Chucking it 401: Health and Insurance Abroad

This post expands on our series of questions about whether you are ready to become a meandering minimalist. If the answer is no, or not yet, we offered some options. Then, Part 1 asked if you actually like travel. Part 2 encouraged you to think through your obligations. And Part 3 talked about your potential travel companions. This post discusses how your health might affect the decision to travel long-term, focusing especially on the single most common question asked of us, especially by friends who live in the U.S. What are you going to do about health insurance?

How Healthy Are You?

Most of us could be in better shape, but this is a more fundamental question. Can you physically leave home for, let’s say, three months? If you have ongoing medical issues, you are probably tied to a particular set of doctors. But even then, it might be worth exploring whether that’s really true. If you are in remission, or if you have treatments every three months, you might be able to travel anyway. Or consider a dream trip as your reward for getting better. Lots of studies show that having things to look forward to can improve your well-being and overall health. Furthermore, travel insurance is available to evacuate you to your home country, just in case. There’s even travel insurance for people who are terminally ill. We were inspired by this CNN story about a person with stage-4 cancer who prioritized travel with his family.

Lots of people tell us that they intend to travel more in their retirement. We want that for you! In fact, we think you should travel more before you retire too. Especially if you have big adventures in mind: think about what’s reasonable for your age and health. Climbing Kilimanjaro is easier in your fifties than in your seventies. (So is flying to Australia, for that matter.) You might want to follow the unwritten rule of foreign service professionals: take the more challenging posts (or trips) earlier in life so you can kick back in France later. We’ve scaled back as we’ve gotten older – no more sleeping on the ground, for instance. But, for now, we still feel like we can handle anything we’re interested in. Please, please, do it now. Let the fact that you are getting older serve as a spur to travel rather than a deterrent!

Health Insurance

Ok. What is it with Americans and health care? Oh, right: it’s the fact that we pay more and get less for it than just about anywhere else in the world. The single most common reaction we got during our planning phase, aside from ‘That sounds so cool!’ was, ‘But what are you going to do about health care?’ We worried about this too, especially at the start, when we were looking into some of the major companies offering private health insurance to U.S. citizens. We found plans costing many tens of thousands of dollars, and those weren’t even the good ones.

Once we knew we were not going to be spending much, if any, time in the U.S. for the next few years, things became somewhat simpler: we didn’t have to sign up for a domestic plan, which saves us a lot of money (John has Medicare B, which is free but doesn’t work outside the country). Lots of countries, especially in Europe, have socialized medicine and cover basic things and emergencies for a small fee. Your standard European or Asian pharmacy will be able to provide medical advice and things you’d need a prescription for in the U.S., usually for less than $20.

But we’re extra cautious, even though we are both healthy. So we bought international travel insurance, good everywhere in the world except the U.S., through MSH International through a cooperative arrangement with the Association of Americans Resident Overseas (of which we are members). The premiums are laughably small by contrast to those from U.S. providers; the deductibles reasonable. And they have vision and dental supplements, which we also got, because we’re extra cautious. They have approved providers in nearly every country we think we’ll be going to. We have not yet gone for a check-up or needed any kind of care, but so far we have found them a pleasure to work with. Stay tuned for our upcoming dental check-up!

If that hasn’t blown your mind, consider this: many expats who remain U.S. citizens simply opt out of health insurance altogether. They live in places where the cost of procedures and even hospitalizations is affordable, and they don’t think the outrageous premiums are worth it. Doctors around the world usually speak English, and hospitals in most places you will want to travel are just as professional as you would expect.

Obviously, this is an important and a fraught decision, and you’ll want to get as much information as you can. We don’t have any advice to offer, except to urge you not to allow the fear of a disease you don’t yet have stop you from making your dreams come true.