Transcript TRAVEL and Respiratory Patients

Disclosure
None
Travel Issues:
International
Concerns, Insurance
Preparations, and
Disability Act Issues
Travel & the Respiratory
Patient
Here’s How Respiratory Patients
Can Plan for a Safe Trip…
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Pick a safe, healthy destination
Consult with their doctor
Buy health insurance
Prepare and pack medications
and medical equipment
Arrange for oxygen supply and
equipment needs
Prepare for climate and air quality
at their destination
Pace themselves- eat well, sleep well
and don’t drink too much
Pick a Safe and Healthy
Destination
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Make sure the vacation
destination will be in a safe
place, close to medical services
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Avoid areas where there is inadequate or
questionable medical help
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Avoid places that can't provide smoke-free
accommodations
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Avoid places filled with their respiratory triggers
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Avoid places with extreme temperatures (very cold,
or very hot and humid)
Communication!
Patient’s Should Consult Their Doctor
Before They Leave…
The doctor should know:
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When they will leave
Where they will go
How long they will be
traveling
Will they be traveling alone
How they’ve been feeling
over the past few months
What the patient should
know prior to leaving…
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Their health is stable and all necessary medications
and immunizations have been provided, as well as
any special needs (oxygen, face masks, ventilators,
etc.) can be met
Some individuals who are not oxygen-dependent on
the ground may require oxygen during air travel
If supplemental oxygen is needed, verify that
supplies of oxygen are available in those specific
areas
Patients Should Have With Them
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A brief written medical history
with back-up copies for their
records at home
An updated medication schedule and written
prescriptions for all medications, including a
prescription for oxygen, if needed
Patients travelling overseas, can contact the
IAMAT (the International Association of Medical
Assistance to Travelers). This non-profit worldwide association has English-speaking doctors
ready to help international travelers
Basic Medical Information
for Americans Abroad
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If an American citizen becomes seriously
ill or injured abroad, a U.S. consular
officer can assist in locating appropriate
medical services and informing family or
friends
Buying Health InsuranceDo I Need Medical/ Evacuation
Coverage?
Yes!
Here’s a simple rule of thumb:
“If you are traveling outside your
home country, you need emergency
medical coverage”
Travel Medical Insurance
Basics
Medical Coverage for
Americans Abroad
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Most health insurance plans in the U.S.
only cover patients while in the U.S., so
when they leave the country they have
no medical or accident coverage
This is also true for Medicare, which
does not cover patients outside the
U.S.
Medigap Plans in General
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There are 12 standard Medicare
supplemental (Medigap) insurance plans
that help pay some of the costs in the
original Medicare Plan and for some health
care costs it doesn't cover
All Medigap plans must cover certain basic
benefits
Each standard plan, labeled "A" through
"L," offers a different set of benefits, fills
different "gaps" in Medicare coverage, and
varies in price and out-of-pocket costs
Foreign Travel
Emergency/
Medicare and
Medigap Plans
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Medicare does not cover any health
care received outside of the U.S.
Medigap Plans C through J cover some
emergency care outside the U.S.
Medigap Plans and
Foreign Travel
Emergency Covered by
Plans C-J
After a yearly $250 deductible is
met, Medigap Plans C-J will pay:
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80% of the cost of emergency care
during the first 60 days of the patient’s
trip
There is a $50,000 lifetime maximum
Which Company Should Patients Buy
Travel Insurance From?
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There are over 15 companies in the travel
insurance business, and each one sells a
variety of plans
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These are easily found through an Internet
search for medical travel insurance
How Much
Should Travel
Insurance Cost?
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This depends on the type of plan, the
coverage, and other factors
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In general, a Package Plan will cost
between 5-7% of the total trip cost
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So, if the total insured trip cost is
$5,000, a package plan would be
around $250-350 (5-7% of $5,000)
Travel Medical Coverage Can
Provide Coverage for Medical
Expenses Such as:
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Transportation to
the hospital
The services of a
physician
Charges for hospital
stays and operating
rooms
Travel Medical Coverage also
Provides Important Benefits for
Emergency Medical Evacuation
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Oftentimes, special medical flights, or
“evacuations”, are required to get an
injured or sick traveler back to their home
country
Medical evacuations can easily cost ten’s
of thousands of dollars, and in some cases
upwards of $100,000
EXAMPLE Policy # 2620975
PROTECT ASSIST
306700 P1 3/2007
Coverage effective date 06/19/2008
Total cost
$120.00
Trip details
Departure date
Return date
06/20/2008
07/01/2008
Trip deposit date
Contact Information
Traveler #1
Insured on Policy
Traveler #1
Coverages & Benefit Limits
Standard Packages
ACCID & SICKNESS MED EXP $25,000.00/Insured
AIG TRAVEL ASSIST
-- Per Insured
BAGGAGE & TRAVEL DOCS $1000.00 Per Insured
BAGGAGE DELAY
CONCIERGE SERVICES
EMERG MED TRANS
Selling Agency
Agency “X
Phone:
"Prex waiver applies to the first $30,000 of trip cost.
Only valid if prex requirements are met."
-- Per Insured
$500,000.00 Per Insured
ID THEFT ASSIST SVCS
-- Per Insured
LIVETRAVEL ASSISTANCE
-- Per Insured
MISSED CONNECTIONS
Trip Cost
$2,000.00
$300.00 Per Insured
$250.00 Per Insured
TRAVEL DELAY
$750.00 Per Insured
$150.00 Payout Limit Per Day
TRIP CANCELLATION 100% Trip Cost Per Insured
TRIP INTERRUPTION150% Trip Cost Per Insured
TRIP INTERRUPTION - RET AIR $750.00/Insured
Optional Packages
Optional Umbrella Package
ACCID DEATH/DISMEM
EMERG MED TRANS
MED COV UPGRADE
$25000.00 / Insured
$500,000.00 / Insured
$25,000.00 Per Insured
EXAMPLE Policy # 2620969
PROTECT ASSIST
306700 P1 3/2007
Coverage effective date 06/19/2008
Total cost
$154.00
Trip details
Departure date
Return date
06/20/2008
07/01/2008
Trip deposit date
Contact Information
Traveler #2
Insured on Policy
Traveler #2
Coverages & Benefit Limits
Standard Packages
ACCID & SICKNESS MED EXP $25,000.00/Insured
AIG TRAVEL ASSIST
-- Per Insured
BAGGAGE & TRAVEL DOCS
$750.00 Per Insured
BAGGAGE DELAY
$250.00 Per Insured
CONCIERGE SERVICES
EMERG MED TRANS
Selling Agency
Agency “X”
Phone:
"Prex waiver applies to the first $30,000 of trip cost.
Only valid if prex requirements are met."
$500,000.00 Per Insured
ID THEFT ASSIST SVCS
-- Per Insured
LIVETRAVEL ASSISTANCE
-- Per Insured
MISSED CONNECTIONS
Trip Cost
$2,000.00
-- Per Insured
$250.00 Per Insured
TRAVEL DELAY
$1500.00 Per Insured
$150.00 Payout Limit Per Day
TRIP CANCELLATION 100% Trip Cost Per Insured
TRIP INTERRUPTION 100% Trip Cost Per Insured
TRIP INTERRUPTION - RET AIR $750.00/Insured
Optional Packages
Optional Umbrella Package
ACCID DEATH/DISMEM
$25000.00 / Insured
EMERG MED ASST & REPATRIATION --/Insured
EMERG MED TRANS
$500,000.00 Per Insured
Coverages & Benefit Limits
Standard Packages
TRAVELER #1
Coverages & Benefit Limits
Standard Packages
TRAVELER #2
ACCID & SICKNESS MED EXP $25,000.00/Insured
ACCID & SICKNESS MED EXP $25,000.00/Insured
AIG TRAVEL ASSIST
AIG TRAVEL ASSIST
-- Per Insured
-- Per Insured
BAGGAGE & TRAVEL DOCS $1000.00 Per Insured
BAGGAGE & TRAVEL DOCS
$750.00 Per Insured
BAGGAGE DELAY
BAGGAGE DELAY
$250.00 Per Insured
$300.00 Per Insured
CONCIERGE SERVICES
EMERG MED TRANS
-- Per Insured
$500,000.00 Per Insured
CONCIERGE SERVICES
EMERG MED TRANS
-- Per Insured
$500,000.00 Per Insured
ID THEFT ASSIST SVCS
-- Per Insured
ID THEFT ASSIST SVCS
-- Per Insured
LIVETRAVEL ASSISTANCE
-- Per Insured
LIVETRAVEL ASSISTANCE
-- Per Insured
MISSED CONNECTIONS
TRAVEL DELAY
$250.00 Per Insured
$750.00 Per Insured
$150.00 Payout Limit Per Day
MISSED CONNECTIONS
TRAVEL DELAY
$250.00 Per Insured
$1500.00 Per Insured
$150.00 Payout Limit Per Day
TRIP CANCELLATION 100% Trip Cost / Insured
TRIP CANCELLATION 100% Trip Cost Per Insured
TRIP INTERRUPTION
150% Trip Cost / Insured
TRIP INTERRUPTION 100% Trip Cost Per Insured
TRIP INTER - RET AIR
$750.00/Insured
TRIP INTER - RET AIR
Optional Packages
Optional Packages
Optional Umbrella Package
Optional Umbrella Package
ACCID DEATH/DISMEM
$25,000.00 / Insured
EMERG MED TRANS
$500,000.00 / Insured
MED COV UPGRADE
$25,000.00 / Insured
ACCID DEATH/DISMEM
$750.00/Insured
$25,000.00 / Insured
EMERG MED ASST & REPATRIATION --/Insured
EMERG MED TRANS
$500,000.00 Per Insured
10 Questions to Ask When
Buying Travel Medical
Insurance
1.
Plans and policies vary greatly. Ask for
a printed copy outlining exactly which
emergency medical treatment and/ or
medical evacuation and transport
services are provided.
2. Ask about a
waiver of any preexisting medical
conditions
exclusion.
Not all M.E.T services are
the same!
• Some offer worldwide travel
medical evacuation that will
transport the patient home or
to the hospital of their choice,
plus cover any qualified
accompanying travel medical
expenses incurred
• Other plans only cover
evacuation and transportation
to the nearest adequate
medical facility
3. What type of
emergency medical
evacuation
transport service is
provided?
4. Ask if there are any
deductibles or
copayments.
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Are there charges for treatments, exams
and tests?
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Are there charges for drugs, medicines
and other services and supplies?
5. Find out if all coverages
are primary.
Will the insurance
company pay foreign
hospitals and foreign
doctors directly or will
the patient have to pay
out-of-pocket and be
reimbursed later?
6. Will they refill lost prescriptions?
7. Will the plan cover on-going medical
expenses?
Many plans will cover
necessary medical
expenses up to one
year after the sickness
or injury, provided
injury or sickness
occurred while on the
trip and the patient
received
initial treatment while
on their trip.
8. Do they offer
24/7 emergency
assistance for anywhere
in the world?
When in a foreign country, there are several potential
problems in the event of a medical emergency.
•The patient might not speak the language
•They probably won’t know where the hospital is
•They may not be able to communicate with the
doctor
•They won’t know if the hospital can provide
adequate care
9. Do they have live
messaging?
Will they relay
e-mail or
phone
messages to
the patient’s
family, friends
or business
associates?
10. Know the policy’s General Exclusions. In
addition to any other exclusions that may
apply to a particular benefit.
Prepare & Pack Medications & Medical
Equipment & Filling Prescriptions Abroad
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Carry a letter from the attending physician, describing preexisting
medical condition and any prescription medications
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All medications carried overseas should be clearly labeled in their
original container
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Verify with the foreign embassy of the destination country that
all required medications are legal
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Take duplicate copies of prescriptions (in generic names)
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Carry your drugs on board rather than packing them in luggage
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Carry a sufficient quantity of required medications and inhalers.
Certain locations such as China & Mexico may have pollution
problems in major cities & may pose special risks for the
individual with lung disease.
Carry a supply of medication for the recurrences of bronchitis.
The antibiotics that are customarily taken for bronchitis may not
be available in destination
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Prepare & Pack Medications & Medical
Equipment & Filling Prescriptions Abroad
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Obtain a special filtration mask and avoid outside exposure when
pollution, humidity, and pollen are severe in areas of travel
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Check with a physician about the advisability of traveling while
using a respirator
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Check voltage/amperage in destination locations (if a respirator
is used) to make sure there are proper power transformers
Carry some medical alert information, preferably a Medical Alert
wristband containing the diagnosis of pulmonary disease. Also
include a history of any known allergies or sensitivities, especially
to medications
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If possible, obtain the names and contact information of
physicians and preferred medical facilities in the destination
cities, in case complications should arise.
Prepare for the Destination’s
Climate and Air Quality
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Before leaving, look in the paper, on TV,
or online to find the local weather and air
quality conditions
Anticipate respiratory triggers that might
be at the new destination: will there be
pollen or air pollution? Will it be extremely
cold, extremely hot, or humid?
plan to cope with these triggers
Pace Themselves!
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Don't do too much, or they may get run down
and vulnerable to infections and flare-ups
Get enough sleep, especially if they’ve
crossed time zones and are coping with jet
lag
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Remember to eat well; too much food may
make breathing more difficult
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High altitudes may also change how alcohol
affects them
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In short: take it easy, and their trip will be
more enjoyable!
People with Disabilities are a
Powerful and Growing
Segment of the Population
According to the U.S. Census
Bureau’s 2002 Survey of
Income and Program
Participation (SIPP) there are
51.2 million Americans with
disabilities.
Let’s Put That Into Perspective…
 The 2002 SIPP indicated that the U.S.
population’s percentage of people with
disabilities was 18.1%
 That is larger than the percentage of
Hispanics in the U.S. population (13.3%),
the country’s largest ethnic, racial, or
cultural minority group
Diversity Within the Disabled
Population
 Each U.S. ethnic, racial, and cultural group has
members with disabilities
 The 2002 SIPP reported that at least 11.5% of
each of these groups self-identified as having
disabilities
For example: Black Americans
reported 19.8%
Hispanics/Latinos reported
13.8%
Whites reported 19.0%
Asians or Pacific Islanders
reported 11.5%
Spending Power of Americans
with Disabilities
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The growing market of people with disabilities
has $175 billion in discretionary spending,
according to the U.S. Department of Labor
$175 billion is more than four times the
spending power of “tweens” (8-14 year-olds), a
demographic sought after by businesses
An Open Doors Organization study estimated in
2003 that diners with disabilities would spend
$35 billion in restaurants that year
The New York Times reported that spending by
travelers with disabilities exceeds $13.6 billion
annually
Examples of the Global Spending Power
of People with Disabilities Include:
In 2005 that there were approximately
10 million adults with disabilities in the
UK. The estimated annual purchasing
power of people with disabilities there
is £80 billion
Canada reported in 2001 that the
combined annual disposable income of
working-aged Canadians with
disabilities is CAN $25 billion
Global Population of People with
Disabilities
The World Health
Organization (WHO)
estimates that there
are 600 million people
with disabilities around
the world
Collective Voices of People with
Disabilities and Their Allies Around the
World Have Been Strong and Persistent
 At least 40 countries have adopted legislation
addressing the rights of persons with disabilities.
 Some of this legislation prohibits discrimination as
its primary goal; other laws address the positive
duty of the State and the community to ensure
the welfare of persons with disabilities and their
access to social support
 Many countries have both types of legislation
The United Nations
 In December 2006 the United Nations adopted
The Convention on the Rights of Persons with
Disabilities
 The Convention is the first comprehensive human
rights treaty of the 21st century. As of November
2008, 41 countries have ratified the Convention;
many more countries have been signatories
indicating they are likely to ratify the treaty
 The Convention on the Rights of Persons with
Disabilities was historic in a number of ways – it
was the fastest negotiated human rights treaty
and had the highest number of signatories on its
opening day in U.N. history
Laws and Conditions
“On the Ground” Vary
from Country to
Country… So Know Your
Rights!
For example…
The Americans
With Disabilities Act
 The Americans with Disabilities
Act (Pub. L. 101-336) (ADA) was
signed into law on July 26, 1990
and was amended (P.L. 110-325)
in 2008, with changes effective
January 1, 2009
 The ADA is a wide-ranging civil
rights law that prohibits, under
certain circumstances,
discrimination based on disability
Other Countries Disabilities Acts
A number of countries have passed laws prohibiting
discrimination on the basis of disability since 1990,
and the model of the ADA certainly influenced many
of these laws
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For example, Australia passed a Disability Discrimination
Act in 1992, and Great Britain enacted its Disability
Discrimination Act in 1995
Each of these laws was affected, to a greater or lesser
extent, by the U.S. enactment of the ADA, and borrowed
concepts and language from it
Journal Article Excerpt: Disability Rights in the USA and Abroad - Robert L. Jr. Burgdorf
Other Countries Disabilities Acts
The British and Australian laws illustrate,
however, that various nations have followed
very different paths in passing laws that can
be loosely considered "ADA-like"
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The Australian Disability Discrimination Act is
extremely comprehensive, forceful, and specific
The British version of a Disability Discrimination
Act, in contrast, is much less broad, specific, and
substantial than the ADA
Journal Article Excerpt: Disability Rights in the USA and Abroad - Robert L. Jr. Burgdorf
The key to a safe and enjoyable
trip is preparation and planning!
Thank You!
Debra Karstadt
for your invaluable research and help
with this presentation
You need to be the
change you want to
see
-- Gandhi
Thank You!
Barbara Rogers
[email protected]
www.necaweb.org