I’m continuing to work through loads of interesting questions I receive from future cruisers. A hot topic, quite logically, is long term medical insurance for Cruisers. How do I get long-term medical insurance (often called ‘Expat Insurance’ or ‘Global Nomad’ medical insurance/ health insurance)? And the cost of medical procedures away from home, as well as the quality of care.
Cost Of Seeing a Doctor when Travelling
Don’t worry, in most places, you’ll travel to as a cruiser the care is very good, even in local government-run hospitals. Over the years, we’ve needed to see several doctors, including specialists.
The first doctor we visited was in Grenada. How I wished this lady had been our family doctor back home. Her staff were friendly, she was on time, kind and there was no rush during the appointment. She was super knowledgeable and was even a professor at the local medical school in Grenada, which trains a great deal of US doctors. She went the extra mile and phoned me back at the boat to check up on my daughter that evening. The cost for the half-hour appointment was EC$100, about $37. This price included a minor surgical procedure.
My husband saw a specialist in Antigua and was equally happy with the doctor. He was a tall big guy, an old-school Caribbean gentleman. With a wicked sense of humor and a roaring laugh. He beamed with pride as he flicked through a photo album showing pictures of the cricket team he coached. His care was excellent. The appointment was over an hour and a quarter, although I’m told it could have been whittled down to 20 minutes if it wasn’t for the stories and jokes. Cost EC$300 or $110 including tests. Not bad for a specialist.
In Colombia, we found out we all needed Yellow Fever vaccinations to go to Panama. All four of us were told to go to the public health clinic. 4 yellow fever shots, plus as many other travel vaccinations as we felt we needed. Free!!! We even questioned the nurse reminding her we were not Colombian.
My husband saw a doctor in Cartagena, Colomba. We googled ‘doctor’ and went to the closest one by taxi. We arrived to find an overflowing waiting room, with about forty people in it, waiting for a single doctor. As soon as the first patient came out of the doctor’s office, were ushered in. He did not speak a word of English, between our broken, bad Spanish and google translate, we got to by. I can’t remember the exact cost, but seem to remember it wasn’t expensive at all, maybe $25.
In Colombia, we walked into an optometrist with a sign ‘English is Spoken’ above the door. We went in to book an appointment. The receptionist profusely apologized that we couldn’t be seen for about 45 minutes, as the doctor wasn’t in.
We went for coffee, and it turns out when we returned that the optometrist we saw was the owner of the chain of a dozen or so optometrists. He spoke perfect English and had driven across the city to see us! Two pairs of glasses each, of both multifocal, with one of each of our pairs of glasses being sunglasses. $350 for each of us, with good brand name, frames (appointment included).
Once again, when we popped by two days later to pick up our glasses, the owner drove across the city to confirm we were happy with everything.
And that’s when both of our bank cards were declined. We were mortified the owner was so embarrassed. While I was on my phone with our bank, I think he was ready to give us the glasses for free. Read about ‘Accessing Money When Travelling‘ so that you don’t get caught out too.
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In the remote San Blas region of Panama, my daughter developed a massive staph infection after scraping some coral and needed to see a doctor urgently. We asked the local villagers and were told there was a clinic on a nearby island about 12nm away.
We moved the big boat and went in to see the doctor, really not expecting much. We were ready to sail through the night, to get to the Panamanian mainland where we could find a real hospital.
There wasn’t much to the clinic. A dusty single-story waiting room and one doctor. We weren’t holding out much hope. We saw the doctor immediately while my husband filled in the forms. The room was small and clean, with all the basic equipment that the doctor needed for minor procedures.
The doctor was young and spoke perfect English. He said in Panama, doctors are required to rotate through the remote clinics for 2 weeks every few months. This is to ensure that even the most remote citizens have access to basic medical services.
The doctor drained, cleaned, and dressed the wound. He gave us a prescription for two weeks of antibiotics plus some antibiotic cream. Total cost $2.50!!!
The next doctor’s visit in Panama was for me. I was really ill the worst I’d felt in years. We went to the local public hospital in Sabanitas. About an hour away from Linton Bay, where the boat was anchored.
It was a Saturday morning, and the hospital was crowded. To be honest, the hospital was really grubby on the outside. The waiting rooms weren’t much better. I didn’t care. I felt like death. I was seen quickly (within about twenty minutes). The doctor’s examination room was clean but old.
I saw an English doctor who sent me for blood tests down the hall (the lab was spotless). After about forty minutes wait for the test results, I saw the doctor again. He prescribed antibiotics and sent me on my way. Cost $5 for two doctor’s visits, $5 for the blood tests, plus $10 for the prescription. The doc apologized in advance for the high cost of the strong antibiotics he prescribed for me.
Since then in French Polynesia, we have seen numerous fantastic doctors ($70 for a consultation, plus two courses of antibiotics and antibiotic cream $49) and specialists ($50 for a dermatologist). The services and care are first-rate and cheap! As good as anything I’ve seen at home. We have a friend that had a heart attack while on his boat. Fortunately, the boat was anchored in Tahiti at the time. He received excellent care.
We saw a fantastic young lady dentist, in the cleanest, most modern surgery I’ve ever seen. Cost $34 each for a checkup plus cleaning!
I had a mammogram and breast ultrasound for $175.88. The experience was fantastic. After the tests. Right then and there the imaging specialist told me, “I’ll forward these to the doctor with my report. Everything is OK. There is no need for you to see the doctor.” Year-one, I had already seen the OBGYN, also professional, thorough, and English speaking. His charge was $105. The second-year, I booked the mammogram and ultrasound appointment directly.
Wrap-up Quality of Health Care When Travelling
In a nutshell, all I can say is that we have been very happy with all of the doctors we have seen so far. Would I have liked to have had my appendix taken out in the hospital in Sabbanitas, Panama? Absolutely not, but the big private hospital an hour and a half away in Panama City would be fine. And from what we’ve heard from retired ex-pats in Panama. Not crazy expensive either. Nowhere near US prices. Speaking of the appendix being taken out, we have a cruiser friend whose kid had his appendix removed in Grenada. No charge, just ECD20 about $8 for the post-op antibiotics. All was good with excellent care.
Expatriate Long Term Health Insurance
We carry ex-pat long term health insurance through IMG Global. I’d love to tell you how good they are. I don’t know. We’ve used them for 4 years and have never claimed. They always take our premiums on time. We set a high deductible of $1000 and regard this as our worst-case dread cover for something really big that we can’t pay for out of pocket, such as surgery, long term care, medical evacuation, etc. Thankfully, try as I might, we can’t get anywhere close to covering the deductable in doctors fees.
We are on their silver plan and have coverage for $5 million each. This is comprehensive health care insurance and not travel insurance.
Family of four, us in our mid-40s (47 is mid-right?) we pay around $250. We also elected to remove coverage in the US, which made an enormous difference to the premiums.
If you are a US citizen, you need to take a careful look at the policy wording.The policy requires US citizens to be outside of the US on the day the policy is activated, plus there are maximum time limits that may be spent in the US before the policy is canceled.
If you have IMGlobal coverage, it is worth checking with the company to see if you are covered for Covid related illness. Depending on your policy and when your policy was issued, you may have no insurance for Covid related claims.
Citizens Other Than The US
Please Note for Non-US Citizens
If you aren’t a US citizen and require a B1/B2 visa to enter the USA, make sure you get a B1/B2 visa if you are traveling in any region where you would possibly be air evacuated to the USA. The Air Ambulance will not evacuate you to the USA irrespective of your condition without a B1/B2 visa as US immigration will not allow you in without a valid visa even if you need urgent care.
For dread coverage, it is possible to apply for a two-year extension to the 6-month maximum period you may ordinarily spend outside of Canada. Most provinces have this allowance, but normally you need to apply in writing.
Medical Insurance Coverage For French Polynesia Long Stay Visa
An added benefit to having an insurance plan in place is that it made applying for our French Polynesia long term visas so much easier. The lady at the embassy in Panama remarked how it was good to see that we’ve had medical coverage for years, and didn’t take out a policy the day before applying. Her take was, they looked more closely at the financial ability of applications without long-term health insurance. They feel the people will cancel the health insurance the day after arrival in the territory, so they want to see a much bigger cushion for health care costs.
Dan Diver Insurance
Dan Diver is another medical coverage provider frequently used by US cruisers. The issue with Dan Diver coverage is that it’s primarily aimed at getting you home and onto the coverage of your at-home medical coverage provider. So, unless your keep your health care insurance at home, Dan Diver doesn’t really help much, as normally they will get you home and not to the closest affordable international health care center.
Dan Diver is not alone in this regard, any emergency medical evacuation coverage will try to get you home where your home-based health insurance is supposed to kick in to take care of you. That is unless you can put an exceptional case to them, to take you somewhere else. But, don’t expect this to happen if it’s going to cost the evacuation provider more getting you to your preference of treatment facility than the cost of getting you home.
We’ve heard frequently that the French Embassy in LA does not accept Dan Diver insurance as proof of acceptable insurance coverage for French Polynesia. On the other hand, we’ve heard of a few cruisers who have shown Dan Diver Insurance at the French Embassy in Panama City and have been granted Long Stay Visas.
Travel Insurance Doesn’t Cut It
Travel insurance doesn’t cut it. For one you are paying for a bunch of services, you don’t need, such as canceled trip insurance or lost luggage. Most travel insurance packages only cover short term travel, for up to 30 days. There are a few plans that allow 90 days. These really are unsuitable for cruisers, unless you will only be using the travel insurance for your first 30 to 90 days.
Directory of Medical Insurance Providers For Cruisers
|Name of Medical Insurance Provider||Headoffice|
|Gowrie Sailor’s Health Insurance||USA|
|Now Health||Hong Kong – UK/ Dubai + other offices|
|William Russel International Health Insurance||UK|
For more planning and advice to become a cruiser start off with my 10 Steps To Become a Cruiser article. If you have any comments on service providers or would like to share your own experiences with medical and health care as a cruiser please leave a comment.