In The ER

In The ER

We had a scare this week with a young friend here in Panama City. An expat like us, our friend hails from Cuba. She’s been in Panama as a university student for about a year.

And Wednesday night, she began feeling sick. By Thursday morning, she couldn’t stand the pain any longer and went to the nearest hospital emergency room to see a doctor. The physician diagnosed her quickly. She had appendicitis. Her appendix needed to come out. Straightaway.

Trouble was, our friend doesn’t have health insurance. The hospital nearest her apartment was a private one, and they wanted payment for the surgery before they’d perform it. If she couldn’t produce payment, they explained, they’d transport her to the public hospital across town, where she’d be treated at no cost but where she’d have to wait her turn, along with all the other uninsured patients.

Our friend called us early Thursday to explain her situation. She had some money of her own, she said, but not enough. We ran over to the hospital, covered the balance, and our young friend was off to surgery. She’s back home now, recovering nicely.

All’s well that ends well, but the experience has reminded me of these all-important health-care and health-insurance issues.

Our young friend has a good option here in Panama (that, yes, I wish I’d thought to mention to her sooner). She could arrange local health coverage for as little as US$40 or US$50 per month. She’s a healthy 20-something non-smoker. She’ll have no trouble getting a local policy at a super-affordable rate, and, because she’s full-time in Panama, this is all the coverage she needs right now.

What if, though, you divide your time between two countries (part-time in Mexico, for example, and part-time in the States)? What if you travel continuously and spend time in three or four countries each year? What if you’re older than my friend? Older than the cut-off age for a local policy?

You have three options for health insurance in a new country. You could buy a local policy (typically very cheap). You could buy an annual travel insurance policy (that could cover you wherever you roam). You could invest in an international policy through an agency like Bupa. This could cover you anywhere, including in the United States, meaning you could give up your U.S. insurance (or Medicare).

Or you could go with no insurance, paying your medical costs as you go. The thought of this might give you night terrors, but, in fact, some places in the world, the cost of medical care is so low that it can make sense not to insure against it.

We’ve prepared a report that walks you through your choices and that details the particulars of health care options in the world’s top 18 overseas havens. You can read more here.

Kathleen Peddicord

P.S. For reference, the total cost of our friend’s appendicitis scare (ER time, lab tests, surgery, anesthesiologist, overnight in the hospital, prescribed medications, etc.) was about US$4,000. I understand that the total cost of this kind of experience in the States could be anywhere from US$20,000 to US$40,000, depending on the State where you happen to fall ill and the hospital where you go to seek care.


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