Vaccines: $2,586
Medications: $690.89
International Travel Insurance Premium: $1,034
Domestic Health Insurance Premium: $4,723.44
Peace of Mind: Priceless
With all of the debate going on about reforming healthcare in the United States, it seems appropriate to add a post about the steps we have taken to stay as healthy as possible while traveling. Obtaining a litany of vaccines and medications (almost none of which were covered by our employer-provided health insurance plans) and maintaining both domestic and international health insurance while traveling can be a complete budget buster. However, in my opinion, the peace of mind is worth every penny.
Vaccines
Keith – 7: Yellow Fever, Meningitis, Polio, Flu, Japanese Encephalitis (2) and Hepatitis A and B combo
Amy – 10 (with 1 more to go): Yellow Fever, Tetanus, Meningitis, Polio, Hepatitis A and B combo (3 so far, 1 more upon return), Flu and Japanese Encephalitis (2)
Keith and Amy – Typhoid (4 pills each)
We didn’t skimp when it came to rolling up our sleeves and transforming our arms into human pincushions. Taking health precautions for a year of world travel is not for the faint of heart or needle-phobic. Luckily neither of us has an issue with needles and Keith had already gotten several of the vaccines so we were able to save our arms and wallets on a few of the shots. We also had no reactions to any of the vaccines.
After researching which vaccines were required and which merely recommended, we decided to err on the side of caution. For example, many travelers to Asia pass on the Japanese Encephalitis vaccine, relying instead on mosquito bite prevention techniques like using DEET, mosquito nets and limiting exposure during certain times of the day. Personally, it seems that no matter how much bug spray I use, I’m still a mosquito magnet, so while the JE vaccine was one of the most expensive, I’d rather not be freaking out every time I get a bite while waiting ten days to see if my brain is going to swell. We also ended up with some vaccines that are for places that we have since dropped from our itinerary, but we like having the flexibility knowing that we can change our plans at the last minute and not face any restrictions.
Health Insurance
One of the most striking features of the vast majority of people who are able to take a year off from work and travel the world is that they come from countries with socialized medicine. These travelers can simply pick up an inexpensive international policy that covers emergency care and medical evacuations while they are abroad. For routine care while abroad, it is usually pretty cheap so many just pay out of pocket and don’t even bother submitting claims.
For Americans contemplating an around the world adventure, the cost of healthcare is a more weighty consideration. Employer provided health insurance is the most affordable, if not the only affordable option available to most Americans. Add a preexisting condition and your rates for independent health insurance skyrocket, if you can get coverage at all. And if you have a 63-day gap in your health insurance coverage and can’t get insurance through your employer, you may just be completely out of luck and have to rely on the keeping-your-fingers-crossed that you don’t ever get sick again approach. Christine Gilbert has a great post on her blog almostfearless.com summarizing different health insurance options for Americans traveling abroad.
It took months of research and the assistance of an insurance broker to figure out the most affordable option that provided us with creditable coverage – the industry term for a health insurance policy certified as legitimate by the state in which it is provided and that is recognized by other insurance companies for the purpose of satisfying the continuous coverage requirements – and wouldn’t reject us based on preexisting conditions. And to be honest, despite our various degrees and working with an expert, we still wouldn’t say that we completely understand all of the fine print.
It might seem excessive to get coverage that is only good in a country that we don’t intend to spend any time in during the next year. But we needed a domestic policy for two reasons: first, in the event we unexpectedly return to the United States and need medical care, and second, in the event we return to the United States at the end of our trip and don’t immediately transition back into jobs with employer provided coverage. While we are basically still young and healthy, we know of peers who have rolled the dice on maintaining health insurance coverage and ended up with a $30,000 case of appendicitis. We ultimately decided on a fairly bare-bones policy compared to the policies we were used to from our employers (i.e. one with coverage limits and without a prescription plan) that we can upgrade if necessary when we return home at the end of our trip. After figuring out this piece of the health insurance policy, choosing an international plan from World Nomads was an easy decision to make.
Still, I think we’ll keep our fingers crossed just in case and hope that we don’t need to use either policy during our travels…and that there is a resolution to the health care reform debate by the time we return to the States.
Are we being health care hypochondriacs? Is it worth the $8,343.44 we have spent before even purchasing our first plane ticket? What do you think?
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{ 13 comments… read them below or add one }
ABSOLUTELY!!!!! But as a parental unit what would you expect me to say?
Another reason, albeit, not as pressing as many others for a total reform of the health care industry.
I think if you just take Airborne, that’s supposed to cure all ailments. At least that’s what their informative and in no way exaggerative commercials have led me to believe.
A steak a day keeps me ticking
I am MORE than AMAZED at all it takes to get ready, and to do what you two are doing.
I think it is GREAT with all the preparations that the both of you have taken, most things will work out for you.
Will miss seeing you, but I will be keeping track (like everyone) via the internet.
Here’s the website of an acquaintance of mine. She and her husband are currently traveling the world and of course had the same dilemma prior to setting off. If you can find them ; D you can read her blog entries about it.
livesofwander.com
What an absolutely exciting adventure for you and Amy!!!!!
I thought you just needed vitamin C and that cures everything?
Seriously though, it’s amazing the adventure you and Amy are about to embark on! I will enjoy reading about your travels via the internet and wish you both good luck!
Absolutely worth every cent! This adventure will change your lives forever. Like you said: priceless!
did you bring dental floss with you?
Well, that $8,343.44 you WON’T be spending on small ceramic figurines for me.
So I am a bit sad.
But, it does mean you and sis have an awesome health net.
So I am happy.
Bottom line: I am deeply conflicted about this move.
PS – since Amy got WAY MORE vaccines than Keith, I think Keith should get extra beer. Or AJ should carry all the luggage. Whatever you two work out.
Neil – we are definitely bringing dental floss! And the healthcare tally does not include the extra out-of-pocket expense for Amy’s dental cleaning and check up that was not covered by insurance because she was just shy of the required 6 months between cleanings, so we can add another $145 to the total. However, better to go only a year rather than nearly a year and a half without dental care, so the expense was worth it.
I’m going on 18 months with no dental cleaning after dropping my insurance for paying out less of my money than I’d given to them. (Not to mention my $7,000 dental implant debacle.) Can we get some national healthcare up in here already?
I think your peace of mind is worth the expense, though I made it through Japan (and many bug bites) without any brain swelling. Thank you for not telling me about this before I left or I would have been much more concerned. See you soon!
Well, I can say you definitely got everything, including several things you probably already had immunity to from childhood vaccinations. Nothing ruins a vacation like polio.
You won’t need any of it now that you’ve bought it, so I think that you’ve taken every step possible to not jinx yourself, which is medically important (and scientifically sound). Presumably you’ve also brought with you prescriptions for cipro, malaria prophylaxis maybe if you need it, and other over the counter stuff to be thorough. The one thing I would recommend is having a doctor in the US phone number or pager so you know what to take when (diarrhea is surprisingly confusing), and to get advice on what may constitute a serious emergency. I think getting a US plan is a great idea, because if it were me, or my family member and things started going awry, I’d rather be here than anywhere else (no matter how effed healthcare is to pay for relatively speaking). That being said, evacuation insurance is very cheap. I get it whenever I go somewhere weird.
And no matter where you are, never underestimate what doors having insurance will open. The divide in care between having it and not in other countries (when you’re not a tax paying citizen) can be ENORMOUS. So, you spent wisely. Except for polio. Hope that was cheap.
Liz – will you give me your pager number so I can call you in the middle of the night to discuss my lower GI distress? I agree, safer is always better when it comes to polio. Thanks for the comment, talk to you soon.