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Medical Attention While Out of the Country
Old 05-23-2014, 05:07 PM   #1
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Medical Attention While Out of the Country

If you have a vitreal (sp?) separation, get your a$$ to the dr. and have it checked. DH, severely myopic, had this in both eyes a few years ago so I was very familiar with the issues, so when I had mine while in Aruba, I wasn't too concerned. Mildly myopic, no symptoms, and encountering difficulties in getting medical attention in Aruba, I wasn't too concerned. DH made me go to the dr. once we got home and am I glad I did...

Unfortunately, I was one of the 1%ers...where the VT results in a retinal tear and separation. Fortunately, it was caught in time where I was able to have a laser repair rather than full blown eye surgery.

As we travel more during retirement, esp. out of the country, our concern is getting medical attention. I was in e-mail contact with my ophthalmologist and he did recommend seeing a local ophthalmologist to ensure no tears.

How do others deal with this...not the issue of insurance, which we had, but of getting medical attention (especially with a specialist) while out of the country. I always thought Aruba wouldn't be an issue due to their ties to the Netherlands, but from what I learned from the locals, getting medical attention is not easy.
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Old 05-23-2014, 08:04 PM   #2
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It's a good question and fortunately not one that I can answer from experience. We have another long trip overseas coming up soon, and what I have done is make a list of the in-network doctors and medical centers in my HI plan network.

If something happens during our month long stay in Hobart, Tasmania then I would go to the nearest in-network Doc for a diagnosis, and see what he recommends. I can then call our HI company and get advice from them about seeing a specialist.
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Old 05-23-2014, 08:11 PM   #3
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Reality is that medical attention, at least up to modern standards, is simply not available in many areas of the world. Some of those areas are surprisingly NOT that remote. Medical evacuation is an important part of travel insurance.
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Old 05-24-2014, 06:28 AM   #4
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Originally Posted by TrvlBug View Post
How do others deal with this...not the issue of insurance, which we had, but of getting medical attention (especially with a specialist) while out of the country. I always thought Aruba wouldn't be an issue due to their ties to the Netherlands, but from what I learned from the locals, getting medical attention is not easy.
It really does depend on many things, but one can get pretty good medical and dental care in many urban areas around the world. Two key issues would be access and language. A tour operator or hotel manager should be able to help with both.

Edit: travel insurance is another option, it is likely to have contact numbers to help get immediate attention when needed. When traveling, it helps to have a cell phone and emergency contact numbers.
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Old 05-24-2014, 08:26 AM   #5
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I had a retinal tear repaired in PV MX in December. Found a referral retinalogist, and he did the operation on an outpatient basis. Total cost was $500 for 2 visits plus the treatment and it was covered by insurance. So far so good.
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Old 05-24-2014, 11:20 PM   #6
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As mentioned by another poster, I imagine it depends on where you are traveling and what your needs are as to whether or not you will find adequate medical attention.

We have been traveling the world for over 2 decades now and have had very good care in Mexico, Thailand, Vietnam and Guatemala. You might need to travel to a larger city to receive this care as smaller towns may not have the choices you would find elsewhere.

We pay out of pocket for care in foreign countries as in our experience it has been affordable.

As we age, the health conditions might be more serious or acute and I understand the fear. However, Billy and I have had acute care in Guatemala City (we had to travel there after seeing local doctors) and I had emergency care for a de-gloving incident involving the ring finger on my right hand. I received good emergency care and then did follow up and surgery in Guatemala City.

In some respects the care we have received outside the US has been superior, more user-friendly and more affordable than that which we would get in the States.

Currently we are in Asia traveling, and we hope to get to Thailand for a complete physical and our yearlies taken care of.

Again, I want to say that I respect the fear that surrounds this issue, especially as we age. But on the other hand, must it come down to a choice between holding this fear and an adventure to a foreign country that would enrich our lives?
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Old 05-25-2014, 07:42 AM   #7
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Currently we are in Asia traveling, and we hope to get to Thailand for a complete physical and our yearlies taken care of.
Bumrungrad? That's very well-respected among business travelers.

Haven't faced this issue yet, but I think we will be since DH is now on Medicare, which doesn't cover you outside of the US. I'm definitely planning to tailor each trip insurance purchase to the places we'll be going and make sure they have good referrals in that area. Our next destination is a cruise within Alaska, so no problem there; after that it might be Australia and NZ.

One area where I know we're rolling the dice is the indirect costs: having to change plans due to illness or injury while traveling, having to fly home in Business Class because your leg is in a cast, etc. DH and I have cheerfully agreed that, should the other one die on a trip, they'll be brought home in an urn. The costs of repatriating a body are crazy.
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Old 05-25-2014, 10:32 AM   #8
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Thank you all for your comments. Some good suggestions which I will implement. I don't plan to let the lack of or perceived lack of medical care outside the US stop us from traveling.

My frustration on this vacation was the difficulty in seeing a local specialist. I had just had cataract surgery in that eye, not 5 weeks earlier, and was probably overly concerned about potential damage as we weren't coming home for another 2 weeks. Fortunately, my health clinic and doctors in that network are all accessible via e-mail and we always carry an int'l cell phone for emergencies

The resort management, a major hotel chain, was more than useless. DH and I travel on our own, so no tour operator to fall back on.
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Old 05-25-2014, 11:45 AM   #9
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The resort management, a major hotel chain, was more than useless.
I once got great dental care when I developed an abscess while in Budapest- the concierge at the Hilton found a dental clinic that was open (it was Saturday, of course), put us in a taxi and told the driver where to take us. It was the first time I ever had a panoramic X-ray.

It may be, though, that with something as complicated as an eye problem, they're afraid to make any recommendations in case the treatment isn't successful.
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Old 05-25-2014, 12:23 PM   #10
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Haven't faced this issue yet, but I think we will be since DH is now on Medicare, which doesn't cover you outside of the US.
Medigap F does provide some coverage outside the US. Compare Medigap policies | Medicare.gov
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Old 05-25-2014, 02:47 PM   #11
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I'm definitely planning to tailor each trip insurance purchase to the places we'll be going and make sure they have good referrals in that area.
I'd be curious to know how to obtain such a travel insurance. Tailored for one country only or choose a few close by? Referrals for what and from whom? What companies sell such travel insurance?
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Old 05-25-2014, 02:50 PM   #12
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Reality is that medical attention, at least up to modern standards, is simply not available in many areas of the world. Some of those areas are surprisingly NOT that remote. Medical evacuation is an important part of travel insurance.
I see medical evacuation mentioned quite a few times, but no information what company to trust to buy that insurance from and what amount to insure for (for one person or a family). Care to share your experience of purchasing such insurance?
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Old 05-25-2014, 03:36 PM   #13
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I see medical evacuation mentioned quite a few times, but no information what company to trust to buy that insurance from and what amount to insure for (for one person or a family). Care to share your experience of purchasing such insurance?
Did you look at this thread?
http://www.early-retirement.org/foru...nce-71940.html
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Old 05-25-2014, 04:35 PM   #14
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There's more than you'll ever want to know about travel insurance on cruisecritic.com; they have a separate Discussion Board on that topic.

DH and I have gone all over (mostly Europe) without it, although we've always had coverage through my employer that covered internationally. My last 2 employers even provided free access to medical referral networks outside of the US although they made it clear that you were still responsible for out-of-pocket costs not covered by insurance and they did not cover extraordinary costs such as evacuation or rebooking costs.

I'm impressed at coverage for a hyperbaric chamber but since I've never gone beyond snorkeling, I hope I never need one!
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Old 05-25-2014, 06:45 PM   #15
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Bumrungrad? That's very well-respected among business travelers.
We will probably have all our needs taken care of in Chiang Mai, although we have used Bumrungrad several times and think they are very high quality.

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DH and I have cheerfully agreed that, should the other one die on a trip, they'll be brought home in an urn. The costs of repatriating a body are crazy.
That is, if the country you are in “allows” cremation. A friend of ours died quite suddenly in Panajachel, Guatemala and his wife could not get him cremated. She buried him in a local cemetery, something she resisted to the end, but “had no choice” in the matter.

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The resort management, a major hotel chain, was more than useless. DH and I travel on our own, so no tour operator to fall back on.
You might try going to a pharmacy in the area. Doctors, hospitals, clinics and pharmacies are often connected, and at least they could get you started somewhere.
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I'm impressed at coverage for a hyperbaric chamber but since I've never gone beyond snorkeling, I hope I never need one!
When I had my finger de-gloved in Guatemala I had 10 treatments in a hyperbaric chamber. Fortunately for me, the chamber was in the same medical complex as the hand surgeon I was seeing. I had 2 surgeries, 11 visits with the surgeon, and with all medication and the costs of a private driver to take me to the city, my total cost was under $3k, paid out of pocket.

$1,000 of that amount was for the private driver.
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Old 05-26-2014, 02:20 PM   #16
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Thank you. This looks the most recent. When I searched a year or two ago, I didn't see lots of help, but found an alternative for us at the time. I'll have to read your linked thread.
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