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Emergency on assignment: surprise diagnosis far from home

International private medical insurance (iPMI) isn’t just about ensuring access to overseas health care or cover in the event of a medical emergency.

Great insurance providers make sure they offer a range of benefits covering every stage of a trip, from initial planning right through to the return home. They understand that people travelling overseas are looking for total peace of mind, wherever they are in the world, and whatever they’re doing.

“Local doctors were concerned about a skin condition she’d had since her arrival and decided to do a biopsy”

For global insurance companies like Aetna International, with members living and working in locations all over the world, this means looking after people travelling to and from economically diverse countries. Sometimes those members travelling from less developed areas to countries with higher quality health care systems can discover previously unidentified medical problems.

With iPMI in place, members can be assured of getting the medical support they need while they’re overseas, with the security of knowing that someone is there to handle the logistics of their treatment when they return home. Which is exactly what happened to South Pacific based missionary, Sister Anne*…

Dangerous diagnosis

Travelling to the United States from her remote island home, Sister Anne had been assigned to work with others in need through a faith-based non-profit organisation based in Utah. Near the end of her mission, local doctors were concerned about a skin condition she’d had since her arrival and decided to do a biopsy.

The surprise diagnosis was leprosy, a disease that’s been nearly eradicated in the United States but remains widespread in certain pockets of the world. To complicate matters, leprosy isn’t always easily detected or treated properly — especially in developing regions without access to quality health care.

Intolerable treatment

In Sister Anne’s case, she started on the treatment regimen recommended by consulting specialists in the United States, but soon found that she was not able to tolerate the standard leprosy medication.

After weighing up the alternatives, her doctors decided that the best remaining treatment option for Sister Anne would include a long course of thalidomide — a drug that is best known for causing birth defects in the 1960s and is now strictly controlled on a named patient basis.

Complex care

But complications soon arose when discussing Sister Anne’s return to her home country and her access to treatment there. This resulted in a call to Aetna International, the non-profit organisation’s global health insurance carrier. Aetna International’s Care and Response Excellence (CARE) team assessed the situation. CARE’s clinical team was told that Sister Anne’s complex medical conditions required treatment with five over-the-counter and 13 prescription medications — yet access was a real concern.

“The only provider willing to be trained in thalidomide administration was in Fiji."

In her home country, it was common practice for a central hospital to distribute medicine to outer island clinics through irregular shipments and local ferries. And since there were no approved thalidomide providers in the South Pacific, a prescribing physician affiliated with the dispensing pharmacy would have to enrol in an educational programme and receive training by the thalidomide manufacturer.

Right to remain

James an experienced CARE clinician, got to work on this complicated situation. He soon found that the only provider willing to be trained in thalidomide administration was in Fiji. This meant that Sister Anne would have to make a difficult day-long trip each month to continue her treatment. After extensive consultations between James and various medical professionals, it was decided that she should instead remain in the United States until her thalidomide treatment was complete.

“James coordinated with Aetna’s contracted suppliers to fulfil the complex needs of Sister Anne’s treatment”

James worked with Sister Anne’s non-profit organisation and the appropriate authorities to get the approval needed to extend her stay for medical reasons. Once her thalidomide regimen was completed, Sister Anne would need 11 other medications shipped to her home.

Over a six-week period of focused collaboration, James found a solution. He was able to coordinate directly with Aetna International’s contracted suppliers, who ship outside of the United States, to fulfil the complex needs of Sister Anne’s treatment. This included arranging for one type of medication to be shipped to Sister Anne’s home country from Switzerland.

Safe shipments 

Several months later, Sister Anne reported that she was managing her condition quite well from home. She said that this was due to the convenient access to the shipped medications, as well as the follow-up consultations and care she received from James and her health care providers in the United States.

For Aetna International members, this type of personalised assistance and intervention is at the heart of the service. The CARE team is accustomed to going above and beyond to provide the one-to-one support members often need when living in an unfamiliar region.

End-to-end support

Sister Anne’s case was unusual in that her condition was discovered some time after arrival in the United States, and subsequently passed through to Aetna International. Ordinarily, our members benefit from a programme of health checks and assessments in the planning stage of a trip. This would have identified the illness earlier, allowing treatment to be organised before travel.

“Our clinicians listen to members’ concerns, help them with access to care and resources, and serve as their advocates”

Our members also benefit from ongoing health care throughout their trip mdash; including clinical health care, medicine transport and treatment of chronic conditions. Meanwhile, members whose employers have opted for a plan that includes Employee Assistance Programme (EAP) have access to practical help and well-being services for people settling into a new life overseas. And in the event of a major emergency, such as a natural disaster or terrorist attack, our crisis management partners, red24, are on hand to support members who have opted for a plan that includes red24’s ActionResponse services.

“We are there for our members before, during and after their trip — no matter where in the world they go,” says Stella George, Aetna International’s Head of Americas Care Management. “We do so much more than helping our members understand their benefits and find quality health care providers. Our clinicians listen to members’ concerns, help them with access to care and resources, and serve as their advocates. In short, we offer whatever one-on-one assistance is needed to ensure our members get the right care, at the right place and time, so they can successfully complete their assignments and thrive.”

For more information on the health care benefits and services available, please contact one of our expert sales consultants.

*Names have been changed to protect the privacy of our staff and members.

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