Why You Can Stop Worrying About Healthcare Abroad

0:00 When we were making plans to leave the US, the people who loved us kept bringing up one concern they had, healthc care. What if we got sick? What if one of us needed surgery? What if there was something serious that happened and we were thousands of miles away from home? >> I think a lot of Americans carry the same assumption that US medical care is the safest option and leaving it is reckless. But then I needed medical healthc care abroad and that experience changed how we thought about everything completely. We've been traveling outside the US for over 3 years. We'll share what we actually pay, what we did when we needed care, and the answers that your family and you may be looking for to put your fears to rest.

0:44 >> I'm Judy. >> And I'm Kevin. Welcome back to Find Gene Marie, where we share our lives as full-time travelers and the connections we make along the way. >> We want to be fully transparent with you. We use Signa Global Health for our health insurance. We've been using Sigma since 2023. When we first applied for our international policy, we paid $5,751. It's gone up 22% and it's now $7,03. That breaks down to be $584 a month for both of us combined. Obviously, if you're a solo traveler, you'll only be paying for yourself, and that will probably be closer to half of what we're paying. Now, these increases have to do with age. And any policy you get, whether it's in the US or international, they're always going to go up as you age because the risk is higher. Insurance companies, they're not going to take the risk without getting some money out of you.

1:36 >> Now, one of the things that we need to talk about is what we use our healthcare insurance policy for. And it's primarily for catastrophic issues. For the most of the time, we pay out of pocket. We have a high deductible, $3,000 a year, and that helps keep our premiums more affordable than they'd otherwise be. In the US, if you don't have healthcare, many providers won't even treat you unless it's an emergency. >> There's a big difference between the way the medical system in the US works and most other parts of the world. In the US, most of the medical costs are assuming that an insurance company's going to be involved, and they're going to take the brunt of the amount, and then you're going to pay what's left over based on your deductible and everything else. when we're overseas, that's not what's happening. They're not generally planning to fund an insurance company and then let you pay the rest that's left over.

2:27 >> And the really nice thing is that healthcare overseas is typically significantly cheaper than it is in the US. >> Some people think they can just go without insurance and self-fund everything. They stick their money in an account and when they need medical care, they pull it out of that account. That's great until you have a catastrophic problem. Cancer, something that's long-term care, a cardiac arrest, surgery after surgery. Suddenly the bills are piling up bigger and bigger, especially if you're in the US system and you suddenly have to pay enormous bills for being in a hospital.

3:01 >> But I think that's also true if you are living outside of the US as well. Uh whatever you've saved is probably not enough for serious health conditions. >> But that's insurance, right? Insurance is always for those big situations. It's not to pay every bill that you actually get. >> And we've found that people are more than happy to take your cash when you are needing healthcare abroad. And you can file a claim afterwards. But for us, we've never actually needed to file a claim. Our $3,000 deductible is high enough that we've been able to pay out of pocket without even coming close to hitting our deductible >> for everything, including surgery.

3:43 You just mentioned surgery. Let's talk about what happened in Vienna that prompted you to end up needing surgery in Serbia. >> Yeah. Well, in Vienna, I was really in a lot of pain from a hernia. And so, we didn't have enough time to get a surgery done there and recover. By the time we got to Serbia, I just decided I have to get it done. She decided I have to get it done. And so, called up and it was a really good experience. Very quick. We have a whole video about all the details, but basically I called at noon, got into the doctor by two, was out by three, had surgery done, and was out by the next day late in the day in recovery in my apartment, which is a very unique experience for a lot of people. We were quoted €1,800 for the surgery. Our actual bill was €100 below that quote, or $1,732 US. with a follow-up visit to remove my stitches, medicine, and bandages. The grand total was $1,832, and there were no additional surprise bills from the anesthesiologist.

4:43 >> Overall, a pretty affordable surgery that probably would have cost $9,000 or more in the US. >> So, I felt really confident with that whole process. And once I was knocked out for surgery, I certainly had no concerns. >> But meanwhile, I was in the waiting room and that's when all of the worries just kind of flooded through my brain. and I realized that I really hadn't done a ton of research and the protocol that the surgeon wanted to use was a little bit different than we thought initially going in. It made me feel a little bit distrustful >> and you got on the internet >> and I got on the internet and did a whole bunch of research and I realized that I'd been programmed to think about the US health care system as always being right, being the best in the world and was questioning whether we had a mistake getting surgery abroad. But the reality was that the more we understood what was going on, we realized that this was actually a really affordable, smart, uh, best practice. And so it kind of put our minds at ease to realize that some of our closely held beliefs maybe really didn't live up to what reality was.

5:52 >> Yeah. Expert medical care all around the world exists. It's not just in the US. It also helped that our experience at the hospital was really excellent all the way around. There was English-speaking nurses. We were guided through all the paperwork and the care was excellent. We had a private room. It was just a great experience overall. Maybe not the same as the hospitals you see in the US, but then again, it was really inexpensive. >> So, let's talk about what things are like when you're not having major surgery. One of the lifts in the US health care system for me has been I have to schedule a doctor's appointment, sit in a waiting room, maybe go through another appointment to get some tests done at a different location, and then maybe have to see a different doctor for whatever other consultation I need. And that's not just money, that's time.

6:43 >> One of the perks of traveling and using medical tourism is that you can go to places that are renowned for certain healthcare. For example, we knew we wanted to get comprehensive medical checkups done. So, we headed to Thailand and in Chiang Mai, we arranged for all of that. We set up an appointment via email, which was super straightforward, and then we had a date. We showed up. They had a turnkey program set up that we could choose which test we wanted to have. I had a mammogram and a women's wellness checkups. We had cardiac tests, all kinds of things. And when we had certain things that came back that needed to have a follow-up, those were arranged for us for the very next day.

7:24 We even got a lunch that was built into the price, which was pretty cool. >> Yeah, it's skinincare checkups and medical checkups, full body scans. Everything was in one facility and we could just go from doctor to doctor and they would guide you from point to point. And so we didn't spend days or weeks doing this. It was 2 days of here's our checkups and here's the things we came back for followup and it was all in one place.

7:48 >> The cost was very affordable and in fact we have an entire video about that process. The thing is, depending on the medical care you need, you can go to those countries to get the best care possible, like Mexico for dental care or Turkey. >> And they're affordable. And even when you have dental insurance in the US, sometimes the caps per year are exceeded when you have to have something like a root canal or a crown replaced.

8:14 Especially if you have more than one, you may hit your maximum. And then all of those costs are just over and above that come out of your pocket. And while you may think that the US is the only place that has top-notch cancer treatment, the truth is that places like Germany and India and South Korea and Thailand all have worldclass treatment centers for cancer. Let's talk about medications. We've been in parts of the world and we've looked up the prices for something and it's onetenth of the price of what we paid in the US and that's just shocking.

8:48 >> There was a prescription I was getting filled in the US and it wasn't covered and it was $1,300 a month and then I went to France and it was $81. It just blew my mind. But it's actually not surprising. In fact, we know people because of this very same thing get a year supply of medications in a particular part of the world so that they don't have to pay US prices. Now, the only thing is you need to be careful and make sure that it's not a banned substance in one of the places that you're traveling to during the year.

9:22 And while some of you may be very comfortable with the doctor you've had and been your doctor for years, in my experience, I've had to change doctors so often because my job would change or the insurance company at my corporation would change and I would have to go into a different network and I've had so many different doctors over the years. I don't even remember the one I like the best. Now, we were actually having a conversation today over breakfast, and one of the things that came up is the challenge of needing a specific service, but you're not just having to go with what your doctor's suggestion is. Your health insurance policy might not allow that treatment. So, your doctor isn't making decisions, your insurer is. It was a feisty conversation because I get really irritated when there's a for-profit service or company in the middle and between me and my doctor that is making decisions because of money. I want to get the care I need.

10:19 >> And often times the idea is to delay and make you jump through a series of hoops in order to maybe get you fatigued and you're too tired of bringing up this health issue and you just give up. because that's really sometimes what I think they want to happen. >> Oh yeah, you probably need back surgery, but they're going to make you go through months of these different tests because they don't want to pay for that surgery.

10:43 And that just makes me crazy because I just want the best medical services. >> And the truth is that when you're paying out of pocket for some expenses, you have more control over the services that you're actually going to get. And one thing that's nice is that there are plenty of fellow travelers who have had health care all over the world, including people in our forum, La Familia. They can make recommendations for the places that they've had good healthcare experiences. So, it's not like you're having to navigate which places to go to all on your own. You know, we use our forums all the time because there's really smart people in there.

11:23 There are several options for global health care providers and we put together this chart to help you work through those and what gotchas you might want to look out for. Now bear in mind when we did cost comparisons we used our ages 61 and 64. But if you're a solo traveler obviously you'll use your numbers which will be about half price from what these numbers are. >> And if you're younger even less than half. >> Let's look quickly at the age column.

11:48 Notice that some providers don't offer certain policies for people over specific ages. Now, one of the things we liked was that Sigma has no confirmed age limits. So, it's not that after you hit 69, you're cut off. And that's a big deal for us. In fact, we were looking at a different policy for Genki, but it only allowed you to be 55 or younger in order to even qualify for that program. >> We're way past that. A lot of people like to talk about Safety Wing, but their essential plan excludes both pre-existing conditions and cancer. It may be the cheapest plan, but there are very big gaps, >> especially if you're looking for catastrophic coverage. That's a big point to skip.

12:26 >> Now, Safety Wing Complete adds cancer coverage, but it still excludes pre-existing conditions entirely. Genki, like Sigma, requires underwriter approval for pre-existing conditions. And although Genki is a little bit cheaper than Sigma, we actually really liked that now that we have an established relationship with them, we do get a loyalty discount, which we might not with Genki. And because Genki cuts off at 69, we don't really want to have to change providers when we're past that age.

12:56 >> We're planning to travel a lot longer than that. Now, all these policies are excluding US coverage. If you're going to be in the US longer than we are, which is about 21 days a year, you may have to choose a different plan. The minute you add extended US coverage, the prices skyrocket up. So, be careful about that. >> With worldwide plans that exclude the US from coverage when you are in the US, it will cover emergency conditions, but that's only if something happens to you when you're in the US, not something that you were diagnosed with abroad and then wanted to have treated in the US.

13:29 So you have to be very careful about that. >> As with any insurance policy, no matter whether you're getting what through your US corporation or a world coverage policy, you want to make sure you understand all the limitations because you can really get burned if you're not aware of something that's excluded or something that has extreme limits. >> Now, if you are in the US for more extended periods of time, a lot of people use an ACA coverage and that kind of works as a gap, but it doesn't cover you when you're traveling abroad. So, it really is just for a narrow purpose.

14:03 >> Now, if you have serious healthcare needs while you're in a remote area, rural area, there's no major hospital, your health coverage may not cover the transport to the hospital. They may cover the medical cost when you're there, but it could be very expensive to get from where you are to where you need that doctor. >> Now, the Genki plan actually does have that included. and Sigma is an extra cost about $953 for us together. One of the most well- reggarded repatriation and evacuation policies is through MedJet. One thing to bear in mind is they do require you to have a home base in the US and you have to be in the US when you start your insurance, which was kind of disappointing. So, something to bear in mind. I'd also be very cautious about the evacuation service protection that your credit card might offer.

14:52 oftentimes they only cover a 60-day trip. So, as a full-time traveler, they may not cover you. And you might think, "Oh, I'll just call and get confirmation." But the person you talk to on the phone is not the same person who's going to accept or reject your claim when you're in that situation. And the worst thing you want to do is rely on that only to find out that you really don't have that protection. >> Yeah. You can't use the argument, "But I called and they said it was going to be okay." It's not going to fly.

15:24 We've got a big trip planned in Africa that's a safari which is a major expense and there's a lot of moving parts and a lot of things happening in that part of the world. >> So although we have our regular global healthcare, we're actually going to get specific trip insurance for this particular excursion. And that's because it will cover all the things that we need it to just for this one section of time. Now, we can't afford to do that everywhere we go, but this is such a big expense, it's worth it.

15:55 >> Now, one question people ask us is that they're solo travelers and they're worried about what happens if they need extended care and they are abroad. One thing that I'll say is that your accommodations, your hotel or your Airbnb often have people who are willing to help you through whatever crisis you're having to deal with. But also because you're not in the US, they don't throw you out of a hospital like as soon as you've had your surgery or whatever your medical crisis might be.

16:26 >> There are always options. When I was recovering from my hernia surgery, I wasn't allowed to lift suitcases up. I wasn't going to make Judy try to put them up in the in the overhead compartment of a plane. So, we just said, "We're going to just check our luggage." It wasn't like I couldn't have done that by myself. It was just nice to have Judy with me. But the idea is you can have people help you with everything. And if you're staying at a hotel, certainly there are services, concier services, other things that will help you get through it.

16:53 >> If Kevin wouldn't have had me along, he could have hired a shipping service that would have taken his luggage to the next destination. Or he could have adjusted the amount of time he was staying in Serbia so that he could have his full recovery while he was there. And especially in Serbia, it was a very cheap place to live. Now, you may think going back to the US and being surrounded by family and friends will help you, but the reality is your family and friends have their own jobs and may not be local to where your home is. And so, the help that you think you're going to get may not pan out. The truth is, if you go to our forum or a Facebook expat group, there probably are people who would rally and be able to help you. So, it's not as though you are stranded in a foreign country and you're completely isolated and on your own.

17:46 >> Let's talk about Medicare. Next year, I'm turning 65 and it's not just an abstract concept anymore. I'm not dying. I'm just turning 65. >> So, let's talk about our plan. We're going to get Medicare A, which is free for the most part, unless you have very high income levels. We're also going to pay for Medicare B and also D because if you don't get them right when you're eligible, you will pay a penalty for each month that you were eligible and didn't get it.

18:13 >> It doesn't seem logical, but it's a real thing. So, kind of have to bite that bullet and say, "Well, we'll take it and see what happens after that." >> Now, our plan is to live abroad for the rest of our lives. But we also know that there could be a sick family member that requires us to spend meaningful time in the US or grandchildren that haven't been born yet that maybe we want to spend more time seeing. So we don't want to just completely assume that our lives will always be outside of the US. So we're planning for a little bit of a contingency >> safety nets >> because we don't know what the next decade is going to look like for us. It just doesn't make sense to have to pay penalties for the rest of our lives because we were looking too shortterm initially and we really aren't fans of Medicare Advantage. We've heard that it's very hard to get out of and you're very limited to the PPOs or HMOs that are part of that plan. So, we would rather not have that at all.

19:12 >> Now, this is what we're doing. you should always consult a Medicare specialist because your situation is unique to you and you want to get the best coverage possible at the best price. >> So, let's just talk about what our final thoughts are about all of this. >> I have a lot of thoughts, but whenever these thoughts come up, it's because of insurance companies, and I feel like they've caused us so much paperwork and hassle over the years and money. So the idea that we've gone through this process of freeing ourselves of the the US system, we still use it when we're back there, but we have so many options around the world. I feel like suddenly, yes, I'm going to pay for health insurance, the global policy, because you got to have those safety nets. But I feel so much more freedom. Like I get to choose. And the fact that Judy has done research about the various countries where we can go get the best care for the best for the for the services that they're best at. I mean, that just feels so good to me. It feels like a lot of freedom.

20:11 >> Now, of course, if you have a medical emergency, you really don't have as much freedom as you could otherwise. But at the same time, knowing that you can pay cash and probably pay significantly less than you can in the US, that is some freedom. And really going to an emergency room anywhere in the world is a much different process than in the US. You don't get this huge bill when you walk out of there. Some people don't get a bill at all. And even if you have an ambulance ride, it's just very different. You have to kind of like change your brain out and put a new one in that says, "Oh, I could have a car accident and they'll just take care of me."

20:49 you actually may find that you get sticker shock in reverse knowing that the cost that you're expecting to pay and what the reality is that it's much lower. In fact, in the four years that we've had global healthcare coverage, we've never once needed to file a claim. Now obviously your mileage might be different and we are fortunate in that we are overall very healthy but at the same time it does help to know that this is a pretty inexpensive way to live for a lot of people who don't have chronic healthc care issues.

21:22 >> Yeah. I think after this time we spent living like this, my fear of having a medical emergency anywhere in the world has disappeared. >> Yeah. I think one of the things that I was worried about when we lived in the US is that if we had a cat catastrophic issue that it could possibly bankrupt us and I don't really worry about that happening because in most of the rest of the world the costs of healthcare are not going to be that high.

21:48 >> There's medical services everywhere and they're affordable and there's a lot of friendly English-speaking people who will help you through the process. Now, this isn't a blanket statement for everyone, but for the majority of you, you can do this. It's not hard. Now, healthcare might not be your only concern when you're considering whether or not to live this kind of a lifestyle. You might be worried about whether you should keep a home base or sell it or rent it. We have that conversation in this next video here. Thank you so much for joining us. The best compliment you can give to us is to recommend our videos to your friends and family.

22:21 >> And remember to >> wander more, >> worry less, >> and bring a passport. Until next time. >> Until next time.