You know how teenagers think they are immortal and that nothing will happen to them. (For
our sons males, that judgment neuron doesn’t seem to get all the way connected until age 25). Conversely, those of us fortunate enough to stumble into become what is generally considered middle age, have usually lived long enough to know Woody Allen had it right when he wrote: “If you want to make God laugh, tell him about your plans.” This is why I have to explain to you why you need medical travel insurance.
As some of you know, I had my own brief hospitalization while away from home, but two of my baby boomer travel buddies have had much more intense experiences.
Baby boomer travel blogger, Patti Morrow of Luggage and Lipstick, spent six weeks in a hospital outside Cape Town, South Africa, after experiencing life threatening injuries in a horrific car accident. She had a “Cadillac” Blue Cross health insurance policy in the United States that would pick up some of her hospital costs in South Africa, but would not pay for her to be transported back to the United States when she could not travel by commercial aircraft due to the severity of her injuries.
More recently, another boomer travel blogger friend, Betsy Wuebker of Passing Thru, experienced a medical odyssey in coastal Colombia.
Betsy agreed to share her experience and advice about medical travel insurance with Midlife Boulevard readers.
If you’re a United States resident who travels internationally, read on so you’ll know why you need medical travel insurance to cover you outside the United States.
If seeing the word “insurance” has caused your eyes to glaze over, go get a cup of coffee or some other source of caffeine. We’ll wait. This is important.
Q.1) Betsy, please share a capsule autobiography leading up to your Colombian medical adventure?
A.1) My husband, Pete, and I have been digital entrepreneurs for ten years, and location independent since 2011. In 2013, we sold everything in Minnesota and moved to Kauai. After a fateful journey from Ireland across Europe to the Winter Olympics in Sochi, Russia, we returned to Kauai and then decided to travel internationally full time.
All told, we have visited close to 50 countries, and set foot on six continents. It has been a wonderful and exciting adventure.
Q.2) When you were mostly living abroad, did you maintain medical insurance in the United States? If not, what did you do about medical care and paying for it during your travels and expat stays in other countries?
A.2) No, we did not. The majority of medical insurance plans in the United States, including Medicare, don’t cover U. S. citizens abroad. Because we’re self-employed, the cost of maintaining coverage was prohibitive, particularly when you consider we didn’t set foot in the U.S. at all for several years. Instead, we covered ourselves with travel medical insurance policies.
The cost of medical care in the places we found ourselves ranged from comparable to the U.S., or much, much less. So we actually engaged in a bit of medical tourism here and there: eye exams and glasses in Thailand, and dental care in Malaysia, Australia, Panama and Fiji.
We never got sick anywhere, and never had any sort of an accident – despite weathering a Category 5 cyclone and a couple of bush fires on our house sits.
But, after a disappointing experience filing minor claims with another company, we switched over to Allianz Global Assistance in 2017. By comparison, the Allianz policy was more affordable and comprehensive. (Disclosure by MLB: Links to Allianz Global Assistance is an “affiliate link”. If you purchase insurance via that link, Betsy and Pete receive a small commission. As you’ll see when you continue reading, their endorsement of Allianz Global Assistance is based on their personal experience with that company.)
Q.3) What was the cost of the medical travel insurance you ultimately purchased and what coverage did it provide for you and Pete?
A.3) Coverage for a six-month policy was about $250 as I recall. We renewed when that was up for several more months for about the same price. At the time, Allianz had three tiers of coverage. The first policy we bought was top tier. When I renewed, I inadvertently clicked the middle tier. Fortunately, that was still pretty comprehensive and included repatriation up to $50,000, and emergency medical expense up to $50,000.
I really didn’t pay too much attention to the coverage limits at the time of purchase. We were mainly concerned about coverage should we be in an accident or something unexpected like that. Little did I know. . .
Q.4) I urge people to read your detailed account of what happened to you, but could you please give us the Cliff Notes version here?
A.5) Pete always says, “Do you want her to give you the short version or the long version?” And then I wind up giving the long version anyway. What can I say? I’m a Gemini and we’re verbose! I’ll try to summarize.
We were on a “visa run” in Colombia after a six-month house sitting stint in Panama in February of 2018. We were to return to Panama and sit again at the same fabulous place, but in order to do so we had to be out of the country for 30 days. So, we decided to spend that month in nearby Colombia. (Factoid: Panama used to be part of Colombia before separating in 1903).
Everything was going swimmingly (literally) in Colombia. One minute, we were having umbrella drinks at the resort pool bar, and the next minute I couldn’t get out of the pool because I couldn’t breathe.
What followed was a nightmare experience in a substandard public hospital with a complex diagnosis. I had a heretofore undiscovered and alarming situation with my aorta: two bulging aneurysms and a dissection (which is a tear or split in the aortic wall). Hypertension (high blood pressure, which I had never had before) threatened the weakened aorta with additional rupture. I probably don’t have to tell you that if your aorta ruptures, it’s sayonara for certain within minutes.
This diagnosis didn’t address the breathing problem at all. With regard to that, the cardiologist hypothesized I had some sort of embolism (blood clot) preventing my system from absorbing oxygen.
I spent several days in a substandard ICU in a declining state of awareness and stamina. I could literally feel myself slipping away. There were things going on around me that are horrible to contemplate even now. Their contract cardiologist was professional, yet she all but confirmed my condition was way out of this hospital’s league.
It was then that an amazing network of friends in the United States and people in Colombia that we’d never met sprang into action. They helped us get out of the first hospital. I was transferred by ambulance to the Clinica del Caribe, a first rate tertiary care hospital in Barranquilla, the fourth largest city in Colombia.
It was a crazy three-hour ambulance ride during which I lost consciousness once, but when we arrived at the Clinica del Caribe, they quickly sprang into action. The doctors there diagnosed and removed a massive pulmonary embolism (PE blood clot) from my right lung, vindicating the original cardiologist’s hypothesis. The PE had grown to the size of a baseball cap while I languished during those several days in the first clinic.
Once the PE was taken out, I was a new woman! I quickly improved sufficiently to return to the United States after several days. Upon arrival home, I began treatment at the Mayo Clinic for the aorta issues. That part is ongoing.
Q.5) Yikes! What was your experience with Allianz through all this? Have you had to cover any medical bills from Colombia yourself?
A.5) Overall, Allianz was absolutely amazing. In the first hospital, the administrative office was challenging to work with, which was exacerbated by the language barrier.
Eventually, I had to make a Google Voice call to the Allianz claims representative from my bed in the ICU. Once they realized how serious the situation really was, Allianz took over directly.
When we arrived at the second hospital, there were minor issues at the inception of care, which Pete easily coordinated with the administrative office and Allianz. This allowed us to concentrate on my care and recovery rather than insurance paperwork.
There were a few bills that we paid directly, primarily at the first clinic. It seemed like every time we turned around there, they wanted a million more pesos (about $300 USD). Allianz reviewed everything we submitted and reimbursed us promptly in accordance with our coverage. I want to say they cut the final check at the beginning of May, so about a month to review a complex set of circumstances.
Q.6) What type of coverage for medical transportation did your Allianz policy cover?
Note by Suzanne: Because we’re U.S. residents with decent private health insurance for reimbursement and could initially self fund a hospital stay abroad and be reimbursed later, we don’t purchase medical travel insurance (something I will rethink after learning about Betsy’s experience). However, we do buy an annual policy that covers medically necessary transportation to wherever we want to go as long as we’re 150 miles from home—even in the United States. Many travel medical insurance policies only cover transportation to the “nearest appropriate medical facility”. If that’s 7,000 miles from home as it was in Patti Morrow’s case, too bad.
A.6) I’ll just caution people who think they could self-fund an emergency medical care situation abroad. Emergency and inpatient medical expenses, even in a country where things are cheaper than in the United States (i.e. : almost everywhere), add up quickly. Not everyone has an extra $20,000 laying around to await reimbursement.
We could have cobbled together payment for the expenses we incurred, but it would have been an additional burden to coordinate and oversee. You may be very glad you have a medical travel insurance carrier who will communicate directly with your providers in near real time, as opposed to requiring a “submit and be reimbursed” scenario. If you’re incapacitated and without a strong advocate, you may not be capable of appropriate medical oversight.
In Colombia, Allianz covered the 3 hour ambulance transport from the first hospital to the tertiary care hospital. I don’t know the itemized breakdown, but that cost was about $300 (everything there seemed to be a million pesos, no matter what). I don’t remember if Allianz paid them directly, or we paid it up front to expedite our leaving and then were reimbursed.
I had complete repatriation coverage – dead or alive – back to the United States with Allianz whenever I was deemed fit to fly. Unfortunately, I wasn’t fit to fly upon arrival at the second clinic; we all agreed that a plane ride at that point would have killed me.
So then it became a matter of getting me well enough to fly home. The aorta was deemed an uncovered pre-existing condition even though I had not known about it. As such, it wasn’t covered, but the embolism aftercare overlapped. This was enough to cover medical escort, business class tickets, etc. back to the United States. When purchasing travel medical insurance, be sure you read the fine print and understand the coverage.
We didn’t have to worry about a thing. The medical escort – a very nice (and handsome!) EMT from Florida arrived, took us under his wing, and saw to all the paperwork and logistics with airport boarding, immigration, luggage and the like.
Q.7) Given your experience, what type of medical travel insurance would you recommend for U.S. residents for travel at home and abroad?
A.7) I would say investigate various carriers, but we definitely recommend Allianz. Don’t try and nickel and dime your coverage. Buy the top tier. For something like $50 more, you will have peace of mind.
If you have a pre-existing condition (which I now do), you’ll want to make sure you’re covered. As of now, with Allianz, you simply need to buy the insurance within 14 days after your first trip-related purchase.
An annual policy for the two of us runs about $450 at the time of this writing. We’ll be purchasing that ahead of our next international trip in the fall when I’ve hopefully got this aorta thing solidly in the rearview mirror. There are additional logistical tips at the end of my post about my Colombian medical saga. When choosing a medical travel insurance policy, we have learned there are possible issues we never even thought of before.
Note from Suzanne: When researching your options for medical travel insurance, take a look at sites such as Squaremouth which provide information about multiple companies, so you can compare and contrast benefits and reviews. I used this service with good results when a trip we were taking required proof of medical travel insurance.
Q.8) Anything else?
A.8) In closing, I’d just like to convey my thanks (which will never be sufficient, but perhaps this interview is a way of paying it forward in a sense) to all of those who intervened on our behalf during this crisis. We had countless people pulling for us, and more than several who went above and beyond: exceptional caregivers, folks who were willing to access their networks, and influential people who “encouraged” the situation along. It is humbling to be in their debt.
Colombia gave me back my life in a series of miracles. This is a gift for which I hope to be worthy in the future in whatever I do.
Thank you, Betsy. Best wishes for your continued recovery.