Getting health care as nomads

We have health insurance, as most do. But it’s not generally easy nor inexpensive for us to use medical care in the USA even with insurance.

Health care is messed up in the USA. Especially for nomads. A major problem is access. Access to services is hard! Physicals need to be scheduled months in advance. Likewise routine dental care, like cleanings.

We are also aware that we (or nearly anyone) could be wiped out financially by a health emergency. So — what to do.

Our solution (?) is multi-level.

First:

We carry an Obamacare Bronze level HSA compliant health plan. Nasty deductibles. We pay 100% of the first $6,500 of medical expenses each ($13,000 for family). Then, after that, the insurance kicks in and covers everything at 100% for the rest of the year.

Our family premium for 2017 is $766/month and our deductible is $6,500 for each of us. We have to pay sixteen to twenty-two thousand dollars out of pocket, between premiums and deductibles, each year before our insurance pays a nickel. And we have to use Network Providers to get this deal. We do have access to a nationwide network for emergency and short-term routine care.

We should be protected if tragedy strikes, no matter where we are in the USA, though we’d have to hot-foot it back to Oregon if long-term chronic care became necessary.

If you are RVers and in need of insurance check out RVer Insurance Exchange. They specialize in insurance for RVers and have been helpful to us. We have no financial relationship with them, we just use their service.

And Second:

We have started using international medical services. Since we’re in Thailand off and on for 3 1/2 months we decided to take advantage of Bangkok’s outstanding medical facilities. Thailand is a first world country when it comes to medical care. It’s certainly a different system from the USA, and in many ways better.

We purchased a comprehensive “Check-Up” package from a privately-run hospital. The tests and services were impressive. The list is provided below.

Bangpakok 9 International Hospital is a modern eleven-floor medical facility in Bangkok. It is fully accredited and has a good reputation.

Photo credit: www.holidayhealth.com

It was all very organized. At 9:00 am on our appointment day, the hospital sent a car to our condo to pick us up. Yes – they sent a car.

We arrived at the hospital and were introduced to our concierge, who spoke english very well. She escorted us everywhere we needed to go in the hospital. It was a bit of a circuit. We started by changing into hospital “scrubs,” then had vitals checked. We then went from one station to another within the hospital getting things done. Starting with a blood draw, moving on to x-rays and the other tests. Keng and I were separated but I always had a concierge with me to help with translation if needed. Most of the techs and doctors spoke pretty good english, anyway.

A cardiologist did the cardio work-up and evaluation, an otolaryngologist did the ear/nose/throat exam and evaluation, a dentist did the teeth exam, an ophthalmologist examined our eyes, and our consultation at the end was with an MD.

The testing equipment looked very similar to the equipment in the USA. The techs were very proficient and professional.

It was, by far, the most extensive physical I’ve ever had. I had a question about kidney stones (I’m a stone former) and requested a consultation with a urologist. They were able to work this into our schedule on the same day.

Likewise, we both wanted to get our teeth cleaned. This was also worked into our schedule on the same day. The teeth cleaning was ultrasonic and extensive, and done by a dentist.

At the end, about 4 hours later, they dispensed some medication for me (to dissolve wax build-up in one of my ears), and summoned a car to take us back to our condo.

And the cost? $400 each for the Check-Up package, another $35 for my consultation with the urologist and about $85 each for the teeth cleanings. We walked out with clean teeth, a large folder of test results with clinical observations and conclusions and a CD containing the raw data of the medical tests.

So easy, and so competently done. And so comforting to have these extensive tests done. This work would have cost many thousands of dollars in the USA. We were also able to use our HSA funds to pay for the work, saving even more.

And, as it turns out, we’re in pretty good shape (for the shape we’re in). It’s all good!

Here’s the pamphlet insert for the Check-Up package. Note the price for men over 40 years old is 13,000 Thai baht. Divide by 33 to get US dollars.

How about you? How do you get health care as RVers?

11 thoughts on “Getting health care as nomads

  1. I’m so glad you found healthcare that was affordable and top notch. We have health insurance from where I retired, but it is extremely expensive. It’s great coverage, but good in Florida only, so we are back to Florida at least every six months because of rheumatoid disease. We have to have something that covers expensive medications and follow up blood work while on the road, which is not easy for RVers. There is a new telehealth program for RVers now called RV Health that just launched (link is https://rvhealth.com/). It probably won’t be helpful for chronic conditions that require close followup and procedures, but it may be wonderful when antibiotics, etc., are needed while on the road. It’s hard for RVers to find solutions–thanks for sharing your experience with overseas healthcare. I’m glad you’re both in ‘pretty good shape!’ 🙂

    Like

    1. It’s hard to find policies with access to a nationwide network. We’ve been able to, but have had to change carriers every year for the last 3 years. Medicare is off in the distance for me (I’m 60) — that will help us.

      Keng’s family is in Bangkok and we visit every two years. Not often enough to rely on for regular care, and certainly not for emergent stuff. But good to get a thorough check-up and any regular care that’s due.

      We’re in the Palm Springs area frequently. It’s a couple hours drive to Mexico… Might be handy for dentistry and such. We’ve heard about Telehealth and will get signed up when we get back to the USA.

      Thanks for your comment.

      david

      Liked by 1 person

      1. I think they all kind of suck. We travel so much that being tied to a small, local network is the worst for us. We’ve had to change carriers every year for the last 3 years to keep the option of a nationwide network. We’re lucky it’s still available at all I suppose. Fortunately, we’re pretty healthy.

        Like

  2. I don’t know too much about the healthcare systems in other countries, and enjoyed reading about your experience. That seems like a very cost-effective way to get such a thorough check up. When we didn’t have employer-sponsored health care for a year and had to purchase it on the Colorado health exchange market, it was a nightmare. I turned 30 in that time period and the plan dropped me from our catastrophic coverage (telling me after the fact) and I had no health insurance coverage for ~1 month, despite hours on the phone to try and fix it. Connect for Colorado blamed it on Kaiser (our provider), and Kaiser blamed it on Connect for Colorado, so of course neither was able to fix it! Hooray. The system kinda forces people into working regular jobs, to not have to deal with stuff like that…

    Rant complete. I love following along with your travels, thanks for the post!

    Like

  3. A really interesting insight into healthcare here. I hear a lot about expensive us healthcare, but to see you break down the numbers for what you pay was insightful. Being from the UK, I realise how lucky we have it

    Like

    1. Keng and I are part of a small minority of people in the USA that aren’t currently subsidized. Most either have subsidized coverage through their work, Medicaid (low income), Medicare (65 years +), military service coverage, Obamacare subsidies (income below 400% of Federal Poverty Level), or some other program.

      We have benefited from the Obamacare reforms greatly in that we have guaranteed access to coverage without exclusions – but we pay the full freight. That’s why we purchase such a stingy policy. It covers us for catastrophe only.

      Liked by 1 person

What do you think of this post? We love to hear from you.

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.