Emergency Medical Evacuation

I am going to Guatemala for a month of Spanish immersion this November, and then I am flying to PR for six months (I rent an apartment in Rincon year round and split my time between NJ and PR). While researching travel insurance for Guatemala it occured to me that I should get it for my six month stay in PR. My main concern is getting good medical care in case of a medical emergency, and in medical evacuation in particular. What I'm concerned with is how likely and under what circumstances would a travel insurance policy go along with an emergency evac from PR to the USA. The policies generally state that it must be ordered by a physician (oh right, I am so incompetent that I can't treat Vic so I think he should be air lifted to Morristown, NJ where they have real medical care [I am a little over the top here, but I hope you see my point]) and if the treatment needed cannot be obtained locally (do read my entry in the referenced thread below, bottom line is I medvac'd myself out of PR to NJ after going to the emergency room 3 days in a row at what I was told was a good hospital, Bella Vista in Mayaguez).

There are several threads on this forum addressing medical care in PR. This one contains a summary of a serious problem I had, please read it if you can before going on, or at least read my entry:

https://www.expat.com/forum/viewtopic.php?id=359991

I'm looking for your experiences, thoughts and opinions about the efficacy of emergency medical evac using travel insurance (I'd love to hear from anyone who has been medvac'd out of PR or knows someone who has). And while we are on the topic please share your list of hospitals/doctors to use or stay clear of. I know this is a well worn topic, but it remains absolutely important.

I'm very interested in this post, hopefully, some good information will come out of it!

I haven't had any experience with any emergency evacuation from PR, but I did run into a slight problem when trying to get emergency evac insurance for a trip to Europe. The tour company I used recommended several companies, and none of them would insure me because I was a resident of PR. I never did find out what the reason for not covering PR is. I was told "we do not cover your country at this time." So, I finally found a company through the worldnomads.com website - one based in Denmark. Two restrictions were noted with this policy: 1. I was not covered for anything while I was in PR (This may have been because it is my residence.); and 2. They do not cover anyone over 66 (Not there yet, thank goodness.)  This info doesn't answer your question, but may indicate that insurance companies have questions about PR. The age cut-off I suppose is just protecting themselves against the odds.

Of course, if I had a problem serious enough to require an emergency evac from overseas, I would not want them to ship me back to PR.

vkbudd - I have studied World Nomad travel insurance and it is in my very short list of policies to purchase. I discovered it via the excellent travel site http://alittleadrift.com/ Shannon has used WN since 2008 and highly recommends it - however she has never had to use it - and reviews from people who recommend a travel insurance and have never used are useless to me because the proof in the pudding is the (neg or pos) experience of someone who HAS used it. This is my motivation for starting this thread - I want to know what happens when a person has a medical emergency and tries to use the policy.

Vkbudd - to correct your info about WN: (1) their age cutoff is 70 and not 66, (2)  they will insure a resident of PR who is planning a trip to Europe. To verify this got a quote using their website (worldnomads.com) for a residentof PR traveling for one month in Europe: $132 (for one person). Also I believe that you can choose where you'd be evaced to so you wouldn't have to go to a PR hospital. As an aside I understand that medical care in Mexico is excellent in large and small hospitals and there are  top of the line hospitals in Cancun and Mexico City. Also a physcian I know told me that the hospital in Ponce (PR) is excellent.

I've come to some conclusions since I started this post. The major factor is the quality of the management of the medical emergency by the insurance company. I called WN to ask questions about their policy and I was quite pleased with the knowledge, attitude and response. Apparently a medical assistant is assigned to your case and the quality and expertise and effectiveness of that person is critical. He/she will coordinate and arrange services and be your life line.

Getting your ducks in a row is also important. I'm going to Guatemala. Now I suspect that NM will know which hospitals are the good ones. But I plan on doing research to determine which hospital(s) are the best ones so that I can request an initial evac to a good hospital in Guatemala if needed.

Anyway, I hope that someone who has been through the evac experience, or any experience with travel insurance, will respond to this thread.

Oh sugar! I took a second look at NMs policy for PR -> Europe and the age cutoff IS 66. Wow! However for my trip to Guatemala with residency in the USA (I don't pay attention to the number of day I live in the USA or PR, I just maintain my NJ residency, and I know you don't have this option) the age limit is 70. Hmmm.

Then for my Guatemala trip I changed my residency from the USA to PR and low and behold the cutoff age changed from 70 to 66! I'm going to call them at ask why! PR seems to get screwed no matter what. I am simply astounded by this. What does this mean? The if one is a resident of PR they think one is more prone to having a medical emergency?

An addendum. I went to the NM site again but indicated I was a resident of Guatemala and would be traveling in the USA for one month. Age limit: 66!

Then I indicated that I was a resident of England and taking a one month trip to Guatemala. Age cutoff: 66!

Seems that if you are a resident of the USA age cutoff is 70, otherwise age cutoff is 66. Wow!

Wow, how strange is that?