Medical Insurance for Travel outside US- Suggestions

[Muirgen Afloat]

We are getting ready to start our journey down the coast to the Sea of Cortez and then eventually through down to Panama, through the canal and into the Caribbean.
I've done some looking into medical insurance mainly for major emergencies as from all the feedback I've gotten it's cheaper to pay out of pocket on the small stuff if you need a doctor.
But I'm just overwhelmed with everything. Does anyone have experiences or have medical insurance that they would recommend?

Also what first aid kits are you carrying aboard? Looked at several threads, but most the links didn't work anymore. We've got a kit that came with the boat and have some of our stuff we brought, but want to make sure I'm not missing something I should have. Thanks.

 

[tiltrider1]

I am not much help here. When I go Paragliding in Costa Rica I have always used RoamRight for my insurance. While I have never made a claim I know others who have and commented on the quality of response.

RoamRight is highly respected by adventure sport travelers. I have no idea how it would work for you.

 

[Comodave]

DAN, Divers Alert Network, has insurance for medical evacuation. I don’t believe it is actual medical but rather it covers getting you home in a medical emergency. I really don’t know much about it so don’t take my comment as a recommendation.

 

[guy with a boat]

Try GeoBlue. It’s the travel insurance affiliate of Blue Shield.

 

[Muirgen Afloat]

I am not much help here. When I go Paragliding in Costa Rica I have always used RoamRight for my insurance. While I have never made a claim I know others who have and commented on the quality of response.

RoamRight is highly respected by adventure sport travelers. I have no idea how it would work for you.

Thanks I'll look into it.

 

[Muirgen Afloat]

DAN, Divers Alert Network, has insurance for medical evacuation. I don’t believe it is actual medical but rather it covers getting you home in a medical emergency. I really don’t know much about it so don’t take my comment as a recommendation.

Thanks I'll check it out

 

[Muirgen Afloat]

Try GeoBlue. It’s the travel insurance affiliate of Blue Shield.

Thanks, I'll check it out.

 

[Hippocampus]

Having cruised out of my home country have had medivac insurance. Things to think about

Most companies only offer medivac if the commercial major airlines are running. At the beginning of Covid this was an issue for us. Similarly with any civil unrest or major weather event it’s not unlikely that such insurance would not be operational.

Companies offer multiple levels of intervention. Some include prevetted local providers, local stabilization for transport, or other local services. Some do not and only offer transport to your home country.

Transport varies as well. Some offer transport to the closest provider in your home country. Others offer increased choice up to and including transport to your choice of provider. Some have a designated provider in your home country. Not uncommonly a level 3 trauma center such as U of Miami for the Caribbean.

They also vary in support during transport from nothing, to a RN to a trauma team.

In short you get what you pay for. But you need to carefully read the fine print, assess your risks and risk tolerance and your budget. Cruising in Europe presents different risks than cruising where health care is sketchy at best such as the Windwards or western Caribbean.

I had a wound that resulted in sepsis while in Grenada. I flew home after receiving inadequate care there. I knew it was inadequate due to my being an M.D. I ended up In surgery immediately upon arrival home and then 4 days in hospital. Then months of after care. Not unlikely without my background I’d be dead.

Wife fell 12’ off a ladder trying to put the boat to bed. Suffered ankle fractures in three places. Also ligamentous injuries to her hip. Also received inadequate local care. Evacuated and saw ortho at local, home tertiary center. Prior inventions undone. New interventions undertaken. 5 months of Rx. and rehab.

If you cruise long distances eventually you’ll get sick or injured. Most will be minor but some significant occurrences aren’t unlikely. It’s a crap shoot. Got excellence care for a bizarre fungal inner ear infection in BVI (probably from diving). Physician British trained. Multiple times have had to personally direct care as provider was less knowledgeable than myself. Wife’s an RN and I’m a MD so not the typical patients. Would suggest it’s equally if not more important for cruisers to be educated. Anything is better than nothing but a brief course in wilderness medicine supplemented by reading about local regional health issues (especially important for the tropics) is very much worthwhile.

 

[Larry M]

We had international health insurance though IMG for 7 years. We had to stay outside the US for more than six months but could seek treatment in the US. We had a $55K claim. We paid the deductible and never saw a bill after that. They have multiple plans but are picky about preexisting conditions.

https://www.imglobal.com/international-health-insurance

 

[Larry M]

Before we left on our trip(s), we worked with our doctor in Seattle to put together recommended medications. The list was pretty extensive including lidocaine and Ringer’s lactate. We never had any issue with our prescription drugs in other countries. We did keep a hard paper inventory.

Antibiotics and some other medications that are prescription in the US were sometimes over the counter in other countries but it wasn’t always convenient when you needed them.

 

[lwarden]

Arno Chrispeels specializes in medical coverage overseas. He has a number of cruisers as clients and represents GeoBlue. Arno travels extensively in Baja and knows the medical system well down there.

arno@healthisinternational.com

 

[Hippocampus]

Important point in post #11. Telemedicine has gotten quite good. Multiple ways to achieve it but all need before hand set up. All require having appropriate supplies as as well. We divided ours into
Accidents, burns and poisoning
Allergies and autoimmune
Infection
Metabolic and vascular volume support
Surgical and orthopedic
Cardiovascular
Given current offerings would add a defibrillator as well

Kits were made up to be congruent to past medical history. Detailed PMH of all crew was obtained prior to transit.

 

[Muirgen Afloat]

Important point in post #11. Telemedicine has gotten quite good. Multiple ways to achieve it but all need before hand set up. All require having appropriate supplies as as well. We divided ours into
Accidents, burns and poisoning
Allergies and autoimmune
Infection
Metabolic and vascular volume support
Surgical and orthopedic
Cardiovascular
Given current offerings would add a defibrillator as well

Kits were made up to be congruent to past medical history. Detailed PMH of all crew was obtained prior to transit.

Thank you for all your posts. Big help.

 

[Muirgen Afloat]

Arno Chrispeels specializes in medical coverage overseas. He has a number of cruisers as clients and represents GeoBlue. Arno travels extensively in Baja and knows the medical system well down there.

arno@healthisinternational.com

Thank you!!

 

[Muirgen Afloat]

We had international health insurance though IMG for 7 years. We had to stay outside the US for more than six months but could seek treatment in the US. We had a $55K claim. We paid the deductible and never saw a bill after that. They have multiple plans but are picky about preexisting conditions.

https://www.imglobal.com/international-health-insurance

Thank you.. this is great.. and for your other post too.

 

[Hippocampus]

One thing to consider. For most states and insurers telemedicine calls are not reimbursed unless patient and physician are in the same state at time of occurrence.
Some providers have a don’t ask don’t tell attitude toward this restriction but it may come into play as does Medicare reimbursement restrictions do with international travel and routine care for long distance coastal cruisers.
For long term coastal cruisers to some extent this can be circumvented by using the chat function of the EMR(electronic medical record) if the situation allows for up to a 3 day delay. When long term coastal cruising we pay attention to locals opinions, American Hospital Association information and Us news and report ratings. With both myself and my bride having been providers we are fortunate in being able to self direct care. I believe it’s very important for any international or long term cruiser to do some form of basic medical training. Find the various wilderness medicine courses a good place to start.
Unfortunately most people judge care by the least important factor-bed side manner. I could care a rodents behind about that. I do care about their judgment, knowledge and skill set. Knowing the basics allows you yourself to negotiate most occurrences without outside help. And when you can’t judge adequacy of others interventions .
Also think it’s important to have a health care proxy on the boat with you as well as advance directives delineated. If not feasible to make sure your health care proxy is aware of your plans and available by phone during your travels.
This stuff is like talking about funerals. Unpleasant and hopefully never needed. But lack of forethought can result in disaster.
We continue to use UpToDate and the professional level of Medscape as our internet resources for best practices. These may not be available to you but others are such as the Mayo Clinic site and such. But if you have friends who are providers regardless of their field of practice those two and scientific American medicine are likely available to them. A informal communication whereby they forward pertinent summary articles to you can be most helpful.
Developed a middle ear infection while in USVI. Put myself on the usual antibiotic for it without benefit. Saw a local ENT and given different antibiotic without benefit. Researched it and found a fungal infection was a possible cause. Went back to local ENT with that information and placed on antifungal with prompt resolution. When traveling think importance of some knowledge and access to a source of further knowledge has increased importance. Please educate yourself.

 

[dannc]

Important point in post #11. Telemedicine has gotten quite good. Multiple ways to achieve it but all need before hand set up. All require having appropriate supplies as as well. We divided ours into
Accidents, burns and poisoning
Allergies and autoimmune
Infection
Metabolic and vascular volume support
Surgical and orthopedic
Cardiovascular
Given current offerings would add a defibrillator as well

Kits were made up to be congruent to past medical history. Detailed PMH of all crew was obtained prior to transit.

One needs appropriate supplies and adequate amounts of those supplies, which to be honest, might be hard to predict.

This was brought home to me when watching one of Ryan and Sophie video blogs many years ago. She got a severe burn from a kitchen accident a few days out from port. They had what they needed on board to treat the injury but they really did not have enough of what they needed for the length of time to make it to port. They made due though.

Flip side was it took them some time and effort to get treatment when they got to port. I believe it was Spain. Seems like it was the weekend or a holiday or some such and it took some time to get to a health care provider that was open.

Later,
Dan

 

[Hippocampus]

One needs appropriate supplies and adequate amounts of those supplies, which to be honest, might be hard to predict.

Excellent point. Which is why we set up separate containers as outlined above. Required space was around 4x4 feet in total and needed to be stored air/watertight and dark/cool/dry. Also hyper acute stuff (bleeding, anaphylaxis, shock, airway compromise, burns etc.) needs immediate access.

Prediction is a crapshoot but you can make educated guesses. In high lat it’s unlikely you’ll see stings, bites or poisons as it’s unlikely you’ll be in the water unprotected and exposure to land fauna/flora is limited. Opposite in the tropics. Fractures and burns can occur anywhere. Please wear your foulie bibs when boiling anything when it’s bumpy. And of course you can McGiver a lot of stuff with some background knowledge.
Just like the boat you choose the med kit is chosen keeping in mind where you expect to be and how far away from outside support. After a few nerve racking experiences had little trust of available support in the eastern Caribbean so to the extent possible tried to be self sufficient and spent the bucks on medivac insurance.