Travel plan idea blog

Aritcles on the importance of travel insurance and information on medical evacuation membership programs

This article contains a pretty scary scenario:

My aunt and I were visiting Mexico, and due to a medical emergency she had to be evacuated back to a hospital in the U.S. because we felt that adequate care couldn’t be provided in Mexico. This emergency medical transport cost over $40,000. Is this an unreasonable amount, or is this what such evacuations cost?

The answer is that air ambulances really cost $40,000 or more. Here's a blog entry explaining Medjet Assist. This is a program where for an annual membership fee you can get medical evac services if you need them. The first article I linked to mentions the same one, Medjet Assist, and another one, AirMed.

Speaking of medical evacuation and things, here's an article on the importance of travel insurance:

Even if you have comprehensive health insurance at home, your coverage abroad might be significantly reduced or nonexistent. Medical coverage typically is offered for travel insurance, though the limits vary widely.

Apparently those limits don't usually include bringing you home when there's a medical problem. They usually drop you off at the nearest hospital that has a high enough quality rating, no matter what country it's in.

Here's another article recommending travel insurance. They quote a travel agent who says "most, but not all, private company insurance does cover people who become ill or injured while on vacation in the United States.... Definitely purchase (travel insurance) if you are traveling internationally. Most insurance companies don't cover you outside the U.S."

All this talk about the necessity of travel insurance makes me wonder about taking it out myself. It would be the first time, but why not? Apparently insurance isn't all that expensive ($35 according to one article). And the chances of me getting sick are probably small, but if I do, I don't want to end up paying $40,000 like the person in the first article...

The question would be do I go for travel insurance, or so I add medical evacuation coverage of some kind (with one of the Airmed or Medjet membership programs).

Preventing or treating traveler's diarrhea

I had my reservations about writing on traveler's diarrhea, until I read that it affects up to 70% of travelers. It usually doesn't require medication, but it sure can ruin a trip.

Some precautions include staying away from tap water, lettuce, ice cubes and undercooked foods (in high-risk locations). Another option would be preventive antibiotics before your trip or antibiotics that you bring and take at the first symptom. Travel medicine specialists are divided about which medicinal approach is best.

"We arm every traveler [going to high-risk areas] with antibiotics," says Dr. Herbert L. DuPont, director of the Center for Infectious Diseases at the University of Texas School of Public Health, Houston, and chief of internal medicine at St. Luke's Episcopal Hospital, Houston.

For prevention, he prescribes rifaximin (Xifaxan), a drug that blocks most of the organisms that cause traveler's diarrhea. DuPont helped develop the drug but has no financial connection with the manufacturer. He recommends it for travelers to Mexico and Latin America, Southeast Asia and Africa if the trip is three weeks or less.

"If you're going longer, it's not a good idea," he says, because the drug is expensive at $3.50 a pill and because immunity develops over time with repeated exposure.

But others, including the federal Centers for Disease Control and Prevention, don't recommend antibiotics as a preventive for traveler's diarrhea. I'm not sure why exactly when they are mostly effective.

"Most travel medicine doctors don't give preventive medicine across the board," says Dr. Terri Rock, a travel medicine physician in Santa Monica. She prescribes preventive antibiotics for "those who have had a tough time with traveler's diarrhea or those who can't miss a single day of their trip." Travelers might bring emergency antibiotics such as Cipro (ciprofloxacin) instead.

I was surprised to read that traveler's diarrhea is such a common problem, never having suffered from it personally. I think these are things that helped me avoid the problem.

I tend to eat safe foods: steaming hot or dry (like bread). Moist, room temperature foods are the worst. In a developing country avoid foods like salad and cold meat. Also avoid milk products unless you can be certain they were pasteurized. Beer and wine should be fine, but alcohol diluted with water or ice could be a problem. Even fruit juices served in a glass could be diluted with contaminated water.

Medications like Prilosec reduce stomach acid and put you at higher risk for traveler's diarrhea. Just in case you needed some extra incentive to be careful...

AP article recommending travel insurance

Here's a good AP article on travel insurance, basically recommending that you buy travel insurance for expensive trips and travel medical insurance when you go abroad. There are also tips on where some policies may be lacking (for example if you cancel because of a sick parent you're not necessarily covered) and website links for further reading on insurance.

Medical tourism for Thailand and India

Here's an interesting article from New Zealand that says more people are traveling for medical care (medical tourism). It says that India and Thailand are likely to benefit from this trend. It can also be discussed on my health message board.

Types of travel insurance

The ads are a bit irritating but the information in this article about different types of travel insurance is worth reading. Here's a sample:

Comprehensive Coverage
A travel insurance policy usually offers two types of coverage: trip cancellation and/or interruption and emergency medical evacuation. Reimbursements for lost baggage or trip delays are nice if they come bundled with trip cancellation/interruption or emergency medical evacuation, but they're usually not good buys on their own. Generally, a comprehensive travel insurance policy will cover every need you can anticipate and costs 5 to 7 percent of the price of your trip, so a vacation package valued at $US5,000 can be insured for $US250 to $US350, and is well worth the piece of mind.

It's also possible to buy year-round policies. Frequent travelers can buy insurance for a length of time, rather than for a certain trip. I'm told it can be quite inexpensive (sometimes less than $100 USD per year). Always read the policy for any limitations and exclusions that may apply.

Health care in rural Thailand

In a word, don't trust hospitals in rural Thailand. Now a disclaimer: I've never been to a hospital in Thailand. I only know one person who has had a negative experience in a Thai hospital. So I'm not saying all Thai hospitals are bad or anything like that. I'm just pointing out that when you travel, medical facilities may not be what you're used to.

Here's the story. My friend was doing some adventurous travel in Thailand when she cut herself rather badly. Nothing life threatening, but serious enough to send her to the hospital for stitches. She reports that the hospital was incredibly dirty.

To make a long story short (she thinks because the hospital was so dirty), she got an infection and decided that rather to risk a stay in the hospital, she would fly to Korea. Needless to say, a commercial flight with a bad infection is no fun at all. If you can afford the international travel, you should strongly consider a few extra bucks for insurance that covers medical evacuation.

Americans need international travel medical insurance

Why do Americans need medical insurance abroad? If an American citizen becomes seriously ill or injured abroad, a U.S. embassy or consulate might help finding medical services and informing family or friends. According to the Department of State, they can also assist in the transfer of funds from the United States. However, payment of hospital and other expenses is the responsibility of the traveler.

First, know what medical services your medical insurance will cover overseas. If thie answer is nothing, go shopping for international health insurance. If your health insurance policy does provide medical insurance worldwide (or at least wherever you're going), carry both your insurance policy identity card as proof of such insurance and a claim form.

Also check on medical evacuation insurance: many health insurance companies will pay "customary and reasonable" hospital costs abroad, very few will pay for your medical evacuation back to the United States. Medical evacuation can easily cost $10,000 and up, depending on your location and medical condition.

Much of this travel medical insurance information was taken and adapted from the US Department of State.