GS Emergency Medical Assistance Benefits

Question

I am in the middle of my first road trip. (Upstate New York to Florida Keys)  Joined GS ($$) and Road Asst($$) and the Emergency Medical Assist Plus(+)($$$).  $$$$ was  adding up but felt I was cautious and protected.  I needed out of New York winter.  I am recovering from cancer and potentially could have had complications.  I did not. However my mother, who is 97, did have a fall with an injury. She was listed on our policy and we paid for her coverage. She broke two vertebra in her back and continues with severe pain.  We have stopped our return trip north due to her discomfort with RV travel.  I now learn that injury and medical assist benefits require hospital admission.  As a retired emergency physician, I know admission is not generally indicated. However I was exploring the possiblity of flying her home to family for further care and pain control. Discussions with your "support and planning team" made me angry as they were declining coverage because she was not admitted to hospital.  Your brochure is selling this program and mentions "after your hospitalization. Clearly your program is taking advantage of many people who are treated and streeted by ER's (most ER visits)but are clearly not able to travel 1500 miles by road (RV).    Disappointed with coverage  JD, New York

dbbls · Answer

I purchased this a few years ago for coverage while in Canada during a trip to Alaska. I was told it would cover me for a heart condition. I went to purchase it again for the return trip and found that it would not cover me for what I wanted. It pays to ask lots of questions.

darsben · Answer

Most policies of the type require hospitalization some are worse than GS.
You mention the brochure but not the POLICY surely you were given one but never read it. I am not blaming you because I never read them either until I got burned once.
If you would have come here first and asked someone may have helped you avoid the GOTCHA. Instead you chose to join to complain because they followed the terms of the policy and you are upset. Surely as a physician your practice went round and round with insurance companies denying coverage because of the stipulations in the contract.

As a further gotcha some policies will only evacuate a person only if the hospital they are in is unable to treat the case and then the evacuation is only to the nearest hospital capable of treating the condition; but only after consulting with the medical director of the insurance company. If procedure not followed claim will be denied even if later the insurance company agrees. So the Burn victim is screwed as is the stroke patient and the heart attack patient if at a small rural hospital

downtheavenue · Answer

You have to read the fine print of the actual policy/contract, not just the sales brochure. Most of these medical policies are like extended warranties, they have enough exclusions that they don't pay more than they do pay.

maholan · Answer

Point well taken regarding policy vs brochure.  I can think of many senarios where the insured in an RV is injured or ill but not admitted to hospital, but your trip is over. This policy does not protect as I had hoped.   My mistake.  But others beware. If you are pronouced dead, you are not necesarily admitted to hospital either. I will have to read the fine print on that when I get home.  JD

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