May 27, 2012

Healthcare for Cruisers

It’s one of those questions that comes up again and again—‘are we covered by health insurance, if so which insurance, what does it cost, and what does it cover?’

First off a caveat—we’re Canadian so our worst case scenario is even if we have been out of the country long enough that we’ve lost our healthcare coverage (this varies from province—but the cut-off is typically 183 days per year with some provinces allowing you to be out longer as long as you have an intent to return) our coverage will resume after a waiting period (typically three mos—but there are provinces with no wait period).

cruisers need to take preventative measures when it comes to staying healthy--rescues are hard to come by
That said, this is what we’ve done:

US West Coast—We were insured beyond our basic Canadian insurance. Our Canadian insurance reimburses costs up to what it pays in Canada—which comes no where close to the US cost of healthcare, so we decided ages ago never to be in the US without some sort of additional coverage—we always have visitors insurance for the US no matter how brief the visit might be. On the trip down the coast we didn’t need to use it.

Mexico—We maintained our Canadian coverage but had no supplemental coverage for Mexico. We had one bad experience in Mexico—we needed to update vaccines and in Santa Rosalia the Doctor offered to get us them—charged $80 in advance, then failed to get the vaxes or to reimburse us. But this was an exception.

Mexico is one of the countries that is considered great for routine healthcare (others we've heard raves about include French Polynesia (we got free vaxes in Nuku Hiva), and Malaysia). And both La Paz and La Cruz are popular for check-ups. Typically treatment was excellent and modern—my skin cancer checks (I went for two, Ev had one) were accurate and affordable ($125 for a full screen and biopsy). Treatment for pneumonia was straightforward--two doctor visits ($30, $50), x-rays ($25), inhalers ($50).

During our 18 months we also visited local dentists every six mos—basic cleanings were around $30, fillings another $30 and Evan needed a root canal which ended up in the $600 range. Keep in mind Mexican dentists rarely use x-rays and rely on physical signs of decay. So our rule of thumb is to visit the same dentist at the same time as another family. If too many cavities are found we know we’ve hit on someone who’s too enthusiastic with the drill and we all move on.

Between preventative care, prescriptions, two eye doctor visits and glasses and contacts for Ev (we got Maia's glasses in Canada), skin-cancer check-ups and a root canal, treatment for pneumonia our expenses were about $1200 for the 16 months we were in Mexico. We could have squeezed in check-ups on a visit home the first year, but we were confident enough in the Mexican system that for preventative care and day-to-day follow-up care we were happy.

Crossing the South Pacific we carried Dan evacuation insurance. This insurance can evacuate us to a place we can be treated—but it doesn’t cover treatment costs once you’re there—so having a plan about where to go is vital. We did get some prescription drugs—anti-malarials in Vanuatu ($20), cream for a skin infection in French Poly $30.

In Australia we have bought basic insurance (ranges from $150/per month per family up). Dental is out of pocket—Ev and I went to the school and had checkups for $60 each, Maia went to a local dentist and her check-up and cleaning was $200 and a filling was $210. I’ve had a ‘well-woman’ check-up $110 and a skin check for $185. Evan saw a Dr. for sore knees which came to $75 plus $133 for x-rays (should get some of these expenditures back).

So all this said—there really is no one medical insurance answer. It varies according to how long you are away from your home country and where you spend your time while away. Our basic plan is to keep up to date on all preventative healthcare—we vaccinate for whatever the locals are vaxing against (assuming we may be even more susceptible), we take our anti-malarials or whatever preventative drugs are needed, we get check-ups, we don’t let things linger (too long…)and we buy insurance when we're in more expensive countries.

Staying on top of things is vital to staying healthy though.


Diane, Evan, Maia and Charlie the cat said...

Had a note from our friend Graham: We had the same situation. We insured the whole time we were away with Allianz Worldwide Care, based in Dublin, Ireland. They have a thing called the "Long Term Sailor Policy", which worked extremely well for us the three times we had to claim. Would thoroughly recommend them.
Here's the plan:

The crew of SV Fluenta said...

Much thanks - "Healthcare" plans remains on our "to do" list for June.

Diane, Evan, Maia and Charlie the cat said...

you're very welcome!

Unknown said...

Very informative post! There is a lot of information here.