What to Do about Healthcare and Health Insurance When You're Living Life Untethered

by Pat Giniger Snyder

Us in India where we took malaria pills and bought international health insurance in case of an emergency!

While I know we have fans out there from places across the globe, this blog is for people from the US, as I have limited knowledge about healthcare & health insurance in other countries.


General Information

Healthcare and health insurance for 50-plus travelers is important. Adam and I have Medicare and AARP supplemental from United Healthcare and we have coverage wherever we are in the US. I had a major horse accident in Texas, and the EMS worker asked for my Medicare number, and from that point on we never saw a bill.


Adam's doctors are in the NY metro area and mine are in Maryland. So we make it our business to get there for our annual medical appointments. The AARP Rx plan we chose is connected to Walgreens which are everywhere in the US, so our doctors can call in our prescriptions, and we can get our meds wherever we are. However, if we are going to be traveling abroad for an extended time, we get a “vacation override” for monthly medications, which means we have enough for when we’re out of the country. You should make this arrangement well in advance of your trip so that it isn’t “last minute.”


Unfortunately, I've had to see different specialists in the US, especially after the horse accident. In some states, like Vermont where there is a shortage of doctors, getting a new patient appointment was almost impossible. I had to go to an urgent care facility which was connected to the University of Vermont (UVM) healthcare system. Once registered, I could see UVM specialists, who I didn't have access to on my own. In other states, like Utah, I could see healthcare providers as a new patient with no problem.


But Speaking of a Problem...

Both our AARP-United Healthcare supplemental and Rx monthly premiums are currently taken out of our Social Security checks,


BUT, I did run into a problem earlier in the year when I THOUGHT my Rx was being paid automatically. IT WASN'T. And because I was traveling abroad, I didn't get the notice of non-payment until I had already gotten kicked off my Rx plan!!


It took me 5 months to get reinstated. It wasn't easy because it was not during the open enrollment period and Medicare wouldn't automatically allow me back on my Rx plan. The short story of how I did it is our permanent address enabled me to apply for an entirely unrelated health insurance plan to cover the "donut hole," and once I was accepted into that, United Healthcare allowed me back. But for five months, I had no Rx coverage and worse -- for as long as have a Medicare Rx plan, I'll have to pay a small monthly penalty.


I've learned my lesson! BE SURE YOU HAVE AUTOMATIC HEALTH INSURANCE PAYMENTS IN PLACE IF YOU ARE LIVING AN UNTETHERED LIFE!


For people under age 65 with private insurance, you need to check your policy or with your health insurance company about coverage when you're away from your permanent address, including what they cover for emergencies (particularly those who have HMO’s and/or are covered under the Affordable Care Act). Every policy is different, so you need to check.

International Travel

Health insurance coverage outside the U.S. is a whole different story. Sometimes your health insurance plans cover emergencies or even visits to healthcare providers when you travel abroad. Medicare and our AARP supplemental have extremely limited or no coverage at all for travel outside the US. So when traveling in countries where we're "not sure" of the healthcare, Adam and I purchase international travelers’ insurance.

With international health insurance, you want to be covered for “emergency evacuation” -- that is, if you have an emergency and want to be evacuated back to the US. We have a friend who was seriously injured while on a trek in Africa and had to be airlifted out of the country. His evacuation rider covered everything.


There are a bunch of health insurance companies for intern'l travelers. One that we've used is World Nomads. Fortunately, we’ve never had to make a claim. If you google “international health insurance,” a lot of companies will pop up, including CIGNA.

If you get sick while traveling, every country has different rules and payment fees for foreigners to see physicians. When we were in Barcelona where we did not have international health insurance coverage, I saw a private OB-GYN, and paid about $60, including tests. If your health insurance just covers ER visits, you'll have to pay out-of-pocket for private doctors and dentists.


Interestingly, in some countries, you can buy certain Rx medicines directly from a pharmacist without a prescription. You'll have to do your research to find out which countries do or don't allow you to purchase them, and then which specific Rx drugs can be bought over-the-counter.

As for inoculations, before travelling to China, we got Hepatitis A (to prevent getting disease from food). For India, Cambodia and Vietnam Adam got a vaccine for typhoid, and we both took anti-malaria pills. Check with the Center for Disease Control and Prevention (CDC) about the specific country where you'll be traveling and the vaccine(s) suggested.


If you have questions or want to share your experiences, please do!



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