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Everything travelers need to know about being sick overseas


(Tara Jacoby for The Washington Post)

The fantasy of trekking around the world to find yourself never fails to inspire. But the reality is typically less glamorous. You’re probably more likely to experience a food-borne illness or catch a cold on a plane than some life-altering epiphany — quickly turning a trip of self-discovery into a crash course in foreign health-care systems. As the novel coronavirus dominates the news cycle, staying healthy abroad is on everyone’s minds.

Navigating the nuances of medical care in another country comes with challenges even when you’re feeling well. If you’re packing for a trip or are abroad now and looking for care, learn lessons from the travel pros: Taking a few precautionary steps and bookmarking helpful resources might keep an illness from entirely derailing your trip.

What can I do to prepare for potential illnesses?

You should schedule a pre-trip doctor appointment, says Lin H. Chen, president of the International Society of Travel Medicine (ISTM) and director of the Travel Medicine Center at Mount Auburn Hospital, in Cambridge, Mass., which is affiliated with Harvard Medical School.

“During a time with emerging infections and outbreaks, it’s absolutely a good idea to check with a medical professional — a travel medicine specialist or primary care provider — to prepare for a trip,” she says.

An appointment at a travel clinic is crucial for more complicated itineraries, especially for trips to under-resourced corners of the world. These visits typically update your vaccines, give preventive tips tailored to your specific itinerary and equip you to self-treat any common health problems that might arise along the way. The Center for Disease Control’s website lists which vaccines you should have depending on your destination.

Chen also advises travelers to assemble a first aid kit. In addition to basics like bandages and antibacterial ointment, stock your kit with medications for diarrhea and allergic reactions, backup birth control, painkillers and a ready supply of your daily prescription drugs, which you may not have access to abroad.

Are there extra steps I can take to be ready for emergencies?

Take a moment to jot down your destination’s emergency phone numbers and pinpoint the nearest hospitals with emergency rooms. But during a growing viral outbreak, health-care professionals also encourage international travelers to notify the State Department of their plans, which you can do online.

“I recommend that all travelers who are American citizens or nationals register their travel in the State Department’s Smart Traveler Enrollment Program (STEP), at a minimum,” says Celia Maxwell, associate research dean of Howard University’s College of Medicine and an expert in pre-trip medical preparation.

It only takes a few minutes to enroll in STEP, which notifies the nearest embassies and consulates of your trip details — making it easier for U.S. officials to contact you and offer emergency assistance. STEP also ensures you receive timely safety alerts about your destination.

What are the easiest ways to get care and find a doctor?

For minor and easily diagnosable symptoms, first consider a trip to the pharmacy, which could save you time and money. In many parts of the world, locals speak to pharmacists for many of the same ailments Americans would see a doctor to treat, from fevers and stomachaches to rashes and urinary tract infections. Plus, certain medications, like antibiotics, may be available over the counter, often at lower costs than you’d pay in the States.

When you need the attention of a doctor or urgent-care clinic, a few handy resources can help you identify doctors and medical facilities with a track record of caring for American travelers. First, look up the local U.S. Embassy or consulate, which maintains lists of clinics, hospitals and English-speaking providers on their website (navigate to the “U.S. Citizens Services” section of each embassy’s website to find these local resources). You could also sign up for a membership with the nonprofit IAMAT (International Association for Medical Assistance to Travelers) to get access to their directory of English-speaking doctors and clinics, which all charge standardized rates. A similar, though less detailed, resource is ISTM’s global travel clinic directory, which includes contact information for the society’s membership of travel health-care providers.

But what if you don’t want to leave your bed? Seeing a doctor for a minor illness might be as simple as picking up the phone. The concierge desk at a hotel can generally arrange for a doctor to visit guests directly in their rooms. Expect to pay more for the convenience of a house call.


(Tara Jacoby for The Washington Post) (Tara Jacoby for The Washington Post)

Will my U.S. health insurance cover me while I’m abroad?

If you expect your domestic health insurance plan to pick up the bill for international care, you could be in for a costly surprise. Although many private U.S. health insurance policies include a form of travel coverage (Medicare does not), it’s usually only for care considered a true emergency — and what counts as an emergency varies from plan to plan. Don’t expect a sore throat to qualify, though a serious case of covid-19 hospitalization might.

Be aware of the big “but”: Even in cases where your domestic plan covers international medical emergencies, the coverage may leave you with considerable financial obligations. You could end up owing thousands of dollars if your plan requires you to meet a high deductible and out-of-pocket maximum before the insurer starts pitching in a dime.

To understand what your plan covers, call your insurer; clarify what constitutes an emergency and what you could owe. You may then purchase a travel medical insurance plan to lessen the burden if a medical emergency happens.

Can travel insurance help pay for my medical expenses?

The right type of travel insurance can have your back in cases where your domestic health insurer does not cover you, but coverage varies quite a bit from plan to plan. For health expenses, make sure you buy a plan that includes adequate medical and emergency evacuation coverage.

Many popular plans offer medical coverage along with trip interruption and cancellation protection, all of which can help you recoup financial losses when a health-related incident forces you to abruptly change your itinerary. Take World Nomads, one of the most popular options among international travelers; they bundle up to $100,000 of emergency medical and dental coverage in all of their plans. Alternatively, insurers like IMG and SafetyWing sell policies more specifically focused on travel medical coverage. To easily window-shop, use an established comparison site like Squaremouth, where you can compare the major insurers’ latest restrictions on the 2020 coronavirus outbreak.

Keep in mind that most policies require you to purchase coverage a few days in advance of your departure date. If you’re already traveling without coverage, you’re not entirely out of luck; a few insurers such as SafetyWing and World Nomads let you purchase while you’re abroad, though a waiting period may apply before the plan fully kicks in.

Can I get my prescription filled overseas?

There’s nothing simple about getting American prescriptions filled or replaced while abroad. And don’t count on someone sending you extras; mailing prescriptions across borders breaks laws in many countries.

Ideally, you should plan ahead: Pack extra drugs. Check local regulations to ensure you can legally pass through customs with your Rx (a few countries including the United Arab Emirates and Japan prohibit some common prescriptions and over-the-counter medications), then bring a supply to hold you over if your trip gets unexpectedly delayed — a wise precaution at a time when mandatory quarantines remain a slight possibility for international travelers.

But what if you lose or run out of your medication in a foreign country? There’s no surefire solution, so use all the resources you have access to. Call your travel insurance’s assistance line; a representative will typically advise you on the best course of action. And check in with your local U.S. Embassy or consulate; embassies can assist U.S. citizens in emergency cases when your health depends on daily medications.

Embassies can also provide addresses for trusted pharmacies. Try taking a copy of your U.S. prescription and a letter from your doctor indicating why you take it. While most countries don’t technically allow pharmacists to fill foreign scripts, the druggist may have some leeway if you explain the direness of your situation. You may ultimately need to visit a local doctor to get a domestic prescription written for an equivalent drug.

Will I be able to fly home with a contagious illness?

When you feel under the weather, your instincts might tell you to jump on the next plane home, but flying with contagious illnesses is not what experts advise. Travelers should voluntarily delay their plans until they’re no longer contagious, according to the CDC’s guidance on air travel. Anyone who flies frequently, though, knows few travelers actually follow this instruction.

But even if you’re one of the many travelers who don’t voluntarily stay grounded, flying home might not be an option. Airlines have broad rights to refuse travel to passengers who seem too sick to board. In other words, if you’re coughing up a storm near your departing gate, don’t be surprised if an airline employee pulls you aside to inquire about your health. And in the rare case of a government ordered-quarantine, you don’t have a say in the matter. Delaying your trip may cause inconveniences, but your seatmates will appreciate you waiting to fly until you’re in the clear.

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