How to Navigate a Foreign Country's Healthcare System
At home, medical problems have their established solution. You go to your doctor and follow his or her directives.
On a trip, variables are unknown. Questions which would never be asked at home must be stoically considered abroad: "Should I continue with my camping trip in the remote Cambodia highlands, or should I get this sore throat looked at while I'm in Bangkok and have access to medical services that will not be readily available in the jungle?"
The preceding question is an example of a sound train of travel thought. We hope whomever is asking it gets that sore throat checked out before he/she departs. But in order to make that decision, there are plenty of informational and logistical preliminaries that must be figured out.
This post is aimed at arming you with information and strategy that will clear up the gray area of using your travel health insurance and help you navigate a foreign country's healthcare system.
No one should board a plane where the pilot admits he doesn't really understand how to fly it, so don't fly with insurance that you don't know how to use.
Know what your trip insurance covers (and how it works)
It's common sense, but in busy modern life, this is an easy corner to cut.
Don't assume your insurance policy at home covers situations abroad. Don't assume your trip insurance covers hang-gliding accidents. Know thy coverage. Medical emergencies can be full-time jobs so don't wait until one to learn how to use your trip insurance.
I've heard from travelers who believe that the $20ish checkbox they ticked when they bought their plane ticket (the one that offers them a refund if they are deemed medically unfit to travel) gives them medical care abroad. It doesn't. That box provides zero actual medical coverage outside the airport and I pity anyone who has found this out the hard way.
Read your policy carefully. Write down anything that you don't know that you think you ought to know and call up your insurance company for clarification.
One reason I insure with Seven Corners is because when I am unsure about something, I don't have to spend existential hours online scouring their FAQ section or anxious hours on hold. When I have a question, I ring them up and there's always a knowledgeable English speaker around to answer my dumb gringo questions.
Have your documents in order
What's worse than being ill in a foreign country? Being ill in a foreign country while having to dig for documents. Here's what you should have in order before you leave:
- Vaccination records
- A list of prescriptions you take
- Copy of your passport
- Insurance documentation
...And anything else you think would be important for a doctor to know about you should you become his patient. For extra credit, translate any food/medicine allergies you have into the language of your destination country.
Bring a physical copy of the insurance card that your insurance company mailed to you
Even though I boarded a Vietnam-bound plane using an eTicket on my phone, at the hospital I visited there, they looked at my iPhone's digital travel insurance card like it was an April Fools' joke.
When getting medical care in a foreign country, paper documents and eDocuments are not all created equal - who knows how they do things wherever you're going - so be sure to bring valid paper documentation.
When traveling, research medical services as a general rule
Back in the day, this would have been a hassle. But it seems the Internet is here to stay, which means so is locating medical options when you travel.
The US State Department keeps a list of doctors and hospitals in foreign countries everywhere the U.S. maintains an embassy. Procure a paper or PDF copy before you go of where to go for medical attention.
If your travel insurance policy is through Seven Corners, you also have the added benefit of tapping into their WellAbroad program which gives you doctor and hospital information inside or outside the U.S.
Have translation resources to tell your doctor essential information
Keep in mind, many accredited hospitals and clinics abroad have in-house translation services, or English speaking practitioners. But just because a place advertises English, doesn't mean you will get an interpretation free from misunderstandings. This would be fine if you were conveying how to make pizza, but when talking about your health, let there be no ambiguities.
In the event that in-house translation services aren't up to snuff, know some other options available.
It's a good rule of thumb (even if you have a translator) to bring a translated digital sheet listing your symptoms, your recent geography, and any other relevant information. Ten years ago, you would have needed to translate your symptoms using a massive medical dictionary. Now, just go to Google Translate, write a thorough, but simple summary of your symptoms (use subject-object sentences) and translate it (3-5 paragraphs usually indicates a thorough length) and then copy and paste the translated version to your note app to show your doctor.
If you are in need of a human translator, hotels provide a good clearing house to link you up with a good one. In a pinch, The Global Translator Network SpeakLikehas a global network of translators that can conference call into an exam room. You can also get cheaper rates (with less certification) by using a one on one language learning service like Italki, and (if it's okay with your teacher) you can schedule a class on Skype when you plan to be visiting a doctor.
Get second opinions of big decisions
This holds as true at home as it does abroad. You need to be your own patient advocate. Do you have a doctor in your group of family and friends? Can you call your regular doctor for medical advice on your travels?
If one doctor wants you to undergo something that seems drastic, get the opinion of another doctor. I've met a few travelers who tell tales of foreign doctors who nearly had them remove an appendix when the cause of their pain was parasitic.
Healthcare workers have one of the toughest jobs out there. Most are genuinely committed to your well-being and recovery. But like any human, they have a life filled with distractions, make mistakes, overlook things and get overwhelmed. A good patient is one who informs him or herself in order to not be a passive part of the medicine's process.
Know thy network of medical resources
Here are a few resources to keep in mind:
- Travel insurance (policy information)
- Friends and family in the medical field
- Vetted medical literature
- Trusted and reliable websites
- Your insurance carrier's customer service number
- The knowledge of how to use the information available to you
Know the number of your Embassy and don't be afraid to call if you really need help
All of this advice so far has been aimed at arming you with options and a mindset with which to use them.
But, if you find yourself in a desperate situation where no one speaks your language and you're simply not of a state of mind to deal with the struggles at hand, call your embassy. They can't bail you out of jail, won't pay for your medical bills, but they will be able to help you get into a better position to help yourself.
Take health precautions while you travel
The easiest way to deal with a foreign country's healthcare is not to deal with them at all by making as many healthy decisions as possible before and during a trip. Next month I'll do a full piece on the topic of: Avoiding getting sick while traveling by avoiding the situations and habits that make one ill.
As a general rule, dedication to fitness, diet and knowing how to relax have all been shown to positively affect health. By its nature, traveling interrupts our routines, causes us to go off schedule and temps us with tiramisu. But a vacation from home doesn't need to completely undermine our commitments to well-being. An extreme example is my uncle who doesn't book a hotel unless he's sure there's a gym within walking distance.
When it comes to safety, go with your gut. If something makes you uncomfortable about a cab driver, find another one. If you're not familiar with reading wave breaks and rip tides, ask the locals about the surf before you swim.
The safety list could go on and on. I could start listing the obvious, like, don't feed the sharks you're swimming with. But everything that could appear on the list could be summed up by saying, "Be mindful." Travel puts you into situations that make it difficult to be mindful, but it's when you're on the road that it's so important that you are. Had I been more mindful on one fateful jungle trip, it's possible I wouldn't be writing this scarred from back to back raccoon attacks.
About the Author
Luke Maguire Armstrong is the author of "The Nomad's Nomad." He has spent the last decade traveling, writing and designing, and funding philanthropic programs around the world.
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