This is what happens, when you have full insurance, and your husband has a Heart Attack in Jamaica.

Before you read the Blog below, please know this:

Couples Negril, Air Canada Vacations, Island Routes (the team that represents Air Canada in Jamaica) and the University of West Indies Hospital - Tony Thwaites Wing and Dr Raquel Gordon all went above and beyond in the care of my Husband, and of me while I frantically tried to get him proper care through my Out-of-County Emergency Medical Insurance.

This is not an insurance issue, a resort issue or a destination issue. It is the Spanish owned Hospiten group of hospitals located in several popular tourism destinations. Jamaica, Dominican Republic, several locations in Mexico and in Spain.

They are a cash for care business and WILL NOT accept any out of country medical insurance. Period.

The on site Doctor/Omega Health, the Transfer Service and the Hospiten Group of Companies in partnership with the Heart Institute of the Caribbean are the people we take issue with. Omega Health demanded cash for the resort Nurse and Doctor Care, even WITH my out of country Medical Insurance in hand, while we were being transferred to Montego Bay. Hospiten held my husband captive and withheld proper care for OVER three days until my insurance company was able to make alternate arrangements. The Cardiologist at Hospiten refused to transfer him to "The Heart Institute of the Caribbean" where she has privileges until $53,000USD was paid in advance. Once they knew we were going to another hospital, a Further $10,000.00 USD was demanded before they would release him from Hospiten in Montego Bay.

As a Senior Travel Advisor, this is very disturbing to me as I am mandated by the Travel Industry Council of Ontario (TICO), to advise every client that they should not travel without Insurance Coverage. I sell Insurance to Ontario clients, with the belief that if they get into medical trouble, they will be taken care of. In most circumstances, this would be the case, but with the dawn of this "Medical Tourism" business model - they will not accept insurance, ANYONE's Insurance. Cash or Credit card is the only acceptable means of getting the care we so desperately need when in such a vulnerable situation. I am an agent, I KNOW what to do, and did it, but still got caught in this crazy life or death struggle.

What is worse, is that both my Husband and I called the Canadian Consulate in Kingston Jamaica, separately, begging for help. We both left messages, and to this date, neither of us have had a response of any kind.

The blog was originally written in a proved Agent Only group. Until I knew what was happening, I didn't want to panic our family - and simply didn't have the energy to deal with the inevitable outrage.

The Blog:

This is what happens, when you have full insurance, are a senior travel agent, and your husband has a heart attack in Jamaica.

We are in Negril Jamaica, at the Couples Negril Resort for some much needed R&R. We arrived on Friday, for five nights of romance and relaxation, but things didn't exactly go as planned.

Monday 555pm, The husband is having tightness in his chest and down his arm, he runs into the bathroom, is vomiting, and asks me to call for help.

Monday 6pm. Call to front desk to ask for ambulance, husband showing classic signs of heart attack, the Nurse arrives (Omega Health is the company who runs the nursing area), calls the doctor. I call my Insurance.

Monday 7pm. After doctor is called, comes, checks him out, ambulance is finally called.

Monday 715pm - On the way to hospital in the back of an ambulance, nurse argues for 20min that she needs $300usd UP FRONT cash to pay for ambulance ride. (She has already noted our insurance information, I have already talked to insurance to open claim and advise we are on the way to the hospital). Her company, she explains, demands this as policy. She is mandated to get the money as a part of her nursing position. She takes his BP, on an old style BP Gauge but does not have a stethescope to listen. (Jesus) I refuse citing insurance coverage, and what cash I have I know I will need for the two hour drive back to Negril from Montego Bay.

Monday 900pm. We arrive at Hospiten in Mobay, nurse who was with us from resort (Omega Health) tells us that hospital will not see husband until I provide $4000USD by credit card. (Don’t have one). I call insurance again, they get all info, provide guarantee of payment, emails are sent, Hospiten says they have not received (still no care for husband, he is on a stretcher in the hall), I call insurance again. They assure me it has been sent, I ask them to resend to MY email, I forward to Hospiten. The receptionist now advises that the computer at front desk is apparently having trouble receiving emails, finally I convince them to go check another computer. Finally husband gets more pain meds (10pm)

Monday 1100pm, Husband is transferred to ICU, Hospitalist Doc And Cardiologist arrive to assess. Care plan is they will transfer to Kingston to the Heart Institute of the Caribbean as Mobay Hospital does not have the facilities to do Angiogram. I call insurance again, they authorize this treatment. ICU kicks me out saying visiting hours are 5-6pm for 1 hour, and I cannot stay there - they do not have anywhere I am allowed to stay onsite. They tell me they will be transferring him first thing in the morning. Cardiologist at Hospiten advises that when they transfer him, she will travel with him to Kingston along with a nurse, so there will be no room for me in the ambulance. She will be the one that performs the Angiogram in Kingston.

Tuesday 100am, back in Negril, alone.

Tuesday 730am I text husband to ask if they have a time they will take him to The Heart Institute of the Caribbean in Kingston. They again tell me I cannot travel with them, but they are feeding him breakfast (?) and will take him afterward.

Tuesday 900am, no word on what is happening. Husband advises ambulance is coming soon. He is loopy - I ask him if he is on pain meds, he is not sure. (?)

Tuesday 945 am, I am told they don’t know when transfer will be arriving as approval from insurance company did not get sent to The Heart Institute of the Caribbean from Hospiten. Hospiten says nothing, but advises insurance company needs to contact The Heart Institute of the Caribbean in Kingston.

Tuesday 946am I call insurance to find out what is happening and why the delay. They tell me they provided authorization to Hospiten for the Angiogram. I advise them that The Heart Institute of the Caribbean in Kingston hospital wants paperwork from them.

Tuesday 1155am, The Heart Institute of the Caribbean in Kingston calls me directly to advise forms sent from insurance are not as they require, insurance company needs to approve an itemized list of procedures etc. and can I provide $10,000.00 usd, deposit so they can send ambulance. I call insurance company FREAKING out asking them to call The Heart Institute of the Caribbean while I wait on hold (special skill learned as travel agent) for almost an hour. Insurance assures me they now have all info. Transfer is happening.

Tuesday at 137pm, hospital in Kingston calls again, to advise that they now have all of the correct paperwork, but still demand a $10,000.00 usd credit card, even though they have the guarantee of payment from insurance.

Tuesday 139pm, I call insurance to advise of this new requirement. (Kingston hospital says they knew all along, insurance company denies knowledge, but surely this can’t be first time anyone has needed assistance from this hospital?) Insurance company tells me they have some options, and will call me back.

Tuesday 253pm, nobody calls from insurance, so I call again. They tell me they are contacting a company local to Kingston Jamaica, who they hire, to make payments on clients behalf, they have been advised of the $10,000USD required, and will make the payment. (SunMed)

At this point, Husband is still in pain, but at least being monitored in ICU in mobay. I am beside myself as this is more about cash, and nobody is taking a “patient first” approach.

Tuesday 318pm, insurance calls back to tell me that the process has started.

Tuesday 715pm, husband calls (and I speak with docs), The Heart Institute of the Caribbean in Kingston called Hospiten in Montego Bay to advise insurance payment has not been approved. (It was, but payment email notification of $10K has not been confirmed as received).

Tuesday 720pm, another call to insurance, The Heart Institute of the Caribbean in Kingston says they need email confirmation with receipt that payment has been sent. Insurance advises they are unsure what they want, company that has been hired to make payment has done so. I tell insurance to please call The Heart Institute of the Caribbean in Kingston to find out if received, AND I WANT A TIME that ambulance will arrive to get husband. Or, can they please arrange a medical transfer back to Canada for proper care of husband. (Begging - crying - desperate for help). Insurance tells me they will sort out and if they see email confirmation of receipt of payment before shift end (11pm) he will call.

(No call).

Wednesday 600am I call insurance to find out what is happening and is ambulance on way for transfer. They don’t know, but assure me it is happening. I press, wanting to know if email of confirmation has been sent. He puts me on hold, calls hospital, no confirmation. He advises that company hired to make payment, did so. I ask him to call and confirm, and call me back. It’s 9am. No call, no care for husband. I am here in Negril, at fabulous resort, they are taking the very best care of me, but husband needs angiogram, stent and possible open heart surgery, but care is being held ransom to $10,000 usd. Insurance blames lack of action on The Heart Institute of the Caribbean in Kingston, and The Heart Institute of the Caribbean i points finger right back.

Every time I call insurance I need to start again advocating for him, beyond frustrating. On hold again.... I have no idea, how our clients, would be able to negotiate this, even with the very best insurance, which I have.

Wednesday 931am. I ask insurance again for a time that husband will be taken to Kingston, or that they provide medical to Canada (SECOND REQUEST). They advise company that was hired to make payment has not confirmed with receipt. They assure me (again) someone will call in an hour with an answer. We are now going on 36 hours.

Wednesday 1230pm. Nobody called me back in an hour as promised. I called the husband to check on him, and to see if he has seen the doc yet today. He remains in icu in mobay, seems loopy still but he says they have cut back morphine (?). I called insurance again, re-explained what we need and why, they again tell me they are working on it. I am now begging them (again) to get us the hell out of here and back to Canada by whatever means necessary. They have many words of platitude and sorrow mixed with promises of everything will be ok, we are working on this. I am silently calling bullshit. Fingers crossed THIS time they will get him there for angiogram/angioplasty.

Wednesday 12:14pm. Husband called to advise the cardiologist stopped by to let him know he will be transferred to Kingston tonight, or possibly tomorrow morning. No exact timing. I am assuming this means Kingston hospital has acknowledged the receipt of 10k, and has put a plan into action. No call from insurance. Curious.

Wednesday 156pm. Insurance company called to advise they will transfer him tonight or tomorrow. Apparently the 3rd party who is hired to provide payment to the Heart Institute of the Caribbean is also the ones organizing the patient transfer to get him to Kingston. This makes me a bit happier as at least it is in the control of the Insurance company and not a ping pong game between the two hospitals.

Wednesday 254pm. Husband calls to advise cardiologist wanted to talk to me. Apparently she has not been notified when/time, is NOT happy and this information is something she needs to know in order to prep him for transfer. She will also be travelling with him to do the procedure (that is GOOD NEWS). SO, another call to insurance to find out what the hell. They assure me that everyone knows, (We know the hospital knew it was happening, just not WHEN) but hospital possibly not relaying info to doc?

I have to tell ya, I LOVE Jamaica, but their communication skills at the hospitals could use a little work.Certainly they do not play nice together in the sandbox.

Wednesday 456pm. Insurance called to update on transfer to Kingston. The hospital that Hospiten was trying to transfer him to is the Heart Institute of the Caribbean. This hospital is the one who was demanding $10k USD deposit along with insurance co. guarantee of payment yesterday. Last night they received the $10K USD from my insurance company. This morning they told insurance they wanted a further $10K USD to be paid upfront by credit card, which they provided. (This has since been confirmed as a Demand for payment from Hospiten before the Husband can be discharged from Montego Bay). This afternoon, after another chat with Insurance as to why nothing was moving, they tell me that the Heart Institute of the Caribbean now wants a further $43K USD so that the angiogram/angioplasty is paid in full before they will accept my husband as a patient. Insurance company will guarantee payment, has already provided $20K USD but will not pay in advance the further $43 K. (I can't say that I blame them). This hospital is beyond unreasonable, I question why they didn't just come out with this demand Tuesday morning from the get go? As it is, they have wasted 48hours dicking around at my husbands expense. My guess is, I will need to ask the local newspapers that question.. In the meantime, they are trying to arrange transfer to another Hospital in Kingston called The University of West Indies Hospital, stay tuned. The good news is, husband is stable and grumpy but ok, but still in ICU. And Couples Negril has offered to take me to Kingston from Negril when I need to go.

If you have never booked couples resorts in Jamaica, they are amazing resorts, you really should check them out.

Wednesday 743pm. The transfer ambulance has picked him up and taken him to new hospital in Kingston. University Hospital West Indies, Tony Thwaites Wing. They have reviews all of the med files and have accepted insurance company guarantee of payment. Tomorrow they will do the angiogram to see where we go from here.

Thursday 817am. The transfer to Kingston did indeed happen last night, unfortunately I am still in Negril until I am told if they will return him to Montego Bay, or if they will keep him in Kingston. either way, they won’t let me see him. They are prepping him later this morning, and anticipate the angiogram to happen early this afternoon, then I will know more as to the damage, and if they can fix it. Right now the husband is comfy, able to wander about, he tells me there is AC and a TV in his room, and the hospital looks brand new.

I want to thank all of you for your good wishes and comments. My family and friends are sheilded of this, so having a place to throw all of this information has been a godsend to me. They don’t need to know the minute details, mostly because I simply don’t have the energy to deal with their outrage. Most are not travellers, so think all things work the same outside of their cocoons. So, thank you.

People have inquired as to who the insurance company is that is covering us. Although there are times when I felt their follow through was not good, they were acting in good faith to provide The Heart Institute of the Caribbean what they had asked for.

Each and every time we sent them what they asked for, paperwork, more paperwork with guarantee of payment, a call to me to demand 10kusd from me personally (denied) a further call to demand 10k usd from the insurance company (sent) a call to me to demand the email receipt that the transfer had been sent, a call to me from Montego Bay hospital advising that the heart institute advised that the insurance company did not approve surgery (false), a further demand for a second payment of 10k usd (sent), a call from cardiologist in Montego Bay (who happens to have exchange privileges at heart institute - curious) advising Kingston hospital has not advised of transfer, a further call to insurance fro Kingston demanding $43k usd for full payment of surgery not yet done. (Denied - understandably)

The culprit in all of this lies squarely with The cardiologist and the Heart institute of the Caribbean. Collusion and Extortion are two terms that come to mind. Preying on people when their families lives are in jeopardy, and in their weakest moments. Unforgivable. They took a full 48 hours to purposely delay proper care for my husband in the name of the almighty dollar. Shame on them.

So, now I wait for news from Kingston, then change flights back to Toronto (if I can). Stay tuned.

Thursday 741pm. Husband had surgery this afternoon, one stent put in and he is resting. I go to Kingston in the morning. THIS hospital (University Hospital of the West Indies - Tony Thwaites Wing) is dealing with insurance exactly as we expect, they have guarantee payment from insurace and hit the ground running when he arrived last night.

As an aside, Hospiten demanded full payment in Montego Bay, before they would release him to be transported to Kingston from insurance company - which they did. Read: RANSOM.

Friday 456pm. I am finally in Kingston, checked into a not-so-secure-hotel, and hugged my husband for a long time. Husband is no longer hooked up to IV, is wanting to get the hell outta here and home to Canada. The hospital (University Hospital West Indies) has done everything he needed, he is being well taken care of, and now we are just waiting for doc to come in to see us (me) to fill me in on how long he has to be in hospital/country before he can fly. As I re-read everything, I am glad that I did this, it helps me keep events in order. When we get back to Canada, I have some letters to write and phone calls to make to be sure this does not happen to anyone else. Thankfully I am not shy and have no issues climbing aboard my soap box to yell loudly.

Friday 842pm Dr Gordon was in, she says he is stable, wants him to stay in hospital til Wednesday, and fly home Wednesday afternoon. I am talking with Air Canada Vacations to see if we can avoid the 3hr trek to Montego Bay, and fly out of Kingston instead. Insurance company needs to agree to Wednesday to fly out, so we wait until they approve. Tired girl, I go to bed now. I may actually sleep now that they are working on a “go home” plan. Interesting chat with his doc, she had heard of similar issues, but never this bad and encourages me to report to authorities once we get home.

Monday 919pm. Insurance company and Doctor finally agree that Husband will be "Fit to Fly" on Thursday. Since last Friday I have found out a few more details. Hospiten in Montego Bay didn't put husband on any beta blockers - at all - so it is possible this may have caused further damage in his heart. I'm told this is supposed to be a standard treatment, so will have to follow up when home. They also had him on Xanax while at Hospiten in Montego Bay, not sure what the purpose of this was - other to keep him compliant and floppy. No wonder I thought he was a bit loopy. Thankfully I am now in a more secure location in Kingston Jamaica - and have found myself a driver to bring me back and forth to the hospital. One other curiosity, BOTH my husband and I called the Canadian consulate in Kingston Jamaica, left frantic messages begging for help. NEITHER call has been returned.

BUT - We are OK, and heading home soon. *heavy sigh*