Posts tagged as:

benefits

Hypochondriacs? $8,343.44 for Healthcare

by Amy on September 25, 2009 · 13 comments

Syringes

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?

{ 13 comments }

Benefits Around the Globe

by admin on July 3, 2009 · 0 comments

Quite possibly the most frequent question we got as we told people that we were planning on traveling the world for a year was what are you going to do about health care?  I am not sure what sort of indictment this is of the current American health care system that people are compelled to ask about health insurance before our destinations and other much more interesting topics.  Below we break out the major lessons we learned from going through the process of preparing to replace our employer supplied benefits.  There are some important considerations to be made when planning your travels, and many of them require significant foresight and planning.

Health Insurance:
Health insurance can be one of the trickiest benefits to figure out.  If you are used to the easy and relatively limited choices of employer provided plans, the shear number of choices out there can be daunting.  Also there is the complexity of doing this as an American.  If there is one thing we have learned in doing this it is that the cost of health insurance in the States is significantly higher and more complex than just about anywhere else on the globe.  In fact the plan we went with that provides coverage within the States as well as global coverage is +132% more expensive than the equivalent plan that covers the entire globe ex-U.S.  That is a pretty big premium for U.S. health care.

For health insurance on a global trip your first consideration should be ensuring your provider is an “admitted” plan. This is important for any Americans that may at some point need to return and apply for private health insurance.  To cover any preexisting condition, you must have had “creditable coverage” with no gaps longer than 63 days from an “admitted” plan that is approved in the State you are likely to return to.  While there are many variances state by state, this requirement holds true in Pennsylvania.  Many popular global plans may not be admitted in the US, and that is fine for many non-American travelers, but getting a private plan when you return, and avoiding preexisting condition exclusions can depend on your provider while you are away.  As was mentioned previously we decided to go with the HTH Worldwide Global Citizen Plan underwritten in Pennsylvania by HM Life Insurance Company of Pittsburgh, PA rated A- (Excellent) by A.M. Best.  I would recommend talking with a licensed broker or a potential insurance provider about our options.  www.ehealthinsurance.com is a great starting point.

Life Insurance:
Granted this is a bit of a morbid topic, but an important one and one we learned about by finding out we are “uninsurable”.   Getting through life insurance underwriting with eminent world travel plans can be a struggle, if not impossible.  Most insurance underwriters will require you to declare if you have plans to leave the country in the next 12 months.  And if you lie about it the policy could be voided if it is needed, so telling the truth is the only option here.  If you are planning a global trip and are more than 12 months from departure, think about getting a personal life insurance policy (term is probably adequate and most affordable).  Even if you have employer provided life insurance, it is important to think about getting your own personal policy that is independent of your employer.  Talk to a local insurance broker about pricing and options, but remember that if you are more than 12 months out no need to tell them about your travel plans, it will just complicate matters.  This is especially important if you need full life insurance not just death and dismemberment.   Full life insurance covers you if you die of natural causes, think heart attack or any illness, but death and dismemberment only covers you in the case of an accident, which is the most likely if you are young and healthy.  If you do not have any kids or people that depend on your earning potential, that might be all you need.  Good resources for death and dismemberment insurance include:

•    AAA
•    Insurance Pickle

Disability Insurance:
Disability insurance is a form of insurance that insures the beneficiary’s earned income against the risk that an accident resulting in a disability will make working (and therefore earning) impossible. It includes paid sick leave, short-term disability benefits, and long-term disability benefits.

The key topic for our discussion here is that most disability policies are a percentage (60-80%) of salary.  As we now have no predictable, documentable salaries, insurance companies will not underwrite a private disability policy on us.  As an American the only real option you have at this point, is to rely on Social Security benefits in the event that you become disabled.  But take note that Social Security benefits do not begin for 5-6 months so be sure to have an emergency fund that can cover cost of living in the states for at least 6 months.   Similar to private health care and life insurance securing these benefits through private policies before you leave your current employment is the best advice, this way they are in place before you actually need them, because if you wait until you need them they are very difficult, if not impossible to secure.

We welcome your comments or personal experiences on securing benefits, please share below.

{ 0 comments }