In the last 5 years shipowners saved on average 50% on their crew medical bills with Future Care

If you are not using Future Care’s medical audit and cost containment services, you likely are paying more than you should for your crew medical costs.

For 23+ years Future Care has been helping shipowners and their P&I Clubs significantly reduce the cost of: 

  • Hospitalization
  • Emergency evacuation
  • Out-patient rehabilitation
  • Pharmacy and related medical treatment costs 

We accomplish this goal through specialized skills and services, including audit/forensic medical accounting, PPO network admission, PPO re-pricing, medical case management, utilization management, retrospective review and negotiation.

Future Care’s audit and cost containment services provide the shipowner and P&I Club with confidence that all treatment charged was priced cost-effectively, was medically necessary and actually provided.

Case studies

SAVINGS: $57,225.40 USD
Brazil: A crewmember was admitted with pneumonia, acute respiratory distress, sepsis, anemia, weakness, abdominal pain, rectal bleeding, and hemorrhoids and was inpatient for 57 days.

Future Care appointed a Nurse Case Manager to monitor and manage the care, who provided the ship owner and P&I Club regular updates throughout the hospitalization. Future Care also assisted with the repatriation arrangements. Upon discharge medical charges were reviewed as follows:

Initial Charges: $376,069.29 USD
Total Reductions: $57,225.40 USD
Total Amount Due: $318,843.89 USD (15% of original charges)
SAVINGS: $137.863.32 USD
Savannah, Georgia, USA: A crewmember was admitted to hospital with pneumonia and respiratory failure. Future Care appointed a Nurse Case Manager for status monitoring and to review care provided and cost.

Regular updates were provided throughout the hospitalization, from admission to discharge.

Initial charges: $384,987.14 USD
Total reductions: $137.863.32
Final amount due: $247,123.82 USD
Savings: 36% of original charges
SAVINGS: $65,369.60 USD
Greece: A crewmember was transferred to private hospital in a comatose condition (due to cerebral lesions) and was treated for a fungal cerebral infection.

Due to the rarity of the crewmember’s condition diagnosis was difficult and so Future Care’s Medical Case Manager retained infectious disease specialists to consult with and review the hospital’s treatment team’s initial diagnosis.

The medical case manager engaged the microbiology laboratory of the University of Athens to analyze blood samples and assist in the resulting diagnosis of the crewman’s condition. The crewmember developed a pulmonary embolism and pneumonia while hospitalized, for which he was treated successfully.

During the lengthy hospitalization, of over 110 days, Future Care’s Medical Case Manager closely monitored and managed treatment.

Initial charges: $326,848.00 USD
Total reductions: $65,369.60 USD
Total Amount due: $261,478.40 USD
Percentage of Savings: 20%
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How we achieve savings

The sooner Future Care is alerted in a medical situation, the more likely it is that we are able to control costs. When vessels are enrolled in our Caring for the Crew Program, we manage the case on behalf straight from the onset. 

Savings are achieved in the following ways:   

Our expert team of physicians, accounts and numerous other specialists are specially trained to review maritime medical bills.

Line-by-line they review all charges, against the services rendered, paying particular attention to:

  • Overpricing 
  • Duplicate charges 
  • Mispriced charges 
  • “Unbundling” (billing separately for procedures customarily billed as one, at a lower cost)
  • Any other errors which may inflate the bill 

Future Care’s medical auditing process is completely transparent to the client. Our team does not accept summary charges from middlemen and insists on original billing directly from the provider. 

All final recommendations for audit re-pricing to the shipowner and the Club include copies of the original invoices from the treatment providers.

Our PPO network (in the U.S. and a limited number of other countries) gives customers significantly discounted medical fees – with savings in excess of 50% or more for the shipowner and the Club in the U.S.

When Future Care is involved in the medical incident from the onset, through our Caring for the Crew® program, we can steer the crewmember to an appropriate network facility and, in most instances, secure these favorable fees before or upon admission. 

The ensures not only medical pricing is more predictable but the outcome is also more certain.


Future Care’s access to Preferred Provider Organizations (PPO) enables the shipowner and/or P&I Club to obtain, when available, the steeply discounted rates/fee schedules hospitals and other medical treatment providers accept from the large United States health insurers. Even if a shipowner has not yet enrolled in our Caring for the Crew® program, Future Care can conduct a post-discharge audit and, where available, attempt to obtain PPO re-pricing.

In the United States, access to PPO rates can result in savings of 50% or more. Uninsured patients in the U.S. pay the highest rates for hospitalization and related medical services; the health insurers pay the least. A crewman without personal, U.S. health insurance is likely to be charged the highest rates. P&I insurance is not personal health insurance and the Clubs are not “health insurers”. 

Future Care’s independent network of PPO providers offers the shipowner and Club the greatest opportunity to favorably re-price post discharge medical bills at greatly reduced PPO rates, as if the crewman had the relevant personal health insurance.

Future Care’s team of specialized medical auditors understands how hospitals, physicians and medical providers around the world calculate their fees for services. 

With this understanding comes the ability to negotiate knowledgeably and professionally with the hospital and/or physician billing department, whether located in Balboa or Bremerhaven, San Diego or Shanghai. 

Negotiation includes such benchmarks as the facility’s/physician’s compliance with compulsory or agreed rates, customary and usual and customary billing, provider cost basis, medical necessity and treatment “unbundling,” among many other relevant medical and accounting issues.

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