We put a lot of planning into our vacations and business trips, and with good reason. Travel foul-ups like missed connections are common enough that we know how to deal with them. But we’re far less prepared for an illness or medical emergency on the road. Half of all Americans touring developing countries fall ill within the first month of travel, according to a report from International SOS, a medical-assistance company. Malaria, hepatitis A and B, typhoid and accidents pose the most dire threats. Even a bad case of traveler’s diarrhea, the most common ailment, can make you wish you had never left home. Searching for the right treatment may add to your misery, especially in countries where Western-style medicine isn’t the rule, or where prompt treatment may require immediate cash payment. Americans traveling within the United States fare far better, but managed care can be a headache once you’re out of reach of your network. And even travelers with more traditional coverage may find it hard identifying the right doctor in a strange city. Serious problems, but manageable ones. All it takes is planning before you hit the road.
Schedule a pretrip checkup with your doctor. It’s a must if you’re battling a chronic illness that could flare up under less-than-ideal conditions. If you’re traveling abroad, be sure to go over your immunization status, as well as any vaccines required for your destination country. Specialists in travel medicine know this stuff cold. Otherwise, search online for the Centers for Disease Control and Prevention (cdc.gov), and click on “Travel Health” and again on “Immunizations.” If malaria is a risk, ask whether the new antimalarial Malarone (atovaquone and proguanil) is right for you. It has fewer side effects than older treatments. Think about adding a visit to the dentist to your pretrip checklist. Few things will ruin a trip quicker than an aching tooth. Experts also advise carrying a travel medical kit. Among other items, it should contain a bug spray with DEET concentrations greater than 25 percent. And be sure to include adequate supplies of all your meds. Generic equivalents may not be available.
A prevention plan is only the start. How you deal with sickness or injury on the road is just as crucial. First, know what you’re covered for. If you’re traveling within the United States, many managed-care plans will accept an out-of-network provider as long as you get written permission beforehand. But don’t expect your U.S. policy to cover you abroad, except for documented emergencies. Nor is Medicare much help in a foreign country. For this reason, savvy globe-trotters often take out international medical insurance, through either their travel agent or a broker. A no-frills policy with a maximum limit of $50,000 will cost you $55 to $175, depending on your age and the length of your stay. Coverage for pre-existing conditions costs extra. You may need the services of a medical-assistance company like International SOS, Assist America or Medex Assistance, which will link you to their networks of Western-trained doctors. A standard two-week policy on your own will cost around $55. Before plunking down your money, though, read the fine print to find out exactly what the company covers.
Be sure your medical record is quickly accessible in a crisis. In the past this meant giving your primary-care doctor the OK to fax it to your treating physician. In many cases it still does. But travelers today have new options. WorldClinic in Burlington, Mass., creates secure electronic medical records for its clients. Notified of a crisis, a WorldClinic doctor pulls up your history and consults via telephone or e-mail with your health-care team in the field. A basic one-year benefit plan–including evacuation service–will run you $625. Other companies will help you create your personal medical history and give you a secure site on which to post it. Some services, like PersonalMD.com, are ad-sponsored; others, like 4healthylife.com, charge a modest one-time fee.
For more information on healthy travel, try the World Health Organization’s International Travel and Health site (who.int/ith), the International Society of Travel Medicine (www.istm.org) and the International Association for Medical Assistance to Travelers (iamat.org). The State Department’s Bureau of Consular Affairs (travel.state.gov) publishes a useful series of consular information sheets.
These tips can help you stay healthy on the road. That’s at least as critical to a good trip as making your connections on time.
