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

Health Information for International Travel 2003-2004

© 2003