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Prepping for Long Term Travel: Handling Healthcare and Immunizations

09/24/2012 by Kristin 24 Comments

Going on a long term holiday, or starting a long term backpacking trip? Here are my best tips on how to handle healthcare and immunizations.
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Figuring out the ins and outs of getting immunized and maintaining health insurance on the road took me a freaking while.  I spent days on message boards, calling various insurance companies, and speaking to other travelers before I was finally able get things straightened out.

To save y’all some time, I detailed my findings here:

Health Insurance:

I could wax poetic for days, weeks, perhaps even months on the frustrating and unfortunate healthcare system we deal with in the US.  Suffice to say it sucks horribly.

In most cases, you’ll probably have to quit your job to take a gap year.  If you live in the United States, that means you might find yourself in a bit of a pickle (assuming you’re 26 or over in which case you no longer qualify to be under your parent’s insurance).

I quit my job in preparation to travel.  It seemed like an all-around fantastic idea, until the harsh reality of healthcare costs set in.  I was left with the responsibility of paying for Cal-COBRA – meaning I would continue the same insurance my former company had sponsored, but I’d be paying 110% of the costs (that extra 10% is administrative fees – I could just scream).  I’m sure each state has their own kind of continuation insurance.

This seemed all well and good until I realized the cost is $360 per month for my extremely crappy HMO.

It’s enough to drive a sane person crazy.

crazy
My “bat sh*t crazy” face

One could apply for cheaper insurance, but only if you have visited the doctor for almost nothing for the past year.  Pre-existing conditions (like shoulder surgery, for example) equal instant rejection.

Those in my situation, who are looking to travel long term abroad, have a choice to make: pay up for insurance out of pocket, or don’t have insurance at all in the U.S.

I’m choosing not to have insurance in the US while I’m gone.

I better stay away for a while. 

Immunizations

The funny (but not really that funny) thing about most US insurance is that it will NOT cover your travel immunizations because apparently these are elective.

I know! It makes tons of sense to me, too.

Thankfully, I’m a responsible samaritan who paid out of pocket and immunized herself so that I won’t come back and infect people with Japanese encephalitis.  You’re welcome.

The cheapest method will be to make an appointment with your local department of health organization, which in my case, was Orange County, California.

Upon walking in, it will be immediately apparent that this is not your typical doctor’s office. In fact, it is strangely reminiscent of the DMV, complete with rows of plastic chairs and taking your number and waiting.  Unless, of course, you have an appointment that you booked at least a month prior (be sure to do that).

I should also point out that, at least at my clinic, malaria appointments are separate, and require another fee, of course.

I fully expected the doctor to try to upsell me on immunizations, as the message boards had warned.  She was great, though.  She was very warm, excited for me about the trip, and I was surprised that she patiently waited for me to call my mother regarding my immunization records, just to make sure I didn’t get Hep B twice (FYI, if you’re in your 20s and attended public school in the States, you have probably had the vaccine already).

For Southeast Asia, I got tetanus (had already had the booster, which is necessary every 10 years), another booster of MMR (measles, mumps, and rubella) as well as polio (You probably had these as a child, but it’s good to get a booster. My GP doc was able to give me these and bill insurance as a medical necessity), typhoid which I took in pill form (this method is cheaper and lasts longer than an injection), and hep A.

Some would suggest getting the rabies vaccine. Of course, it runs about $1000 to get the full three-shot series.  It also does not prevent you from needing another shot if you get bitten.  It simply buys you time if you’re in a rural area.  So, if you think you might be in a situation where you could be bitten (by rabid monkeys, dogs, or animals on a farm you might volunteer for) maybe it’s worth looking into.  As for me?  I’ll resist the urge to pet the “cute friendly little” vicious dogs on the street, and take my chances.

I think I’ll also pass on the malaria pills.  Everyone has an opinion, but in general, I think I’ll wait until I get to Asia to make the choice.  I hope these aren’t famous last words (or in my case, probably not that famous).

Travel Insurance

I bought a 6-month coverage plan and will re-evaluate for the remainder of my trip.  Medical evacuation is covered, as well as most of the activities I enjoy (SCUBA diving, cage diving, you know, that kinda stuff).  Of course, I can’t be evacuated back to the U.S., so if anything goes awry, I can fly a friend or family member to me, and they’ll cover it.

Based on what I could find on the message boards, I decided to go with World Nomads.  I hope to never have to file a claim, but we’ll see!

Have some knowledge to share regarding immunizations or healthcare on the road? Do share! 

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Comments

  1. Margyle says

    09/25/2012 at 5:14 pm

    When you leave Canada for more than 3 months you have to let your province know (since it’s our province who provides us healthcare)… but I didn’t do that lol. I know when I got to Japan they put me on a healthcare plan with my company, but then my company went bankrupt lol. Thankfully, I could go on the national plan and it’s based on your income and because I hadn’t really received any wages, it was like $90 for the whole year. Hooray! That’s one of my examples lol.
    Hope it was helpful and that you get everything sorted out!

    Reply
    • Ava Apollo says

      09/30/2012 at 9:50 pm

      Man…I really wish that we had healthcare like that in the US. I was paying $360 just for one month, and it didn’t even cover my physical therapist. I couldn’t find one who would accept my insurance because it paid them out so low. Ughhhh!

      Reply
  2. Adela @ FourJandals says

    09/30/2012 at 7:25 am

    Loving the good travel advise articles you have been posting lately. My advise would be definitely do NOT skimp on travel insurance as you never know what happened. We both ended up in hospital in Canada when doing a ski season and the bills were unbelievable. So worth picking a good provider.

    Reply
    • Ava Apollo says

      09/30/2012 at 9:50 pm

      I have heard a lot of stories about people getting injured abroad and being very thankful that they had travel health insurance. I definitely made that a priority!

      Reply
  3. Laurence says

    10/06/2012 at 1:31 am

    For such a developed nation, the US really has a sucky healthcare system. I just got all my shots for my Asia trip here in France, and it was all covered by the frankly amazing healthcare system, which is included as part of my tax. Can’t be beat!

    Reply
    • Ava Apollo says

      11/26/2012 at 10:54 am

      I agree with you completely. Our healthcare system is shit in the US.

      Reply
  4. Kristin Addis says

    03/03/2013 at 11:20 pm

    I haven’t yet submitted my claim, but yes, I’ve had to use it. Will have to write an article about it once I’ve gone through the process. If your stuff is really expensive, I’ve heard WN isn’t great at coverage in those cases. Also didn’t get Japanese Encephalitis – none of the clinics in Southern California even carried it. I’m under the impression it’s not really a concern, but ask your doctor!

    Reply
  5. haley says

    09/15/2014 at 12:46 pm

    Hi Kristin,

    Per your suggestion I am viewing the World Nomads travel insurance options. Do you typically go for the Standard package or more expensive Explorer package? Do you think the explorer package coverage is worth the extra cost?

    Thank you!
    Haley

    Reply
    • Kristin says

      09/15/2014 at 1:22 pm

      I go for the explorer package because I’m an avid SCUBA diver and I also tend to do a lot of trekking and other adventure sports that aren’t covered by the other package. Just depends on your travel style 🙂

      Reply
      • Anonymous says

        09/15/2014 at 3:03 pm

        Thank you Kristin. I think I will go for the explorer package as I’m hoping to take a scuba lesson, learn to surf and new adventures as I find them. I will be sure to use your link for me purchase 🙂 Please note that I noticed at least 1 of your recommended packing list isn’t available: pack-it cube http://www.amazon.com/gp/product/B002YIRA18/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B002YIRA18&linkCode=as2&tag=bemytrmu-20

        Lastly, is there a diva cup brand you prefer?

        Thanks!

        Reply
        • Kristin says

          09/15/2014 at 4:49 pm

          Thanks so much for letting me know! Fixed.

          This is the only one I’ve used but I find it works well http://www.amazon.com/gp/product/B0015G57Q0/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B0015G57Q0&linkCode=as2&tag=bemytrmu-20

          Reply
  6. Dee says

    07/28/2015 at 1:03 pm

    What did you decide to do with the Malaria pills when you reached Asia? I’m in the same boat. Not a fan (not that I would be of actually getting Malaria either!!), haven’t used it in the past but….I know everyones choice is diff, just wondering what you decided.

    Reply
    • Kristin says

      07/29/2015 at 8:12 am

      I didn’t take anti-malarials when I was in Southeast Asia. I was there for so long and personally felt the risk wasn’t great enough. That said, I know people who have gotten it there (though not many). I did take them when in Eastern Africa because it’s a more severe strain there and I know A LOT of people who have had it there. I decided on malarone because doxycycline requires taking the pill a full month after leaving a malaria zone and malarone is one week. It’s more expensive but I’m not bargain shopping for something like that! In the end you have to go with what you’re comfortable with based on your doctor’s suggestions.

      Reply
  7. laura says

    02/29/2016 at 2:22 pm

    i commented earlier! im going to work in AUS for 3 months living with my sister and aunt, and then going to travel for about a month to thailand, singapore and bali. do you suggest anything for me? should i get vaccines before i go? or get them in AUS? im so lost!

    Reply
    • Kristin says

      03/04/2016 at 6:35 am

      You should get vaccinated. If they’re too expensive in Oz then look into the Bangkok hospital group. They have a few locations around Thailand and they’re very high level with their service.

      Reply
  8. Danyelle says

    09/22/2016 at 2:48 pm

    Hi Kristin!

    I live in CA and my boyfriend and I both love your blog! You do an amazing job!

    We’ve traveled a good amount, but never for so long — we leave in 6 weeks for a 6 month trip through SE Asia and we’re so excited (and better prepared, thanks to you!).

    Immunizations — grrrr! Such a stressful situation!

    We’ve decided to get the Hep A, Typhoid, and JE vaccines but I’m having such a hard time spending $600 on the JE vaccine. I looked into it a bit and found this concept of “travel clinics” in SE Asia (particularly found one in Chiang Mai and one in Bangkok) that administer these vaccines for SO MUCH LESS! The JE vaccine is about $34 at these clinics.

    Have you ever visited any of these clinics? Or have you spoken to travelers that went that route? I’m not huge on vaccines…more of a holistic person, so they make me nervous in general, but I do realize in these situations they are necessary. Now I’m trying to save some money while also making sure I don’t get an expired vaccine with a dirty needle >__< .

    Any advice here is greatly appreciated!

    Reply
    • Kristin says

      09/22/2016 at 3:37 pm

      Hi Danyelle, I’m so glad that you have found the advice to be helpful! Yay!

      Please just take this as my experience and not advice because I don’t feel qualified to give medical advice, but yes I have been to the Bangkok hospital in Phuket (it’s a chain) when I was sick and it’s a very nice hospital with great facilities. I also had my teeth cleaned there. Great both times.

      I hope that helps! Have a blast! Whatever you end up deciding to do, I would love it if you’d share your experience here in another comment 🙂

      Reply
  9. Heather says

    06/24/2017 at 1:42 pm

    HI! I’ve enjoyed reading your travel blog for both inspiration and travel advice for a solo female traveler. Thank you for taking the time to post to help others in their travels. I will be quitting my job and traveling internationally for nine months and, as you experienced, am having a difficult time trying to figure out how to handle my health insurance in the US. (I will be purchasing travel insurance.) As you mentioned, to pay for Cobra while I’m traveling is a very expensive option. But what happens when you return to the US from your international travels? Are you penalized for not having insurance, and therefore, should pay for the Cobra anyways? Or can you sign up for a plan when you return and just have gap time? Any further clarification would be greatly appreciated!! Thank you in advance. 🙂

    Reply
    • Kristin says

      06/25/2017 at 10:30 am

      Shit I don’t know. I’m a bonefide resident of Germany now. Ask your accountant. He/she will know best.

      Reply
  10. Leslie says

    09/11/2017 at 6:08 pm

    Hi there!
    Love all the info and advice you give. Thank you!
    My question is: do you have any advice for a 75 year old woman who is sick of tours and would like to travel solo? Obviously I wouldn’t be up to some of the treks you young folks do but I would still like to see more of this gorgeous world on my own.
    Thanks for any suggestions….other than “stay home”! Ha!
    Leslie

    Reply
    • Kristin says

      09/12/2017 at 11:40 am

      Hi Leslie, I met a woman 2 years older than you in Gili Air in Indonesia who was solo traveling without a tour. She did what I did – hung out on the beach, in the pool, ate awesome food, hung out with locals, went swimming. You still have so many options even if hiking isn’t your thing!

      Reply
  11. Masha says

    03/26/2018 at 3:10 pm

    Hi Kristin! Thanks so much for your blog, it’s so thorough!! I just wanted to get your advice on travel insurance. My boyfriend and I are traveling to south east asia at the end of May for 3.5 months, then coming back to the US for a wedding, and then hoping to set out traveling again. If it was you, would you just risk it and not have travel insurance for the week – month we’ll be back in the US? I’ve seen you post things about burning man or visiting family on your insta, did you go insurance-less?
    thanks so much for your advice!

    Reply
    • Kristin says

      03/26/2018 at 7:08 pm

      Hi Masha, I think the main thing to consider is getting penalized on your taxes for not having insurance. I’d look into that first. I usually get some kind of monthly insurance that covers me if I get hit by a bus but it’s never an ideal situation unfortunately. Some travel insurance will cover you if you’re at least 100 miles from home and that’s what I use for the Burn.

      Reply
  12. Daphne Gilpin says

    04/02/2019 at 9:48 am

    Thanks for explaining that those who are looking to travel abroad long term have to decide between paying for insurance out of pocket or not having insurance. I’ve been trying to learn more about immunizations because my family is planning on travelling soon. I appreciate you sharing this info.

    Reply

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