During our last visit to Canada (Sept 2014) I ended up chatting with an Alberta Health care rep who had the unfortunate news that our family was being cut off of our health care because we spend more days of the year outside of Canada than we do inside. My first reaction was to cry, and go and find Eben so he could continue the call since I was at a loss for words. I am a bit of a wimp when it comes to talking to authoritative figures. But after we got all of the facts Eben reassured me that this wasn’t the end of the world. When we thought about it, we never used our Alberta health care when we were abroad (which is most of the time) anyways. So we didn’t really need it. And if we are ever to return to Canada and spend more days in the country than out, we automatically get it back. This seems fair.
The decision of purchasing health insurance is as personal a choice as what toothpaste you choose. What works for the neighbour may not work for you. But for the sake of knowing some of your options, here is what we have chosen. We have NOT signed up for health insurance while out sailing. What we have encountered, with our few medical run-ins in the caribbean, is that going to a medical facility, paying cash, and getting the care we needed, turned out to be cheaper than any medical plan out there (minus the US, random Adventure travels see the excerpts below). Now keep in mind that none of us have any medical conditions that require regular visits to a doctor, and none of us have had any MAJOR accidents. So being uninsured currently works for us.
–When we were in Miami re-fitting Necesse I had a miscarriage. We had already lined up our midwives back in Canada. When we realized what was happening we called our midwives and they recommended that we visit a hospital and get checked out. Turns out that, sitting in a bed an entire day in the Miami general hospital, one ultrasound and some blood work, costs about $5000!!!! We were uninsured and I was mortified. Some health insurance would have been nice then. So now, EVERY time we are going to spend time in the US, we get insurance, just in case.
–During our rickshaw run in India and Eben’s Sailing race in Tanzania we did get insurance, because a) we had no idea what we were getting ourselves into, and b) the Adventurists highly recommended it (I don’t think they let you participate without it).
To give some examples, in Georgetown, Bahamas we would $20 a visit to see a doctor to get the girls’ immunizations, and the same for my prenatal checkups. In the Dominican Republic, Ellia fractured her shoulder
in two spots (rolling out of bed) and we paid $75 for an X-ray, a doctor’s consult, and a tensor bandage. Both our girls also got some of their immunization done here and we received that care for free at the local clinic. In Puerto Rico we paid $30 to see a paediatrician about an ear infection
. And paid a hospital $25 for a doctor consult and an IV (with meds) for when we got ciguatera
. These are pretty much all of the medical bills that we have had over the past 5 years, and we are VERY
thankful for that. When it comes to the meds, well in the Bahamas it depends on what you need, and in the DR they are dirt cheap.
|Oh look at that sweet face. She was wrapped up like this for 2 weeks.
And medical facilities? Pretty much every island has some form of them. A clinic, a hospital, etc. We have yet to come across a place that didn’t have some sort of medical care if we needed it. We don’t feel like we have to worry about helicopter evacuations since we are pretty much always within a dinghy ride to one of these facilities. For anything smaller we have a pretty rad medical kit onboard. I mean, don’t ask me to perform surgery, but for whatever smaller work/sailing/life wounds we have what it takes. Our second year out sailing I made us a massive 1st Aid kit
, but 3 years later mostly everything in it has expired. I wasn’t going to waste my time doing that again. So I found a company that would do it for me. We now carry two medical kits from Adventure Medical Kits
(their Marine 300
one which we got for our sailboat, and the Ultralight/Watertight .9
we got when Eben went on his crazy sailing adventure in Tanzania). These things are extensive and have us covered to care for huge range of injuries or until a medical facility can be reached.
|Awesome sponsors of ours. Their kits are used for all sort of ADVENTURES.
I love that when shopping for one of their kits you can specify what “adventure” you are about to partake in, for how long, and with how many people, and they can recommend the best kit for you. I definitely recommend you check them out rather than trying to build your own kit, they know what they are doing.
So on we sail, using the local medical facilities when needed, and keeping our fingers crossed that nothing major happens to our family. KNOCK ON WOOD
. Don’t want to jinx us
. But even if we do I trust that the facilities we are around can take good care of us. I mean, we have experienced an infant fractured limb
while out here. Those aren’t bad for “medical stories”.
I'm glad I'm not the only one that feels this way. When I had Emit here in the Bahamas, it cost me $150 for the ultra sound and our flights to Nassau… that's it for my entire pregnancy and delivery (which had to be a c-section)! And as soon as our BIG hospital opens up, it'll be even nicer around here for the clinic care, but most folks cannot believe we're uninsured.
The Bahamas were so easy for medical care. We did some of the girls immunization a and some of my prenatal visits there. When is the big hospital supposed to open, I remember hearing talk of it a couple of years back
Thanks for sharing… this kind of information is really helpful for those of us still in the early stages of planning our cruising days. Hopefully, our strategy of trying to sock away as much as we can into our Health Savings Account (HSA) to cover out-of-pocket medical expenses where services aren't so expensive as in the States. I'm also glad to get a bit of insight into the healthcare industry out of the states. My wife is a nurse and we're toying around with the idea of her doing some nursing work from time to time to re-up the cruising kitty. Of course, that assumes we can figure out how to navigate employment rules in the various countries.
oooh a nurse onboard, your wife may be in high demand amongst the sailors! We have a friend who is a nurse and was sailing and boaters would always call her for advice! (free advice! you should find a way to monetize on that!)
Oh my gosh, the adorable faces on you and Ellia are too much to bear. This post is great and I identify with Ellia's accident proneness. I am a connoisseur of hospitals abroad and I can say that nothing makes me panic like getting hurt in the U.S. Because even when we did have health coverage there, it was unaffordable. I used to pay about $45,000 a year for health insurance, and when I broke my collarbones, they still wouldn't cover my $1600 ambulance ride. I mean, what?! The truth is, if I'd just banked the $45,000 cash, I could afford to get the best treatment anywhere in the world if I got hurt or sick. So we are happy being uninsured now. Because no hospital visit abroad (and we've been to a lot) has cost us anywhere near those kinds of number when we pay in cash. Americans love to tell me, "We have the best healthcare in the world." But actually, that is only true if you can afford it. As in, you're a millionnaire and you can pay Johns Hopkins for the best doctors to treat you while you pay out of pocket. If you are looking for coverage and what's provided, we have the WORST healthcare in the world. Not to mention our appalling infant mortality rate for a first-world country. I'm happy giving up my healthcare and taking my chances and my cash abroad. It's affordable and I've had great care in even the most remote places.
I am glad to hear that you guys agree, that out of pocket is easiest and best while travelling. Unless you are sailing a mango tree in Tanzania, there are exceptions of course! (check out the latest blog post, there is a link to your site! hahahah)