Platinum ($89), with all policies covering both DCI and other dive injury medical expenses.

All PADI plans include death & disability benefits, and provide non-diving accidental death & dismemberment coverage as an option and at an extra premium. The amount of optional coverage available, and the size of the premium, is plan dependent. In an important divergence from the two lesser DAN plans, all PADI dive accident medical coverage is on a per incident rather than the more restrictive lifetime maximum basis. Only the DAN Preferred offers per incident benefits. As with the DAN Standard Plan, PADI Silver Protection has a 130’ depth restriction.

All PADI plans include rescue & evacuation benefits up to the limits of the policy. By calling Assist America [800-872-1414; 301-656-4152 (collect)], the insured can obtain comprehensive worldwide assistance with diving accidents. Like the DAN policies, this can include hospital admission guarantees under the proper circumstances. Pre-authorization for covered service is not required, and PADI’s plans even allow the diver to arrange for his or her own air evacuation.

Additionally, the top of the line Platinum Protection provides divers and their immediate family with travel benefits for accident-related emergencies of any nature. While Assist America affords many of the same benefits as DAN’s TravelAssist, it has the additional advantage of covering divers at any distance from their permanent residence for dive-related medical and air evacuation services. On the other hand, PADI’s TravelAssist emergency number is not staffed by university-based dive medicine experts and does not provide a comprehensive non-emergency dive medicine information service. Like with so many things in life, there’s always a trade off.

DiveSafe

The newest player on the block is DiveSafe, Inc., of Blaine, WA. And how recent is it? According to Peter Meyer, VP & Marine Manager of the plan’s administrator, Jardine Risk Management, Ltd., the policy was formally launched at DEMA just this January, and has only a little over 100 subscribers at present. The premium is $55/year, a portion of which goes to two organizations dedicated to protecting the diving environment, The Coral Reef Alliance & Reef Environmental Education Foundation. Underwriting is by the National Accident Insurance Group.

The simplicity of DiveSafe has considerable appeal. There is only a single policy and it is activated immediately upon application. It stipulates no depth limit or exclusions for tech diving, contains no deductibles, offers no options & requires no pre-approvals for covered services. It is competitive with DAN & PADI plans in this price range, with lifetime limits of $100,000 for medical dive accidents, $10,000 for death & dismemberment, and up to $2,500 each for repatriation of remains, replacement of lost dive gear, and diving vacation cancellation or interruption. There is, however, an important difference between dive vacation cancellation benefits under DiveSafe and the DAN & PADI policies that include this feature. Unlike the PADI & DAN plans that cover dive trip cancellation when diving ability is substantially limited by personal sickness or injury, the DiveSafe policy requires that the cause of cancellation be a covered diving condition. In other words, under DiveSafe you cannot be reimbursed for trip cancellation due to appendicitis, severe flu or an auto accident. You are protected only when the cancellation results from a dive injury occurring prior to the dive trip.

Like PADI dive accident coverage, the DiveSafe policy includes emergency medical evacuation benefits up to the limits of the medical dive accident coverage. As with DAN & PADI plans, all customary ancillary support services are included. DiveSafe travel assistance features are handled by a subcontractor, WorldNet Services. As with DAN & PADI plans, DiveSafe will work with the injured diver to arrange for hospital admittance/discharge deposits or other necessary advances for medical services. Although DiveSafe presently cannot pre-authorize/guaranty payments for services, Mr. Meyer told “Undercurrent” that he hopes to incorporate up to $25,000 worth of such discretionary authority by mid-summer of this year.

So, Which Plan is Best for Me?

The answer is, “It depends.” As with most insurance, there is no “one size fits all.” Before purchasing any coverage, the diver should review the features of available policies in order to determine which best meets his or her specific needs. For example, a individual living in a very rural area who only dives a nearby quarry will not be heavily influenced by the $10,000 dive trip cancellation coverage offered by DAN’s Preferred Plan. However, he will be interested in the requirement that the diver must be at least 50 miles from home before DAN TravelAssist benefits become effective. On the other hand, for the individual who primarily dives exotic & far-flung venues this situation will be reversed.

When comparison shopping, consider such important features as lifetime maximum vs. per occurrence benefits, depth limitations, coverage for non-diving related injuries, coverage for significant others, and availability of both emergency and non-emergency expert medical assistance.

Don’t get caught diving naked.

DAN – http://www.diversalertnetwork.org/insurance
PADI - http://www.padi.org
DiveSafe - http://www.divesafeinsurance.com

DocVikingo"

Best regards.

DocVikingo

PS: Since this was written, there's another player---> Dive Assure http://www.diveassure.com/

 

[DrSteve]

Thank you everyone! Esp Doc Viking!

 

[divebag]

I was recently on a dive trip to Cozumel and met a diver who got bent while diving. She had DAN insurance (not sure which level). She was very disappointed in the way DAN was handling the incident. She apparently had to pay for all expenses for hyperbaric treatment, delayed stay on the island for more treatment and additional travel expenses while there. It ran into several thousands of dollars and she was lucky enough to have enough credit limit on her credit card to pay. No pay - no treatment according to her. She indicated she will be reimbursed eventually by DAN, but had to pay upfront. She said she was advised by the doctor of an alternative policy that will pay for all arrangements/treatments and was easier to work with. I'm not sure what the name of the other policy is, but she said she was going to cancel her DAN policy and purchase this alternative policy due to the inconviencies.

I am not bashing DAN, but just reporting what I heard from a stricken diver. I presently have the DAN premium policy, but am lucky enough to have not needed to use it. I also cannot guarantee the accuracy of what this diver reported, I have not read all the fine print and other policies may be similar?

 

[DrSteve]

Thank you. We will be checking out all of the major policies available. I was leaning towards DAn just because it so "in your face" and well known.

I was recently on a dive trip to Cozumel and met a diver who got bent while diving. She had DAN insurance (not sure which level). She was very disappointed in the way DAN was handling the incident. She apparently had to pay for all expenses for hyperbaric treatment, delayed stay on the island for more treatment and additional travel expenses while there. It ran into several thousands of dollars and she was lucky enough to have enough credit limit on her credit card to pay. No pay - no treatment according to her. She indicated she will be reimbursed eventually by DAN, but had to pay upfront. She said she was advised by the doctor of an alternative policy that will pay for all arrangements/treatments and was easier to work with. I'm not sure what the name of the other policy is, but she said she was going to cancel her DAN policy and purchase this alternative policy due to the inconviencies.

I am not bashing DAN, but just reporting what I heard from a stricken diver. I presently have the DAN premium policy, but am lucky enough to have not needed to use it. I also cannot guarantee the accuracy of what this diver reported, I have not read all the fine print and other policies may be similar?

 

[DandyDon]

I was recently on a dive trip to Cozumel and met a diver who got bent while diving. She had DAN insurance (not sure which level). She was very disappointed in the way DAN was handling the incident. She apparently had to pay for all expenses for hyperbaric treatment, delayed stay on the island for more treatment and additional travel expenses while there. It ran into several thousands of dollars and she was lucky enough to have enough credit limit on her credit card to pay. No pay - no treatment according to her. She indicated she will be reimbursed eventually by DAN, but had to pay upfront. She said she was advised by the doctor of an alternative policy that will pay for all arrangements/treatments and was easier to work with. I'm not sure what the name of the other policy is, but she said she was going to cancel her DAN policy and purchase this alternative policy due to the inconviencies.

I am not bashing DAN, but just reporting what I heard from a stricken diver. I presently have the DAN premium policy, but am lucky enough to have not needed to use it. I also cannot guarantee the accuracy of what this diver reported, I have not read all the fine print and other policies may be similar?

Something's not right here...?! :voskl1:

I was on a Cozumel dive boat a few weeks ago when a member of my group complained about feeling bad, then requested O2 - which then got him off loaded onto an ambulance ride to the Chamber. I wasn't his dive buddy, but I was the one he came to, the one who got the crew to bring the O2 kit, and the one to walk him to the waiting ambulance. I asked if he had DAN coverage, and his response: "Signed up 2 days ago."

I hoped that he wouldn't have any problems with such new coverage, but there were no questions. He did 2 chamber rides without paying a cent; they just billed DAN - after comfirming his coverage, I'm sure.

ON a side note: After a second dive and return to home dock, everyone else grabbed their gear and split, leaving me alone to tend to the injured diver's stuff. Rinsed it all, and took it to his room to dry.

:shout: Hello?! If you ever see a member of your group leave in an ambulance, especially if he's your dive buddy, please consider helping with his gear. Thank you.

don

 

[divebag]

I remembered the name of the insurance company the local mexican doctor had recommended to her. It is Dive Assure.
http://www.diveassure.com/