Stranded in the pandemic, his travel insurance failed to cover $38,000 medical bill – Press Enterprise
By Arthur Allen | Kaiser health news
Duy Hoa Tran, a retired Vietnamese school teacher, came to Los Angeles in February 2020 to visit his daughter and two-month-old grandson. Two weeks later the door closed behind him. To prevent the spread of COVID-19, Vietnam has closed its borders. No commercial flights would be allowed into the country for the next 18 months.
Trans daughter An Tran, who has a PhD in business administration and teaches marketing at La Verne University, did what she thought was necessary to provide medical care to her then 65-year-old father during the pandemic. But the only option for a visitor on a tourist visa was travel insurance. In early March 2020, An Tran found and bought a policy for about $ 350 a month from a company called Seven Corners.
She couldn’t have bothered either.
The elder Tran had been staying at Anan’s house in Diamond Bar for about a year when he told his daughter that he was having trouble seeing with his right eye. A visit to an ophthalmologist brought a solemn verdict: Tran had severe glaucoma and would quickly go blind if he did not have an operation.
Seven Corners issued prior written approval for the Dr. Brian Chen Best Practices. To be sure, An Tran called the insurer “many times” to confirm they would pay the costs, but no one she spoke to would give her a definitive answer, she said. However, Chen assured An that the insurance companies would normally have covered the treatment, which was fairly routine.
On April 19, Tran underwent the first of three eye surgeries to correct the glaucoma. The operations – the last on July 19 – were successful. And then on August 5th, Seven Corners sent An Tran a denial of service letter.
The company’s insurance policy excluded coverage for all “pre-existing medical conditions,” that is, all medical conditions, “whether previously manifested, symptomatic, known, diagnosed, treated or disclosed,” the letter reads.
Shortly after her father’s eye surgery, An Tran of Diamond Bar, Calif., Discovered that travel insurance typically offered little coverage for health problems related to a pre-existing medical condition. (Heidi de Marco / KHN)
Tran and her father hooked up to nearly $ 38,000 in medical bills, despite Seven Corners having pre-approved the surgery and paying around $ 6,000 for insurance over the past year and a half.
As for the bill, “Obviously my father can’t pay it,” said Tran. His monthly pension of $ 260 from the Vietnamese government is not enough for him to live in Vietnam, she said.
The surgical procedures that Duy Hoa Tran received are fairly routine in the United States, said Dr. Davinder Grover, a Dallas area ophthalmologist and clinical spokesperson for the American Academy of Ophthalmology.
Medicare would generally pay about a quarter of the $ 37,896.83 Tran was billed for the operations, Grover said. If Trans daughter had known beforehand that insurance wouldn’t cover the procedures, the doctor’s office might have been willing to charge about $ 12,000, he said.
The policy An Tran bought had no deductible and offered coverage of up to $ 100,000 in medical bills, including COVID treatment. However, travel insurance generally only covers emergency or urgent medical expenses, according to the California state insurance commission that governs policies in the state.
Megan Moncrief, Chief Marketing Officer of Squaremouth, who aggregates travel insurance plans from various companies – including some from Seven Corners – and offers them through its website, said the policy language is not uncommon for travel insurance. She noted the policy stipulation that some acute conditions would only be covered if the patient sought treatment within 24 hours of the first symptoms.
Moncrief said the fact that Tran did not receive immediate treatment could be the reason that his operations were not covered. (Seven Corners declined to comment on the case.) She admitted that it was hardly surprising that at the first sign of discomfort he hadn’t rushed to the doctor: “I don’t know if I would have done this if I had just would have done “blurry vision.”
Seven Corners’ refusal to pay despite pre-certification is not uncommon, she said. By pre-certification, the insurer confirms that a procedure is a covered benefit, but does not guarantee that the insurer will cover it for that particular patient.
Travel insurance tends to provide little coverage for health problems related to a pre-existing medical condition, whether or not the medical condition has ever been diagnosed, says Susan Yates, general manager in the US at Falck Global Assistance, an international insurer.
“Health insurance can be difficult for visitors to the United States, especially those who are not permanent residents or citizens,” she said. The Affordable Care Act does not cover tourists, although some resident non-nationals can purchase coverage.
“It is usually better for a visitor to get travel insurance in their country of origin, but in some countries (Vietnam is one) the insurance market is not developed,” Yates wrote in an email.
Tran had tried unsuccessfully for months to fly home to his town near Ho Chi Minh City, where his wife lives with another grandchild. On 14 occasions, An him bought tickets for regular scheduled flights that were later canceled. He was also unable to get a seat on charter flights arranged by the Vietnamese government; these tickets were generally only available through third parties, charging up to $ 10,000.
Ophthalmologist Chen offered to discuss the case with KHN, but his medical group’s attorney said it was a guideline to discuss insurance issues with reporters even if the patient consented.
After KHN contacted him to discuss the issue, Chen An Tran announced that he was waiving his $ 8,144 fee for the operations. The Acuity Eye Group, where he practices, would not immediately acknowledge Chen’s offer, but did inform An Tran that they would seek approval to waive his fee and all other fees.
On September 15th Duy Hoa Tran finally managed to take a charter flight back to Vietnam. He’s happy to be home, said An Tran.
Under California child responsibility laws, she could be held liable for his remaining bills.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health topics. Together with Policy Analysis and Polling, KHN is one of the three major operational programs of the KFF (Kaiser Family Foundation). KFF is a non-profit foundation that provides the country with information on health issues.
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