Good Sam TravelAssist NOT SO GOOD

[Kruzianer]

Read this in the LATimes, 9/21/18, Business section by consumer Advocate/Reporter David Lazarus: The short version is that Travelassist denied her claim because she neglected to get prior approval for treatment in the middle of a medical emergency and stuck her with a $71,000.- air ambulance bill.
The long version, these two ladies were staying in a Mammoth Lakes, Ca RV park. One of them experienced some unusual symptoms and went to a Mammoth Lakes Emergency room. She was told it was life threatening. She was in no shape to make any calls. Local doctors couldn't stabilize her condition and decided to transfer her via air ambulance to Reno,NV. Her companion joined her for the trip and upon landing contacted Good Sam and was given a case number. After three days she was released and she and her companion rented a car to drive back to Mammoth Lakes, believing all would be covered by Travel Assist.During the drive back the Good Sam rep called to say their claim had been denied. No probs with the medical costs as those were covered by Blue Cross.Upon appeal she was told that she would have been covered had she called first to obtain prior approval and let Good Sam make the arrangements.(Note- how many of us in a half dead condition would make such a call?)When David Lazarus reached out to Marcus Lemonis, chief executive of Good Sam Enterprises he was told that Travel Assist
'isn't a reimbursement plan". The coverage is based on Travel Assist making all the arrangement rather than paying the member back. Tom Wolf, Chief Financial officer for Good Sam stated that a contract is a contract, no matter what. Wolf described Travel assist not as an insurance but as "an advocacy service" on behalf of Good Sam members. One bright spot in all of this is that when the RVer reviewed her claim with Blue Cross she was told that Blue Cross probably cover the air ambulance.Makes me want to rethink continuing my enrollment in Travel Assist.

[ThePowells]

I am reasonably certain that the GS plan would EXCLUDE emergency travel as A) the liability for contracting a medical helicopter would be enormous, B) I doubt the coordinator would even talk to Good Sam and refer them back to the facility that is treating them, and C) I doubt that any air service would take GS's credit card.



So, she is expecting GS to reimburse her $71K for a cost covered under BC/BS?


That plan is designed for medical transportation back HOME, or to a long term facility, not for emergency transportation between a primary care facility and a higher level care facility.



Granted, Ella has enough problems getting Gomer out to change a flat tire but would anybody reasonable expect GSRA to be able to dispatch a 12 million dollar helo?


Just somebody else looking for any reason to bash Lemonis and GS. Granted, if the next closest RV dealership had half of the product selection that CW (closest) has than I wouldn't shop at CW at all. It's just that sometimes you need something now, or you want to be able to put your hands on it just to make sure.


Nothing to see here. Just another side show.

[Kruzianer]

Perhaps if you read thru the plan you would discover that air ambulance is covered regardless from where to where. They even post a nice picture of a helicopter and the tag line 'emergency medical transportation' at the top of the brochure! Secondly the lady got the $71,000.- bill first. She was NOT expecting Blue Cross to cover the air ambulance bill. It wasn't until later when she reviewed her bills with Blue Cross that she was made aware by Blue Cross that they might cover it.
The point was if you're on your deathbed there's no way you're going to be in charge of your mental facilities to make a call to Good Sam and for GS to turn their back on this is BS!

[NYBobbo]

Yes, you should expect them to arrange for a helo if needed, it's in their contract. The issue is they never called travel assist. Even if they denied it at the time it would give reason enough to take them to court afterwards.


The fine print in contracts are written by lawyers to protect the originator of the contract. They make it in fine print just because most people don't read it.


I have to call my insurance people within 24 hours of getting admitted to a hospital or they won't pay. Unless I'm unconscious or someone else can't call for me - I notify them.


3 days and released seems a bit suspect - but then I'm not a doctor.


from description of plan literature:


MEDICAL EVACUATION AND REPATRIATION SERVICES
TRAVELASSIST Premier must arrange and WE must approve all arrangements for
the services described and defined in this section to be covered at no cost to YOU.
*Expenses incurred without our intervention or assistance are not covered.

[ThePowells]

Originally Posted by NYBobbo

Yes, you should expect them to arrange for a helo if needed, it's in their contract. The issue is they never called travel assist. Even if they denied it at the time it would give reason enough to take them to court afterwards.


The fine print in contracts are written by lawyers to protect the originator of the contract. They make it in fine print just because most people don't read it.


I have to call my insurance people within 24 hours of getting admitted to a hospital or they won't pay. Unless I'm unconscious or someone else can't call for me - I notify them.


3 days and released seems a bit suspect - but then I'm not a doctor.


from description of plan literature:


MEDICAL EVACUATION AND REPATRIATION SERVICES
TRAVELASSIST Premier must arrange and WE must approve all arrangements for
the services described and defined in this section to be covered at no cost to YOU.
*Expenses incurred without our intervention or assistance are not covered.

So lemme get this right.....


You are out running around the backwoods and manage to turn your Jeep toad over and suffer a serious injury that would make ground travel risky or medically impractical and the Paramedics on the scene determine that a hotload would be needed. That's when you whip out your handy dandy GS card and call Ella and request your own helo, rather than expect the medical PROFESSIONALS that are ON THE SCENE to request a helo from the appropriate Level 1 trauma center, or you are riding around and your GPS takes you the wrong way and your toad gets confused with somebody else's car you you end up the victim of a drive by and the hospital you are at decides you need to be transported, you call Ella?
How about you have a stroke and the facility you are at is a primary stroke center and starts the TPA protocol is Ella gonna know where the secondary stroke center is? What happens if she calls CMC looking for Charlie Mike 6 instead of Air Care 4 that is sitting on it's pad on the other side of the hospital and the flight crew can ride over on their golf cart and prep for transport while the aircraft is brought over?


Next problem will be getting a coordinator to even to discuss patient information with a road service provider. They kinda picky about that HIPPA stuff.

[Kruzianer]

You all need to reread what I posted. The lady was incapable of calling TravelAssist. The Doctors at the Emergency center determined she needed emergency medical assistance ASAP. The Doctors called the air ambulance. Her companion did call Travel Assist once they got to the hospital.

Quite frankly, I find it reprehensible to sell me this type of policy and then turn around in my dire hour of need and tell me that I've got to call first, then they will assist me making arrangements and then it's ok. By that time I might be dead ! So try not to muddy the waters with running around in the backwoods and all that garbage. Read the article yourself. I gave you the info where to find it.

[ThePowells]

Maybe reading the contract would have been beneficial. I like using the "reasonable person" standard as it is woven through so much that I do.


What reasonable person would expect that a road service provider can provide air medical transportation? What if they are in our ER and they call for a helo to UNC and they do call GSRA and Ella wants you to go to Vidant? Do you tell the Doctor that GSRA wants you to go to Vidant so you have to go there so you are going to sign out AMA and wait for Vidant? Where are they going to pick them up at? No helo is going to pick up a patient without a medical request and the request became void when the patient signed out AMA.

1) They entered a CONTRACT
2) They should have read it.
3) Any medical provider that will wait for a helo transport to be approved by a road service provider is a quack and criminally negligent for any further injury or complications of a delayed transport.
4) Any coordinator taking a call from GSRA is gonna

5) Anybody that expects different........ Well, first rule of the forum is play nice, so IMPO, not reasonable...

[Miamicamper]

yeah, I would totally think my health insurance would pick up the tab rather than Good Sam to begin with, although they did put that on the brochure so that was a bit misleading. But if it were me I would have just naturally assumed that my health insurance would cover it. I do think Good Sam needs to take that off the brochure because nobody in their right mind would call them in an emergency situation and they know it.

[hohenwald48]

From the Good Sam Travel Assist summary plan description. Page 2, left hand column about half way down.

"MEDICAL EVACUATION AND REPATRIATION SERVICES
TRAVELASSIST must arrange and WE must approve all arrangements for the
services described and defined in this section to be covered at no cost to
YOU.*Expenses incurred without our intervention or assistance are not covered."

Seems pretty plain to me. Good Sam Travel Assist did exactly what they were obligated and contracted to do. I know the OP doesn't like that but sometimes it helps to read contracts before the fact.

Here's a link if you want to read it yourself. The base plan and the premium plan both have the same wording -

https://images.goodsam.com/goodsamtr...escription.pdf

A picture of a helicopter on a brochure really isn't part of the contract. We must be living in Bizarroworld. I mean, here I am defending CW.

[ThePowells]

Originally Posted by hohenwald48

From the Good Sam Travel Assist summary plan description. Page 2, left hand column about half way down.

"MEDICAL EVACUATION AND REPATRIATION SERVICES
TRAVELASSIST must arrange and WE must approve all arrangements for the
services described and defined in this section to be covered at no cost to
YOU.*Expenses incurred without our intervention or assistance are not covered."

Seems pretty plain to me. Good Sam Travel Assist did exactly what they were obligated and contracted to do. I know the OP doesn't like that but sometimes it helps to read contracts before the fact.

Here's a link if you want to read it yourself. The base plan and the premium plan both have the same wording -

https://images.goodsam.com/goodsamtr...escription.pdf

A picture of a helicopter on a brochure really isn't part of the contract. We must be living in Bizarroworld. I mean, here I am defending CW.

Feels strange, don't it.

[egwilly]

This is why I throw all the junk mail from Bad Sam in the trash.

My opinion, yours may vary.

[Yosemite77]

Having read countless complaints about them in their forum over the years, why anyone would support the GS Club is beyond me. The only thing they can be counted on is to do what’s best for their bottom line, which of course comes at the expense of their customers.

[azpete]

this is a good reason to read your contract when you are in good health. when you are stricken, or ill, is the last place you should be trying to find out what is and what is not covered.
it is amazing to me how many people who never read anything until there is a crisis, and then ASSUME that everything is going to be covered.
i have had owners who didnt believe they had a 500 dollar deductible on their extended warranty, because the assumed it covered everything,
there are exceptions in every policy. and prior authorizations is one of the pitfalls that insurance companies take full advantage of. i have found that out several times. even in emergencies.
it pays to read.

[hohenwald48]

I just bought a new motorhome a few weeks ago. There are about a zillion documents you have to sign during that process. I read every one of them thru and thru.

I asked the paperwork guy how many folks do that. He said it only happens 2-3 times a year. Everybody else just signs.