Health Care Abroad

[George Wade]

If you can afford health insurance while abroad, the agent may be able to remind VA of the rules if any paid in cash treatment abroad is required. Then the insurance co. does not have to pay the whole shot ?

[mesquaukee]

With the price of insurance and knowing the costs of staying in a hospital in the Latin American countries why have insurance.

It is around 35$/day for an air conditioned private room with a TV and your spouse can stay overnight.

Just stay away from all transfusions as the above posts indicate.

Medications you can get anywhere without a prescription. They are cheap. It must be said if you are taking specialized meds for diseases such as Parkinson’s etc. you will not be able to get them or they will be expensive.

Seeing a doctor and then buying the prescription costs a fraction of what it would cost back home. The same goes for dentists.

The only insurance you could possibly need is strictly for a mediovac if you unable to beg, borrow or steal a seat on a flight back home.

[captmick39]

Originally Posted by hellosailor

Something to remember is a benefit of being the captain and master of a US-documented vessel. WIth that status and proof in wiriting, you can go to a dispensary pharmacy and they are allowed to issue a full set of rx-only meds to the vessel for use outside of US waters.

(I think "dispensary pharmacy" is the correct word, your ordinary corner drug store can't do it.)

Similarly, if you have a local doctor who has known you and dealt with you over the years--he can just issue the scrips as needed. There are some excellent books on wilderness medicine and bluewater medicine that have suggestions. Among them, silvadene type cream for burns, rather than antibiotics.

But for the life of me...I can't figure out why any commercial grade trauma/aid kit costs so bloody damned much, while anything that says "first aid" (which should be a separate kit) only is stuff with 150 bandaids and four types of ache pills....

You sure got that right!
Prior our acquisition of a brand new military surplus batallion Trauma Kit.

Went to EMT School as a VFD member & put together a list w/assistance fm. Paramedic Instructor

Went out & purchased a Large/multi-divided (Water tight & FLOATING) Camera Bag (complete w/nice shoulder strap). & then proceded via medical supply warehouse/retailers/Drug Stores to acquire each & every thing on the list.

By the time we were done (long ago...as in '93) the expense had been CHEAPER (while Better Stocked) than 1 of those "trama kits"...& ours FLOATED!

Went further & even sewed in LABELS for each compartment so when the lid/flap was whipped open, locating what was needed almost instantaneous.

-HTH

[captmick39]

Originally Posted by Kaya 09

Capt Mick, FYI - Kaya is a female(1) . I would hardly call an injury that was able to be splinted/bandaged immediately worthy of calling in a medvac!(2) Further, as we were in the Gulf of Mexico - a quick email to web md was not an option, although this is an excellent service (we had just started cruising and had not learned to use the single side band to send emails). So - we were left to our own devices and having a top of the line medicine kit was definietly worth the investment. You are correct in search for health coverage. If you type in your personal data, they will call you. The higher your deductible, the better (ie 10k is a good start. You really only need the coverage for the emergency or serious illness coverage. Anything less can be treated locally in the islands).

Va. Boy - there is also another transport service called DAN (?)(3) it is provided through the scuba diving services and it is an insurance that provides discounted transportation for emergency medical services. My husband and I are back in the states at the moment and plan to head south again this fall. We will probably not be back in the states for a couple of years. I will certainly have this coverage prior to leaving as air transport services can cost a fortune.

Kaya,
Obviously things worked out well (as apparently the pinky can type now?) & (1-noted above) My apologies for any sexual connotation/stereotyping MISINTERPRETATION...I thought I was clear....KAYA IS A BETTER MAN THAN ME!!!!!! ntl, duly noted, not that it matters whether male or female, (2)compound factures, with skin protrusion(regardless the limb, OR DIGIT) yes, IS Incredibly Painful. That PAIN won't KILL YOU...the Staph, Gangrene, or Other INFECTION (almost GUARANTEED in a marine invironment) WILL Indeed Make You DEAD.

Obviously MD who viewed the aftermath felt the same way as Cipro is an Incredibly Powerful Antibiotic.

While a medivac may not have seemed necessary at the given time & locale...heading directly to the closest port would have been (necessary, imho, for an injury of this nature...again, I'm guessing You/she/both rec'd a stern dressing down fm. the MD's when they saw, heard, & realized Your election to wait so LONG before ER attendance?). Given Middle of an Ocean, or more than 3 days from land...I'd make that call, at the absolute FIRST sign of ANY infection. Losing an ARM, or hand, or even finger is too high a price to pay versus a "life-flight" to save same. Paying the bill (or ins. company sharing in those costs) After Fact won't be cheap, it IS S.O.P. for USCG & they don't send You a "bill". It's SOP for Merchant Marine...should be for us also. Not being a "granny/worrier", just saying, ONCE infection is set in, everything gets exponentially worse. Ignorance, or bad decision making can cost lives or limbs, always better to err on side of caution (since we have no "911" on the high seas). jmho,

(3)Roger that, DAN-Diver's Alert Network, excellent .org;

[captmick39]

Originally Posted by donradcliffe

Most meds are still good long past their use by date, which is set by the drug companies in collusion with the FDA. One big exception is doxycycline and its derivatives, which can go toxic.

Antibiotics are available in most of the world without prescription and cheaper than the US. Non prescription stuff like ibuprofen, tylenol, vitamins and supplements are way cheaper at Walmart, so stock up with the big bottles. Lipitor seems to be cheapest from the Canadian pharmacies.

Get the heavy pain meds from whoever in the family just died of cancer--"so sorry to hear about Uncle Mark, what did you do with his pills??"

Doing this a a FEDERAL & NOW STATE FELONY in all 50, just so You'll know? It's the Nurses/Dr's whether hospice or otherwise to REPORT YOU, YES YOU DON DILLIWORTY for doing same. Possession of meds from the deceased gets You a 1 way to the pokey...seeing Your own MD is Far Cheaper than the BOND would be. Don't get that knock on Your door, and keep a close eye on Your Scripted Meds (ALL OF THEM) w/teenagers either IN YOUR HOUSE or w/access to Your bathrooms/heads/wherever You store those scripted meds.

Just trying to keep posters (& READERS) here out of PRISON.

If posts get deleted for advocating criminal behavior, I wonder where the mod's are?

[Hud3]

We're not here 24/7, Mick. Almost, but not round the clock. Thanks for the warning about the illegality of using another person's prescription drugs.

[captmick39]

Originally Posted by Hud3

We're not here 24/7, Mick. Almost, but not round the clock. Thanks for the warning about the illegality of using another person's prescription drugs.

after getting "busted" myself, for stating something stupid, (in like NANOSECONDS) formerly, no disrespect to Moderators was intended.

Setting the record straight, wanted to come back & edit out "mods" comment...too late, couldn't, so an APOLOGY will have to suffice.

Folks, ON that "setting the record straight"...Wife's an administrator, Hospice, Supervises all the nurses/cna's/social workers/chaplains in the field, 34yr veteran RN...

they deal with this issue (& the STEALING FROM THE DYING...BEFORE DEAD) daily. Needed everyone to know that the nurses/cna's still come After expiration of the terminal, and they MUST (a requirement of LAW now) report ANY Shortages of controlled substances and all persons who had access to same.
Again, it's the LAW.

There are better (and LEGAL) ways to get what's needed, as stated previously in this thread. No disrespect to the original poster of that commentary either, especially on the rest of the posting.

& PLEASE keep Your controlled substances that are owned, under Your control. Sometimes the least suspected...is an enabler for a total mess of a human being. More addicts out there now (here, in the US) are getting "high" on grandpa's supply than any other source. It's a BIG Business.

[Cheechako]

Our doc was a sailor too. Unfortunately we didnt think to find out specifics on each med prior to leaving. Some anti biotics do go toxic. We never used any of it, so it didnt really matter. I take that back, we did give some anti biotics to a needy person in a third world country.... they were in date
I agree with Mesquakee, for out of the country, good health care is too cheap to insure for.

[hellosailor]

captmick-
There's the law, and then there's reality. Many many medical personal, including hospice providers, will quickly take a hint and turn their back when it comes to the subject of "leftover" meds. The meds are often expensive, taking them back and throwing them out is qute literally sinful to many folks, when they could be put to good use for others who cannot afford exorbitant US drug prices.

So, what happened to Uncle Don's meds when he passed? Oh, we flushed them down the toilet, they're gone already. And that's how it gets written up. No one goes to jail, unless there's a real good reason for it.

Now, as to carrying rx meds without the original container or the rx on you...well, giving some rentacop an excuse to play officer is kinda pushing your luck. That's something else entirely.

Hey, it's against the law to jaywalk, too. But a whole world of pain is going to descend on the cop who writes a summons for that, without a Damn Good Reason.

Back on the medical topic...I have to disagree, having fairly recently aided someone who got fallen on. Most everyone thought it was some skins tears and a swollen/sprained ankle, but by the time I got down to the ankle I could see it was swollen larger than an egg. FORTUNATELY, I got them into a wheel chair and iced it without moving it (the swelling and the shoe were immobilizing it) instead of letting them try to walk.

Prognosis an hour later at the ER? Both the tibia and fibula had snapped clean off at the ankle, two non-displaced fractures. If there had been ANY motion of either bone, they probably would have needed ankle surgery and the odds of ever walking properly or pain-free again would have been ZERO.

Without more training than I have, or diagnostic imaging, all you can do is play the odds. If there has been a trauma and you can't be certain of the extent--better to call the medevac and get proper care for it. Sure, you may waste $50,000 on a medevac but I guess it depends on whether you can or want to gamble that much versus a life of continual pain--or a death. In the US, we usually try to spend it. In much of the world, that's just not possible and low-to-no care is normal.

I was pretty much astounded last year when a bus tour, operated as a land excursion by a cruise line, ran a bus off a mountain road in Venezuela. The victims were medivac'd to Florida's Miami-Jackson Ryder Trauma unit because it was the closest "class 1" trauma center. A standard of care that we consider normal in any US major city, is totally unavailable in a country like Venezuela.

Versus other places where the same care is available--and the bill may be little to nothing. Also unlike the US.

Something to think about.

[captmick39]

Originally Posted by hellosailor

captmick-
There's the law, and then there's reality.
Try that one on both the DEA Agent, the AUSA, & the Judge...
& let me know how the "reality" defense works out for You, fair enough? Many many medical personal, including hospice providers, will quickly take a hint and turn their back when it comes to the subject of "leftover" meds. And for what it's worth, You are asking them to put their Career, License AND FREEDOM (versus incarceration) on the line...that's a pretty hefty price. Who suffers when the "asker" (like You) just happened to be a Police Officer/Federal Agent? The meds are often expensive, taking them back and throwing them out is qute literally sinful to many folks, when they could be put to good use for others who cannot afford exorbitant US drug prices. Sorry, but this is simply not correct. The most powerful pain meds, my wife has been on (both Oxyconten & Oxycodone) some of those "powerful meds"...cost of $8.oo a month, no co-pay/insurance issues, that was the Std. Generic Price at Walgreens? Hardly "expensive" by anybody's standards. Accessability is/was/will be Your issue & concern...going to Your MD, explaining the sitrep for that "cruise" will get You the same script...been there, done that (including Cipro, Flagyl & Doxycycline...shoulda seen the pharma.'s eyebrows when I handed them 10 scripts w/those 3 on top?! We dropped $150. for EVERYTHING on a 2 wk basis of supply per disposition on script. Our MD also had a letter on file, & we delivered him lots of pics, along w/the perishable meds(to dispense as 'samples' for those financially challenged locally..he IS the GP for our community) upon return. We Were "prepared"...also cost the price of a few nice waterfront meals for 2. I don't personally consider that "pricey"(while preparing for 6mos on the h2o).
So, what happened to Uncle Don's meds when he passed? Oh, we flushed them down the toilet, they're gone already. And that's how it gets written up. No one goes to jail, unless there's a real good reason for it.
Agreed, Your scenario does sound nice & sweet; may even happen that way 99x out of 100. Mr/Mrs '100' gets a cool new adjoining pair of bracelets to wear, ride in the back of a Crown Vic w/a gov.org tag & a new humble abode for the next 3-10 yrs depending on the Judge's inclination. If it were my license, no offense yet I'd tell You to go F' Yourself...never been lucky enough to prevail in a lottery; with Murphy as my sidekick in life, You'd be that DEA Agent.
Now, as to carrying rx meds without the original container or the rx on you...well, giving some rentacop an excuse to play officer is kinda pushing your luck. That's something else entirely. I take it You've never been boarded by the Coasties? Me? OVER 2 dozen times over the years (used to think it was the ponytail, now being shaved head, I give up? Maybe just 'look' guilty?) & when THEY find Your "stash", it's a far cry from Your "rent-a-cop" scenario...They don't play. Never had Customs & DEA & USCG all tearing my boat apart at once....
& then again, Our Meds Were In Bottles w/Our Names on the labels & scripts, IN DATE, etc. If You HAVE ever been boarded & they DIDN'T take a peek in Your frig.; well all that can be said is You must look like a really honest "nice guy"?
Hey, it's against the law to jaywalk, too. But a whole world of pain is going to descend on the cop who writes a summons for that, without a Damn Good Reason. Jaywalking isn't a Federal 1st Degree Felony. Possession of Federally Controlled Substances, w/o a script, or a legit. "excuse" besides "they were my dead uncle Manny's & he didn't need 'em anymore" probably won't cut it...just an fyi;
Back on the medical topic...I have to disagree, having fairly recently aided someone who got fallen on. Most everyone thought it was some skins tears and a swollen/sprained ankle, but by the time I got down to the ankle I could see it was swollen larger than an egg. FORTUNATELY, I got them into a wheel chair and iced it without moving it (the swelling and the shoe were immobilizing it) instead of letting them try to walk.

Prognosis an hour later at the ER? Both the tibia and fibula had snapped clean off at the ankle, two non-displaced fractures. If there had been ANY motion of either bone, they probably would have needed ankle surgery and the odds of ever walking properly or pain-free again would have been ZERO. Somehow missed the portion where we're disagreeing here? Had that been on any vessel I was on, regardless of Captain's opinion, seeing the same injury in the same condition (regardless of whether having seen the fall/collision of bodies), LifeFlight/medivac would be being arranged or USCG Pickup w/ambulance awaiting their return. No ifs/ands/buts, that radio call would go out. Without more training than I have, or diagnostic imaging, all you can do is play the odds. If there has been a trauma and you can't be certain of the extent--better to call the medevac and get proper care for it. Sure, you may waste $50,000 on a medevac but I guess it depends on whether you can or want to gamble that much versus a life of continual pain--or a death(amen). In the US, we usually try to spend it. In much of the world, that's just not possible and low-to-no care is normal. And our congress/POTUS want us to have the same 'suck' quality level of care, as there? Let's not open that can of worms in this thread, fair enough?

I was pretty much astounded last year when a bus tour, operated as a land excursion by a cruise line, ran a bus off a mountain road in Venezuela. The victims were medivac'd to Florida's Miami-Jackson Ryder Trauma unit because it was the closest "class 1" trauma center. A standard of care that we consider normal in any US major city, is totally unavailable in a country like Venezuela. Pretty sure we've been on that same road; not sure those perferations the wife put in my hand, or that seat w/the other hand will ever heal
Versus other places where the same care is available--and the bill may be little to nothing. Also unlike the US. You just have to wait a few months, for oh, say, that X-ray;
Something to think about.

Amen, again.
Sailor, I only pray that You never find Yourself in the crosshairs of Federal (or any other) Level Law Enforcement. They don't view playing "fast & loose" with the 'rules'...they are called Laws for a reason...their job isn't to play judge...their job is to take You in to custody & let You practice Your logic on the Judge. My point from the inception of this "turn" in the thread was NOT to Encourage Others Here to Break FEDERAL LAW. Nothing more or less. Your position should be the same.
Again, no offense intended.
-Mick

[hellosailor]

Mick?
"Try that one on both the DEA Agent, the AUSA, & the Judge..."

None of those people is ever going to get into the average civilian "re-drug-user" life. No one is interested in prosecuting such small fry, no one is going to come to your home and raid your medicine chest--unless you give them good reason.

As I said, if you want to carry those drugs through a security checkpoint, past a customs inspection, or otherwise flaunt them at a uniform--that's something else again.

Statues and legality are all well and good to consider, much like any other hazard on the streets. Lions and tigers and bears, oh my, but sometimes they're simply so crazy, so wrong, and such a PITA to the entire legal system, that they're best honored by ignoring. Until you can get them thrown down.

Get busted for having a half dozen painkillers and a good excuse for them being in the med kit and you know what the DA is going to say? It's $10,000 of his time and money to take you to court, plead a nuisance charge and take 90 days probation and he'll THANK YOU for it. Then he'll call the CO of the guy that busted you, and order a new ordure discharge port installed in whoever wrote the summons in the first place.

So unless you're running for President real soon...you can dial it down a bit. (Yes, I know some prosecutors and members of "the system".) And if you are running for President? Hell, running on a drug rationalization platform as a victim of the drug war just might get you elected!

[donradcliffe]

I want to thank CaptMick for reminding us that there are people who think like he does, so a little discretion is in order.

The war on drugs is worldwide, so every time you check into another country, you have to declare whether you have any 'drugs' on board. At the risk of having this post deleted I recommend that you check the 'no' box, whether or not you have any 'drugs' and whether or not you have prescriptions for those drugs. If you check 'yes', the best that can happen is that you are going to spoil the custom man's day, because he is going to have to fill out a bunch of paperwork, and you are going to spend the rest of the day trying to keep your drugs and staying out of jail, because you don't have a prescription from a doctor in that country.

I left the question blank the first time I entered Australia because they were having a pretty good look in the lockers, and asked the customs man how I should answer. I said that my wife was a nurse, and....he interupted me and said 'we don't want to go there, do we?' The conversation might have been different if I had long hair, rings in my nipples and gang tattoo's, but he stuck his neck out for me and ignored his country's unrealistic laws.

[captmick39]

Thanks DonRadcliffe;
Common Sense trumps legal beagles 99% of the time and vocal "confusion" versus breaking rules/laws works every time. Customs Officers KNOW You don't have scripts from their country as You're JUST NOW ENTERING it... & 100 out of 100 have their head screwed on straight ever met on this end...ANY Country. If "informed" intelligently, they usually look You in the eye, saying "AND?"......

Like items for personal & Vessel protection we quickly identify WHAT, Where, & how many so they KNOW...no surprises. They like that. They also seem to LIKE the fact that we take our own security & being prepared seriously...fewer for them to have to "look out for" like shepards w/the sheep.

Sailor, on a local planning commission (volunteer) seek ZERO Public office, Now or EVER in the future. The point was, is, will be, That portion of Your post should have been deleted. Advising folks to break federal law is against the board's rules. Further advocating it IN SPITE of logical (AND FINANCIAL) arguments isn't smart. The Imperial Federal Gov.Org is never, EVER "Wrong" when they bust You(or don't), that AUSA doesn't make that "call to the CO", and 'money'/cost is something that is NEVER, EVER factored in to the equation...

...obviously You've never had any interaction w/the federal gov.org or been employed by them...while on the Big "E"(Enterprise) I watched $40M a piece tomcats pushed over the side because more "space" was needed at the time for $5m P3 Orions...go figure. Welcome to "Gubment Thinking". Until You can wrap Your head around the fact that Your BOAT is GONE, Your Freedom is GONE, Your MONEY (& Maybe even Your HOUSE) is GONE, and You've got a federal public defender, You're now becoming a crushed can under that tire called the Federal Legal System w/a roommate named "Bubba" who's calling You "cutie" and even the wife is staring at You during those visits w/both concern and consternation in her eyes...You're pretty much clueless. SINCE the "WAR ON DRUGS" was/is/always will be about the SEIZURES and the incredible funds derived from same, I seek to ALWAYS Own MY BOAT...& never, EVER..."piss on 'THE MAN'S' head". We agree more than You knew.

Getting EVERYTHING YOU NEED for $150.-$200. (the most powerful PAIN Meds being the absolute CHEAPEST in that total) LEGALLY, w/OUR Names on OUR Bottles is far cheaper than a trip down 'federal hassle & life altering lane' in our opinion.

I doubt any would disagree with us, unless of course they have a hard-on for breaking the rules (read=Federally Sanctioned FELONY punishments), risking everything they own, and considering their freedom worth less than $200. tops?

Do it right, or don't leave the dock, a personal rule. If I have a problem w/$200. to properly (AND LEGALLY) "be Prepared" for a 3-6 mo. cruise...I need to re-evaluate my float plan. That can get peed away in 15 minutes(or FAR less) w/the better half in an antique store.

Do What YOU WANT...you're going to anyway...that's Your business;
DON'T GIVE ILLEGAL ADVICE HERE...that was my only point.

[TexSail]

Originally Posted by captmick39

Can't help You that much w/the VA(& not sure Who could short of the joint chiefs?) ;

Can tell You when You head to the third world hospitals can drop all the way down to GP-Medium's for accomedations.

My Dad, w/a new bride was on Vacation in Jamaica posing for a camera & was bitten by a rabid dog. After the confirmation they started the battery of injections...he didn't get rabies....He DID get HepC off the Hospital's bad needles. About 12 yrs ago at death's door (back here in the states) his ins.(NOT VA) sprung for 1 of the first US based Liver Transpants. It took & he's still kicking. After 2 tours in Korea & 3 in Vietman, in the end the closest he ever came to death was compliments of unsanitary practices in Jamaica (& it's still a far cry up from the bottom of the barrel world wide).

As for shipping meds, that can happen, straight to embassy's/consolates. UPS & Fedex deliver to their door, You'd just need a very understanding MD here & a friend to pick up & ship?

As for First Aid Kits, we grabbed a battalion Medic's bag, Milsurp. New, complete with everything. You can't do surgery, You can rapidly splint broken bones, close serious wounds (sutures and stitches); the inventory is extensive and we took a MOP Suit Bag sling & attached to same so it's a "small suitcase w/a shoulder sling" kept right next to go bags for abandoning as 406 epirb & liferaft are automatic. 1 thing to do is buy qt. & gal. freezer bags, repackage everything to be water/air tight inside & it's life expectancy is abt. 5yrs on non-perishables(bandages, etc.).
Not a cheap investment, goes even w/friends on deliveries, priceless when needed. It ISN'T a hospital visit; it Is the next best thing.

Rule #1 when hours/days/wk or more from the ER...try Your best to never do anything stupid.
Rule #2 when You or another forgets rule #1, evacuate the wound, get it really really clean, stop the bleeding, bandage, & keep it clean. Change bandages at LEAST daily...2x minimum if like now, summer, hot & sweaty.
It's also best to get CPR & Red Cross Advance First Aid Certified (at very least) before heading off to "abroad".

HTH,
-Mick

I haven't inquired in the last couple of years, but not very long ago, Jamaica was quite restrictive on the importation of housepets on the basis that the country had zero incidences of rabies and would like to keep it that way. So much for that I guess.

[captmick39]

Originally Posted by TexSail

I haven't inquired in the last couple of years, but not very long ago, Jamaica was quite restrictive on the importation of housepets on the basis that the country had zero incidences of rabies and would like to keep it that way. So much for that I guess.

Nice "public relations" ploy,
fact of the matter is like Haiti, & most of the far east, FIDO is viewed by many locals as a delicacy...as in, dead, skinned, on a spit w/"jerk seasoning" added...."tastes just like chicken".

(Per my Dad Only...haven't set foot on the island in 25 years, however the way he lays it out is pretty much just like above)

"RULES" like these always negate any "bad PR" that could develop down the road for a nation that survives on tourism (like florida & all the crackers here that have been eating "cuder" since time immorial...land turtle called "Gopher tortoise"...now state & federally protected due to former "over consumption").

They had rabid dogs on the Island in 1995...of that I'm certain.