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Greg _STT
(@Greg__STT)
Advanced Member

Hi,
Does anyone know if my Anthem Blue Cross is accepted in the islands. If not what health insurance would you recommend?

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Topic starter Posted : May 24, 2009 10:17 pm
changesinlattitide
(@changesinlattitide)
Advanced Member

You are better off to return "home" for any and all medical/dental procedures if at all possible. You should look into airlift insurance rather than switching your medical coverage. I did see a doctor and went for some lab work while one island. I paid out of pocket.

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Posted : May 24, 2009 10:29 pm
dntw8up
(@dntw8up)
Trusted Member

Call the number on the back of your card and ask if they have any health care providers in the VI.

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Posted : May 24, 2009 10:30 pm
Greg _STT
(@Greg__STT)
Advanced Member

Returning to Colorado is really not an option for most minor medical care. I understand there is one major carrier, Amedex who is accepted on all the VI's and includes airlift coverage.

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Topic starter Posted : May 24, 2009 10:42 pm
dntw8up
(@dntw8up)
Trusted Member

"Returning to Colorado is really not an option for most minor medical care."

Many people pay out of pocket for minor medical care and return to the states for major medical care.

"I understand there is one major carrier, Amedex who is accepted on all the VI's and includes airlift coverage."

This would likely be air to Puerto Rico. Many people would prefer air to the states via MASA: https://medicalairservicesassociation.com//

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Posted : May 24, 2009 11:20 pm
Tippi
(@Tippi)
Trusted Member

"dntw8up wrote: his would likely be air to Puerto Rico"

dntw8up,

You are wrong! Amedex and I can vouch for this brings in a Lear Jet and one goes to Miami. Amedex flies you directly to MIA, where you are transported via ambulance to Jackson Trauma/Medical.

I know this for a fact.

Tippi

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Posted : May 25, 2009 12:04 am
dougtamjj
(@dougtamjj)
Expert

Athem Blue Cross is accepted at the hospital on STX. Kmart west also accepts it for prescriptions. The pediatricians that we go to for our son does not accept it but most doctors will give you a form to send to your insurance company and sometimes they will reimburse you. It depends if you have a HMO or a PPO. Call Athem and ask. Hope this helps.

Tam

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Posted : May 25, 2009 12:51 am
East Ender
(@east-ender)
Expert

Okay, I am going to stand up for health care here. If you advocate for your own health care, you can get decent primary care here. If you need certain emergency services, you will need to be medically evacuated to a place that can provide those services. Tippi, that usually means the closest place, i.e. Puerto Rico. Most medical evacuation insurance reads the same way. If your physician and the insurance company can agree, you may be sent to FL... If there is enough time.

Of course, none of this has anything to do with Greg's question.;)

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Posted : May 25, 2009 1:16 am
dougtamjj
(@dougtamjj)
Expert

The Lab at Sunny Isle also accepts Athem Blue Cross also the eye doctor who is in the same location. I can't remember who it is. Hubby got a piece of metal in his eye and they fixed him right up.

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Posted : May 25, 2009 1:27 am
dntw8up
(@dntw8up)
Trusted Member

Tippi,

What's with the bold print? Relax! I said "likely." Amedex may have a Cadillac plan for some, and I understand that you have anecdotal experience going to FL, but most people will likely go to Puerto Rico.

Here's what Amedex has to say about emergency transportation (note "nearest medical facility" is usually in Puerto Rico):

"Emergency transportation (by ground and air ambulance) is only covered if related to a covered condition for which treatment cannot be provided locally and transportation by any other method would result in loss of life or limb. Emergency transportation must be provided by a licensed and authorized transportation company to the nearest medically facility. The vehicle or aircraft used must be staffed by medically trained personnel and must be equipped to handle a medical emergency.

(a) Air ambulance transportation
(1) All air ambulance transportation must be pre-approved and coordinated by USA Medical Services.

(2) The maximum amount payable for this benefit is fifty thousand dollars ($50,000) per insured, per lifetime.

(3) The Insured agrees to hold the Insurer, USA Medical Services, and any company affiliated with the Insurer or USA Medical Services by way of similar ownership or management, harmless from any negligence resulting from such services, or for delays or restrictions on flights caused by mechanical problems, by governmental restrictions, or by the pilot, due to operational conditions, or from any negligence resulting from such services.

(b) Ground ambulance repatriation: The maximum amount payable for this benefit is one thousand dollars ($1,000) per incident."

The Amedex website is confusing but this is where I found the information I quoted: http://www.e-healthinsuranceservices.com/PSPP6.htm

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Posted : May 25, 2009 1:35 am
Tippi
(@Tippi)
Trusted Member

We don't have a cadillac plan with Amedex.

I challenge the fact that Amedex sends patients who need care to PR. We are not the only ones we know of where Amedex has sent a plane to pick up for the care at Jackson.

Amedex is widely known at Jackson (even has a whole wing of offices within the hospital). I can assure you Amedex will not transport a patient to PR. Amedex prefers to bring patients to Jacskon than pay the high care in the islands.

I don't know how you can even begin to speak about Amedex if you're not even insured with them. Call their 800 number and speak directly with them, you will find Jackson is where they bring patients.

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Posted : May 25, 2009 1:05 pm
Tippi
(@Tippi)
Trusted Member

"Of course, none of this has anything to do with Greg's question."

Did you not read his 2nd posting about Amedex?

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Posted : May 25, 2009 1:08 pm
dntw8up
(@dntw8up)
Trusted Member

Tippi,

"I can assure you Amedex will not transport a patient to PR."

I provided the link to Amedex's published policy on the matter; IF Amedex has changed their policy, you should take up your concerns about the misinformation on their website with them.

"I don't know how you can even begin to speak about Amedex if you're not even insured with them."

You don't know me or what insurance I have.

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Posted : May 25, 2009 1:55 pm
Greg _STT
(@Greg__STT)
Advanced Member

Actually, it sounds like you don't have insurance at all. why would you pay out of pocket if you had insurance. Yes, insurance is a necessary evil, but a gamble I am not willing to take. The Amedex is only about $100 a month for my age, has a $500 deductable and
100% benefits thereafter, much better then most mainland policies. Are you all saying the care in St. Thomas is that bad? I am pretty sure the doctors all went to med school.

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Topic starter Posted : May 25, 2009 3:31 pm
dntw8up
(@dntw8up)
Trusted Member

I have excellent insurance, but people pay out of pocket here for a number of reasons: maybe their preferred provider in the VI is out of their network, or their preferred provider doesn't accept insurance, or their deductible is more than they spend on health care annually.

As to whether health care here is bad, it depends on what you need. Some specialties aren't available on island (you can read past posts on the subject if you care). Yes, all doctors here went to med school, but that's not in and of itself a great feat -- and med schools are not uniformly great, and all students in a graduating class are not equally good at their chosen profession.

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Posted : May 25, 2009 4:48 pm
Greg _STT
(@Greg__STT)
Advanced Member

So, which excellent insurance do you have? How is the hospital? Being atheletic, orthopedic doctors would be my concern. When I called
1 First Insurance, they told me Amedex is the only real full service insurance in STT.

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Topic starter Posted : May 25, 2009 5:01 pm
East Ender
(@east-ender)
Expert

Greg: If you have a catastrophic illness, say you fall playing soccer, hit your head and have a subdural hematoma, know that there is no neurosurgeon in the VI. You would be out of luck. Yes, someone will drill a hole in your skull, but it will probably be a general surgeon. If you break a leg, however, we do have qualified orthopedic surgeons, no problem. If you need highly technical and delicate hand surgery, you will probably want to go to a hand surgeon in the states. It is not whether the health care here is good or not, as I said, primary care is good. As dnt said, there is a lack of availability of certain specialties. In the states, you are accustomed to driving a couple of miles and having every diagnostic and treatment option available.

You do know that half of the doctors graduated in the bottom half of their medical school class, don't you? 😀

What is "full service insurance?" Cigna is the government insurance, United Healthcare is also available.

And sheesh, Tippi- Canoe, I was just looking at his first question. Mea culpa. 😉

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Posted : May 25, 2009 5:49 pm
Linda J
(@Linda_J)
Expert

Another example is joint replacement. I have 2 new knees and went back to the states to have them done for 2 reasons - in order to be fully covered by my insurance I had to use an in-network doctor, hospital etc. And secondly, at the time I had my knees done, 4 years and 2 years respectively, they were not doing kneereplacement on STX - don't know if they are now.

That said, I've had good experiences here with general illnesses handled by family practice doctors.

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Posted : May 25, 2009 7:49 pm
Tippi
(@Tippi)
Trusted Member

Greg,

fyi...2 visits to Red Hook or Yacht Haven Grande Medical clinics and you will meet that $500. I would not recommend the local Urologist and if you have any type of kidney stones or prostrate problems, get the referral and go off island for care. As for other specialists on island I can't recommend any. We get the referral and go to the states for serious care.

Tippi

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Posted : May 25, 2009 8:51 pm
Tippi
(@Tippi)
Trusted Member

Greg,

I've also heard about excellent care in Tortola. From what I understand there are some excellent doctors in the BVI, including surgeons. However, I do not know if your insurance provider will cover you in the BVI.

Tippi

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Posted : May 25, 2009 8:54 pm
East Ender
(@east-ender)
Expert

Tippi: There are two urologists on St Thomas. There are excellent specialists in other areas, too, You sound as if you have not been happy with the care you have received, however, there are others who have had different experience. To say that there is excellent care in Tortola is ludicrous, unless you want cosmetic surgery. They have even fewer specialty services and less advanced care (ICU, etc.)

I stand by my statement that one can get good primary care on St Thomas. For specialized care, yes, there are fewer options. If having state-of-the-art medical care in every possible area is important to you, you need to live in a large urban center with a medical school and a number of specialty hospitals.

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Posted : May 25, 2009 9:08 pm
Tippi
(@Tippi)
Trusted Member

East Ender I'm not interested in debating local health care.

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Posted : May 25, 2009 9:22 pm
Trade
(@Trade)
Expert

Better find a doctor to deal with that massive chip on your shoulder, Tippi. I've had EXCELLENT care with Dr. Jones at Yacht Haven Grande & a friend dearly loves the male doctor there & goes to him even though they don't take Medicare (he gives her a deal on the rate because of that.) My visits to her sure didn't total up to that amount.

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Posted : May 25, 2009 9:35 pm
Tippi
(@Tippi)
Trusted Member

Trade...read my posts I recommended Both Red Hook Medical and Yacht Haven Grande Medical.

Read and comprehend what I wrote.

Once again like another request I made you failed to read the post.

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Posted : May 25, 2009 9:38 pm
Tippi
(@Tippi)
Trusted Member

Trade would you like me to scan my latest receipts and prove to you $500 bucks was spent????

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Posted : May 25, 2009 9:39 pm
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