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Illness Abroad
Preparation
Before going abroad, travelers should be advised
to learn what medical services their health insurance will cover overseas,
as well as any policy exclusions. For example, the Social Security
Medicare program does not provide coverage for hospital or medical
costs outside the United States. If the health insurance policy provides
coverage outside the United States, travelers should be advised to
obtain copies of their bills and receipts (preferably in English)
and carry both the insurance policy identity card (as proof of insurance)
and a claim form. Although some health insurance companies will pay
“customary and reasonable” hospital costs abroad, very
few will pay for medical evacuation to the United States. Repatriation
can easily cost $10,000 or more, depending on the location and medical
condition. Another factor complicating reimbursement for overseas
medical care is the fact that most insurance companies, HMOs, and
managed-care plans now require travelers to notify their review panel
that they have been or plan to be admitted to a hospital for treatment.
They may also require a second opinion before treatment is initiated.
For this reason, it may be advisable to purchase a supplemental policy
that also provides “assistance,” in the form of a telephone
number of a 24-hour physician-backed assistance center, guaranteed
medical payments, and emergency medical transport, including repatriation.
Overseas physicians may require payment in cash for services rendered
and may accept a credit card. See the U.S. department of state website
at http://www.travel.state.gov/medical.html,
which lists medical evacuation services.
Travelers should also consider carrying with them
appropriate medications or equipment for self-treatment should they
become ill during their travels abroad where they may not have access
to optimal health care or any health care at all. Examples of these
items are listed in the Travel
Health Kit section. In addition, health-care providers or aid
workers may wish to carry, at minimum, a 1- to 2-week course of
highly active antiretroviral therapy (HAART) in case of exposure
to potentially infected blood or body fluids.
Health Care Abroad
If an American citizen becomes seriously ill or
is injured abroad, a U.S. consular officer can assist in locating
appropriate medical services and informing family or friends. If
necessary, a consular officer can also assist in the transfer of
funds from the United States. However, the traveler should be advised
that payment of hospital and other expenses is his or her personal
responsibility. Additional sources of health-care providers include
embassies and consulates of other countries, hotel doctors, credit-card
companies, and multinational corporations, which may offer health-care
services for their employees. As in North America, the quality of
health care from overseas physicians may be quite variable. Also,
some foreign hospitals may appear to have facilities that are out
of date, while others have highly sophisticated diagnostic and therapeutic
equipment.
In many developing countries, virtually any drug
can be purchased without prescription, including such medications
as prednisone and chloramphenicol. The quality of drugs may not
meet U.S. standards and be potentially hazardous, or may even be
counterfeit. Travelers should be advised not to buy medications
“over the counter” unless they are familiar with the
products. In addition, travelers requiring an injection overseas
should be advised to ascertain whether the injection equipment is
disposable and to insist, if possible, that a new needle and syringe
be used.
—
Jay Keystone
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