Ill Overseas? 10 Top Tips
On my recent solo trip in Asia, I developed a hernia in my neck that caused a lot of pain in my left arm. Without going into all of the details, I ended up on an odyssey of sorts through the Korean medical system as well as my own Dutch medical system and, as a result, learned a lot about what to do and what not to do if you become ill abroad. Here is my advice:
Before You Leave
1. Get Insurance
You’ve probably already heard this advice, but it’s the most important of the bunch: get insured! This involves two kinds of insurance: health insurance and travel insurance.
I’ve read some bloggers recently who proclaimed that they didn’t get health insurance and that they just paid for health care if they needed it. For most of us who are not independently wealthy and who want quality health care, that’s not really an option. In any case, it’s foolhardy.
Paying as you go might work fine for a mild case of Delhi belly, but what if you fell and broke a leg and needed an operation to set it properly? Things happen, no matter how immortal you feel, and you need health insurance just in case.
Make sure your health insurance covers whatever you might need. Mine did, in that I was able to contact SOS International, which is affiliated with my health insurer. They covered all of the care I needed as part of my normal health coverage.
And make sure to contact your health insurance company as soon as you even consider consulting a doctor. They need to agree to the medical care you receive, so you want them in the loop through the whole process.
Another warning about health insurance: read the small print! We didn’t. It turned out that the company would only accept receipts in a limited number of languages, and Korean wasn’t one of them. One hospital was willing to translate the receipts for me after the fact, so I could submit those, but I ended up paying the other costs (mostly pharmacy bills) because getting a sworn translator cost more than what I’d spent!
You need travel insurance because your health insurance might not cover the costs of cutting your trip short, if that turns out to be necessary. Mine covered health care, but not anything to do with travel.
Fortunately, my husband and I have an all-year travel insurance policy that includes medical evacuation if necessary. Make sure you have this!
When it became clear that I would have to go home early from Korea, my health insurance worked with my travel insurance to make that happen. They forwarded my file and the travel insurance took it from there, helping me to reschedule my flight and booking a taxi for me to get home from the airport. And the travel insurance paid for a cancelled hotel reservation as well as my phone bills for all the international calls it took me to arrange things with both companies.
If I hadn’t had travel insurance, getting home early would have cost me about a thousand euros to buy that one-way ticket, on top of the money I’d already spent on the ticket I had. If I had needed a medical evacuation, it would have cost much more.
2. Bring information
Not only should you get insurance, but you should make sure to know what you need to do if you need to call on their help. Often a health insurance or travel insurance card will have a phone number on it. Make sure you have that number and read up on what their procedures are if you get sick.
I hadn’t done this, which meant some struggle at first to figure out who I needed to call to get the help I needed. That’s frustrating and difficult when you’re not feeling well to begin with!
Getting Ill Overseas
3. Don’t panic!
The Hitchhiker’s Guide to the Galaxy‘s advice, “Don’t Panic,” is absolutely right. As my arm grew more and more painful, and the sightseeing I had so looked forward to became less and less fun, I just wanted to go home.
When you don’t feel well, that’s your first instinct: run home. Run back to where you’re comfortable and everyone speaks your language and you know your way around. You feel desperate not to be in the unfamiliar situation that just a few days before was so exciting. That’s how I felt, even though I knew that health care in South Korea is fine.
Try not to give in to that feeling. It’s often not necessary to go home.
4. Don’t assume that health care where you are is necessarily worse than it would be at home.
In my emotional, irrational state, I made the mistake, after visiting one doctor in Busan who didn’t speak English, of thinking that his lack of English meant I couldn’t get good health care. My travel insurance company, though, was not going to pay for me to go home without a medical indication that it was necessary.
Back in Seoul, I walked into a hospital and asked to see a neurologist. I was able to see a neurosurgeon within an hour! I was relieved to find that he spoke enough English to understand me and be able to explain things to me. Not only that, he arranged for me to take an MRI right away, so I got the results in a couple of days. It never would have happened that quickly at home in Holland, where there are waiting lists for things like specialist doctors and MRI’s, unless it’s an emergency.
The doctor prescribed some new medications, and the pain mostly went away, allowing me to go back to sightseeing while I waited for a follow-up appointment.
5. Get all your paperwork.
Your health insurance company will want to see your file to find out what was done. At the same time, they can help reassure you that you’re getting appropriate care. At one point I was concerned about whether the treatment I was getting was correct (with “correct” meaning “what we’d do at home”). The health insurance company has doctors on staff who can read the file and give their thoughts. In my case it was “Yes, that’s absolutely standard treatment for what you have.” That gave me confidence.
Also, since you’re likely to have to pay upfront and be paid back by your health insurance, keep every single receipt and report (preferably in English), or you won’t get paid back.
6. Find medical people who speak a language that you speak.
It helps! That doctor in Busan, an orthopedist, was probably a perfectly good doctor, but I felt much more comfortable with the neurosurgeon in Seoul because I felt understood. On the other hand, none of the nurses or other support personnel at the Seoul hospital spoke any English at all. We communicated through sign language and sometimes by sitting at a computer typing into Google Translate. But as long as the doctor understood me, I felt okay.
7. Be prepared to pay up front.
Make sure you have enough credit on your credit card or enough cash in the bank to cover unforeseen expenses, which can be very large. In South Korea, you have to pay for everything up front, before you are treated. That was fine when it was 45 euros to see the doctor (a bargain!), but it was tougher when it was 650 euros for the MRI. I knew I’d get paid back, since the health insurance had given me the go-ahead to get the MRI, but I still had to be able to cover it for a while. Make sure you get approval from your health insurer before any big expenditures!
8. Get a doctor’s statement.
You’ll need your file in any case, but if your doctor has decided that you should go home, you also need an official statement from him/her that going home is medically necessary. Without it, your travel insurance will not pay for you to travel home early. You also need a “fit to fly” declaration if you will be traveling by plane. Some conditions make it unsafe to fly, which is why the travel insurance will require this statement before they book you a flight home.
9. Be nice.
You are not part of the system in whatever country you are visiting. You represent extra work for medical staff since you don’t speak the language and aren’t familiar with their system. Wait patiently. Smile. Say thank you. You’ll get better treatment than if you start demanding attention. At the hospital in Busan a nurse who spoke a bit of English ended up personally escorting me around the hospital: to the doctor’s office, to the cashier, to x-rays, back to the doctor’s office, to the pharmacy, and then to physical therapy. In Seoul, a very busy nurse took the time to sit down with me at a computer and communicate through Google Translate.
10. See it as an opportunity.
It sucks to be sick in an unfamiliar country. Try to look at it differently and approach the experience as an opportunity to see another culture from the inside. The time I spent in the busy waiting room of a Seoul hospital turned out to be interesting in itself. Though I didn’t know what people were saying, I could figure out a lot about their system and culture by watching how people behaved in relation to each other. Once I relaxed enough to accept that I was receiving the health care I needed, I realized it was an inside view I never would have gotten otherwise.
Have you ever fallen ill away from home? Is there anything else you would add to this list? Add a comment below!
Rachel, I completely agree with #4: Don’t assume that health care where you are is necessarily worse than it would be at home. When we were living in Panama it became obvious that my husband Dan would need to have his hernia repaired. Not only did his M.D. speak English, he had trained at Pitt, and the hospital was affiliated with Cleveland Clinic! Even better, he gave us his private cell number to call if we had any questions beforehand or issues afterward.
I now understand why “medical tourism” is so popular: The entire surgery cost us $3,000 (balance due before discharge) while his brother’s identical surgery in Florida was over $22,000. That $18,000 difference would pay for a whole lot of vacations!
There’s a lot of medical tourism in Korea too, especially for cosmetic surgery. And the doctor visits were distinctly cheaper than they would have been in the US. So were the pills, though I don’t have any idea what they were exactly.
That’s a very positive approach to getting sick abroad! My son broke his arm in the USA last year and thank goodness we had travel insurance. I’d never go anywhere without it now!
It can certainly ruin a holiday! And obviously no amount of positive thinking is going to help if you’re feeling deathly ill. But after my initial panic was over I tried to look on the bright side.
Thanks for this helpful post. So far (fingers crossed) we have not needed to visit a hospital whilst overseas.
As I discovered, sh*t happens. Being prepared to deal with it makes it easier.
We used to have international health insurance when we were expats, but that has expired now that we’ve moved back to our home country. I’ve never bought it or travel insurance when we’re traveling on our own. After reading all this, I’ll have to seriously look into it. I read another blog where a single mum and her son were horseback riding in Mongolia when he fell off and critically injured himself. They ended up being airlifted and eventually ended up in a hospital in Singapore. As she put it, thank goodness for travel health insurance as they would have gone bankrupt attempting to pay it completely themselves.
If it’s not included in your regular health insurance, there are short-term policies available that will just cover while you’re traveling. And the same goes for travel insurance. Ours is an all-year policy because we travel a lot, but you can get a short-term one. I would never go without it! It would make me too nervous to take that risk. This was a quite minor situation: I was still mobile and the costs would not have bankrupted me. But what if it had been worse? And I’ve heard too many stories like yours!
Some great tips here.I like the advice of “don’t panic”. It is very easy to get frazzled when you are travelling to a foreign place. You really do need to take a deep breath and calmly find a solution to any problems that may arise.
I know! Your immediate instinct is to run home, isn’t it? Safety and familiarity!
Thanks for all these excellent tips! I sure hope you are feeling better.
Thanks, Irene! I’m feeling better. No pain in my arm, just occasional pain in my neck.
‘So glad to hear that you’re alright. Thank goodness. How awful to have to undergo surgery or serious treatment when you’re abroad.
As much as we all love the countries we live in even as expats, we panic as to the care and safety in comparison to that of our own home countries. I know that Korea is considered as one of the most technologically advanced countries as does Germany in the “first world,” but it doesn’t stop one from worrying on point.
Believe me, you did well in trying to keep cool, calm & collected and getting the care and help that you needed. Bravo my dear. 🙂
Well, I didn’t stay so calm initially. As my arm got worse, I just wanted to go HOME! And I stopped staying in airbnb’s and moved to hotel rooms because I didn’t want to have to interact with anybody. It was good that it wasn’t so easy because that gave me time to think more rationally. The fact is I wouldn’t have been treated as quickly at home.