Medical Care Outside the U.S. … One Cruiser’s Experience

“What happens if we need medical care while we’re gone cruising?” Luckily, we have never needed anything except minor medical attention while cruising.  In all but one instance, we already had the medication in our cruiser’s medical kit – if you know you’re susceptible to a particular condition, such as me with sinus infections or my husband with bronchitis, be sure to bring the antibiotic that works best for you in your cruiser’s medical kit!

Our only minor medical trauma that we couldn’t solve was a case of montezuma’s revenge I picked up after eating at a tiny beach restaurant in Providencia, Colombia.  We had flagyl in our medical kit from previous experience with giardia, but knowing there are faster drugs (read faster, not necessarily safer) drugs available for giardia in other countries, we visited the pharmacia instead of relying on the flagyl which I hate.  The pharmacist recommended a round of medication which I took and felt a bit better, at least able to leave the boat & explore the island before we had to move on to San Andres, Colombia in our progression to Panama.  While in San Andres, I felt worse and worse, mainly dehydration despite my best efforts to keep hydrated.    My Spanish is not up to a complex discussion with a doctor with 2 weeks worth of history on what was happening, so I wrote some notes and we stopped at the Red Cross, where no one spoke English.  But the young lady that saw us told me I needed to go to the emergency room at a local hospital.  She set it all up and told us there was an english speaking doctor there that would see us as soon as we arrived.  OK, seems good.

This was prior to the new hospital and at that time you had to wait outside a steel barred door for emergency room services.    We walked up to the rust encrusted steel barred window, which slid aside with a raspy rusty noise and an amazingly friendly face asked us why we were there.  The next thing I knew, the heavy rusty steel door cracked open just enough for us to slide through and we were inside.    We were ushered to a tiny examination room and a few minutes later a smiling young lady came in speaking completely clear English.     While we waited a maximum of a half hour for the medical results to come back from the lab, she sat “practicing her English” with us — she didn’t need any practice, believe me!  She had 2 job offers, one from Norwegian Cruise Lines and the other from Royal Cruise Lines and she was debating which to take.  She wanted our opinion on the two cruise lines.   When the lab results came back, she gave us a medication – turned out to be a weird fungal infection, not giardia – plus a prescription and told us to get some Pedialyte at the local pharmacia when we filled the prescription.

She then apologized again and said she was going to have to give us an emergency room bill.    Out of the country medical services often don’t take US insurance – be sure to check with your insurer to see what is and isn’t covered while you’re out of the US!  As we sat in the tiny cement block windowless room by ourselves, we fretted a bit about how much the charges might be … lab tests (returned with results in 30 minutes), an emergency room visit, the doctor fee, and one of the two prescriptions I needed … YIKES!  She returned, apologized profusely and handed us the bill.  $22    Wow, excellent medical care for $22?  What are we doing wrong in the US?    I recovered quickly with the right diagnosis and medication and we thoroughly enjoyed our stay in San Andreas!

We know several cruisers who have had much more extensive medical problems while cruising.    Heart attacks, surgery to remove a large section of colon, injuries, hernia operations … and we have never heard reports of anything other than excellent care.  Of course, thus far in our commuter cruising adventure, we’ve only explored the US east coast and the Western Caribbean to Cartagena, Colombia and back, so our experience is somewhat limited.   We actually know of several cases where cruiser’s family members few in to Guatemala City or Panama City to get medical care for surgeries like rotator cuff and dental implants because it is reasonably priced and if you use the private facilities, often the doctors are trained in the U.S.  (My San Andres emergency room doctor was not trained in the U.S., she was from Barranquilla, Colombia but her training … and her bedside manner… both seemed superb.)    In some cases our friends had to pay the entire bill themselves since they didn’t have health insurance that covered them outside the U.S., but it was so reasonable that it might have been less than the out of pocket amounts they might have paid in the U.S. for the same care.

Make sure you understand what your health insurance will cover if you’re outside the U.S.A. and need medical care!   There are also travel and international health insurance policies, again, the most important thing is to understand exactly what you’re getting and what will be covered — not exactly easy with insurance!

The other recommendation is don’t leave home without a DAN Divers Alert Network membership!  Very inexpensive, DAN is for divers and non-divers and offers 24 hour Emergency TravelAssist $100,000 emergency evacuation assistance.  There’s also travel insurance available in addition to your membership dues.  I can’t remember what it was to join, but less than $50 for a family membership per year.    Click here for information and be sure to join.

Three Tips for Medical Concerns

1.  Be prepared!  Make sure you understand what your health insurance policy — whether a travel policy, an international policy or regular U.S. health insurance will cover and not cover before you leave the country!  If you have special medical conditions, make sure you’ve reviewed how much medication you will require and make arrangements to get it before leaving the country!  It may not be available outside the US!  I know many insurance companies won’t allow you to buy more than a month or couple months supply, so you’ll need to contact them and explain that you’ll be gone for six months … or however long… and work out something that works for you!!

2.  Don’t be worried about getting quality medical care wherever you’re cruising.  Other cruisers in the same area likely have information, whether it’s just a good dentist for a toothache or a serious medical emergency.  Be sure to ask for input, other cruisers can tell you good doctors/hospitals/dentists/veterinarians and direct you to someone who speaks English if your Spanish or other language isn’t up to the task.

3.  Get the DAN Divers Alert Network membership for the emergency evacuation assistance!  If necessary, they’ll get you back to quality medical care.  But as in insurance, be sure to read all the fine print and know how it works before you need it!

Now, go & enjoy your cruise!   🙂