Category Archives: Health Care

No Reason Not To

When first given the opportunity to live and work overseas I was rather reluctant.  After receiving an offer of a paid three-month visiting position at Imperial College I thought of dozens of reasons why this absurd idea would never work.  (These fears and doubts are described in “My London Epiphany.”) Fortunately, my wife Ruth is far more willing to consider new things and was able to convince me to give it a try.  (I think her exact words were “Dammit, this will be fun. Let’s do it!)  She was right, very right, and for the past 30 years we have lived all over the world happily letting others pick up the tab!

One of the goals of this blog is to play a role for you similar to the one my wife played for me–refuter of those “ready-made” arguments against the adventure of a lifetime; debunker of the beliefs that convinced you that living and working overseas is something only “others” do, not you or your family.  So, for those of you reading my posts but certain that I am not talking to you, please read on:

Argument #1)   Michael, you are a college professor, someone of high intellectual achievement.  I don’t have either the resume or reputation to do what you did.

Response:  “Negative Vibes”, “I Can Do This”

Argument #2)  Michael, I am far too busy at work to think about taking a month or two away from my desk.  No can do.

Response:  “It’s About The Time, Not Just The Dime”, “What The Heck Is A Working Vacation (Part II)”

Argument #3)  What would I ever do with our house while living overseas for a few months?

Response: “Don’t Be Afraid” , “How To Rent Out Your House”

Argument #4)  OK, but even if I do rent out my home, how will I ever find a place to live overseas?

Response:  “It Really Wasn’t All That Difficult”

Argument #5)  I don’t know anyone over there.

Response:  “Making Friends, Meeting Locals.”

Argument #6)  Mike, I am really worried about what to do my wife or one of my kids got sick while we were living overseas.

Response:  “Staying Healthy, Staying Solvent”

Argument #7)   Excuse me, Michael, I have young kids at home. What would you propose I do with them!

Response:  “Do It For the Kids”

Now I am sure you can come up with additional excuses I have not anticipated and not yet written about, especially if your goal is avoiding an exotic, no cost, overseas adventure with your family.  However, since you are reading my blog I can only assume that this is not what you want, and that you, like me, will eventually heed my wife’s sage advice given to me all those many years ago:  “Dammit, it was fun.  Go do it!”

Staying Healthy; Staying Solvent

In Istanbul we had our first encounter with something my wife and I had previously overlooked—the issue of overseas health care. Ruth came down with a mild ear infection, but one still serious enough to warrant a doctor’s visit and a prescription for antibiotics. Fortunately the problem cleared up in a week or so, and the resulting out-of-pocket costs were not too great.  However, it was sufficiently unnerving to make us realize how foolish we had been to ignore this concern and to purchase international health insurance policies on all our future working vacations–something we should have done from the outset.  (I guess we really weren’t as street-savvy world travelers as we had imagined.)

On the second page of every American passport the U.S. State Department prints the following stern warning:

Medical costs abroad can be extremely expensive. Does your insurance apply overseas, including medical evacuation, payment to the overseas hospital or doctor, or reimbursement to you later?

You are then referred to their brochure, “Medical Information for Americans Abroad” on the U.S. State Department website. It is an excellent document to read before starting on any overseas adventure.

When planning a working vacation it is absolutely critical to check with your local health-care provider to determine exactly what they do and do not cover when living and working abroad, including restrictions on injuries and illnesses, maximum length of stay, and exclusions for the country of residence. If you are one of the lucky few whose health policy includes full international coverage, then no more need be done.  (Note:  Some international exchange programs, such as Fulbright grants, include health coverage in their benefits.) However, the majority of policies contain significant restrictions or come to a complete and crashing halt at our national borders. In these cases you need to consider purchasing supplemental health-care coverage for you and your family, and a good place to start is HTH Worldwide. Click on their link Travel Medical and International Health Insurance Basics for an excellent introductory tutorial.

There are two types of policies: Travel Health Insurance pays for such basics as emergency medical needs, ambulance services, hospital costs, doctor bills, and prescription medicines. In the event of a serious injury or illness requiring specialized treatment, Emergency Evacuation Insurance covers the cost of airlifting you to your home in the United States or to the nearest full-service, first-world medical center, a cost that can run tens of thousands of dollars. You should purchase both types to avoid facing a catastrophically large expense.

Some other issues to keep in mind are: 1) Duration. Some policies are capped at thirty, sixty, or ninety days at which point they terminate.  Make sure a policy lasts at least as long as your appointment. 2) Primary/secondary coverage. A primary-care policy pays all medical expenses regardless of what other insurance you may have while a secondary policy only covers costs in excess of the amount you will be reimbursed from your existing policies. Primary coverage is an unnecessary luxury if your current insurer will pay a portion of the expenses.     3) Deductibles and co-pays. Like most policies, the more you are willing to pay the cheaper the cost will be. Determine how much you are willing to risk while overseas and then purchase a health policy with the appropriate deductible.

The exact cost of a joint travel health/emergency evacuation health policy will vary greatly based on duration, coverage type, and deductibles, as well as your age, family size, and host country. But, as one example, the cost of a policy providing health-care and emergency-evacuation coverage for a forty-something adult living and working in Istanbul, Turkey, is $130-300 per month, depending on deductibles and policy limits. This is not a lot to pay for an important aspect of any working vacation—peace of mind!  So, before heading out to Italy, India, or Indonesia, make sure you are fully covered if misfortune does befall.  Without it, your “Other Guy’s Dime” working vacation may end up costing you a huge percentage of your own savings.