I guess I was lucky both times I needed medical attention while on a GCT trip. The first, was on Eastern Europe to Black Sea, when I got food poisoning after a home hosted dinner. Not sure why I got it when my husband ate the same thing. It happened on the ship, and by midnight (we sailed a lot earlier), I was already dehydrated, but Admin Office said I had to wait till morning. I never stopped with the symptons all night, tried to drink water, not good! An hour or so before docking, the front desk called to say a doctor was coming on board to see me. He promptly got on board as the ship was being tied up. Gave me 4 bottles intravenous , confirmed food poisoning, medication, a prescription, and stayed with me until he noticed I was on the mend. Payed him cash, then filed with Trip Mate when I returned home, and they paid in a few days.
The second time was on Russia on the Volga River (or something like that), on my last day I noticed my hand and arm turning purple, fading, coming back, traveling to other arm, etc. I knew immediately it was related to the blood thinner I was taking. At the end of the day tour, at about 5 PM, that night; didn't even have dinner, I was taken by ambulance to a hospital that is for English speaking people The doctor was a Rusisian American who had studied in New York, got citizenship, then returned to Moscow to set up this hospital. Great service, he called in specialists, I saw two of them, had lab work, EKG, and other tests, I paid with credit card over $1200. When I got home I filed with Trip Mate, calling them first, and there was no delay in getting my check. Maybe the difference is I don't have a Medicare Advantage Plan, I did ask Trip Mate if I had to file with Medicare first, which would be sent to my secondary, then an EOB to me, even though they wouldn't pay. Trip Mate told me no need for that, they just paid me.