Do We Really Need Medical Insurance in Central and South America?
 

I know that sounds likes a weird question, but here’s my logic (or perhaps lack of logic!)

My wife and I will be traveling through Central and South America for the better part of a year. She will be 63 and I will be 71. We are US residents. It’s nearly impossible to find travel medical insurance once you hit 70.

We will have good travel and evacuation insurance.

So, for minor medical needs, the cost of local providers is very manageable and not a big financial hit. For anything of a serious nature, the evacuation Insurance would come into play since we would want to be treated US.

That seems to leave only the immediate care for serious illness or injury prior to evacuation to contend with. Though I don’t have a good way to estimate how much that could be, it seems unlikely that it would exceed $5000 USD. Not inconsequential, but not one that would leave us destitute.

I’m interested in other thoughts and opinions. If you think I’m totally flawed in the logic or am missing something, have at it!

Thanks!

I cannot speak from personal experience as a slightly younger Brit medical insurance is somewhat cheaper and easier to come by, but I have seen comments on Advrider from Americans living in Central America to the effect that good medical treatment for even some serious conditions can cost less than a year's insurance premium in the US and that they do not bother with insurance.

I would look into each country you plan to pass through and find out what's up. I know at least some provide FREE medical coverage, (even for foreigners)

But critics will say (this varies country to country) it's crap and places you'd end up in are not good. In most countries those with money go to "private" clinics where the best (mostly US trained) doctors may be found.

I know for at least some of those clinics you pay CASH. It's also quite possible your home med insurance will cover your cash outlays as reimbursements. So check with you insurance company before you leave and be sure to save ALL paperwork and receipts for med services received.

Your initial emergency med care may be "hit or miss". But in most countries now there are GOOD private clinics in larger cities. Small villages? Nope.

But your plan to use you Evac insurance to get you back to USA is the BEST ...
if you are well enough to make a 10 hour flight.

I'm with Kaiser in California, and YES they totally cover me in any foreign countries via reimbursement.

There are several Ride Reports on ADV Rider where riders had major surgeries and came out fine! Also read a story or two where some orthopedic procedure was "re-done" once back in USA. Nobody died!

For initial Emergency treatment it will depend where you are ... and really just luck if someone qualified is near you or not.

You will be shocked at just how many really good Doc's are down there ... and how cheap and easy it is to get hold of most medications WAY less than USA prices.
bier

Unfortunately US Medicare, in fact almost any US insurance, does not reimburse for expenses incurred during extended (more than 3 months) travel.

And, good point about being able to make a 10 hour flight!

One thing we have going in our favor is that we will be on Ural sidecar rig. We are significant less likely to have a serious injury from a single-vehicle accident. That said, we can get t-boned just as easily as a 2-Wheeler can.

Wow! Did not know about the MediCare exclusion for time. I guess they think everyone is doing a 10 day cruise or something? doh

Basic medical care is free in many Latin American countries. I no longer remember which ones ... but worth looking into. But as I said ... that basic care can be FAR below what we are used to.

This is why private clinics do well with more well off patients ... and foreigners.
But even in some of those the state may pay a portion of your bill. Research to find specific plans in each country.

You will hear some nightmare stories about govt. run clinics, but not all are horrible, but a shock to us in some cases.

Other knock on some free health care down there is crowding and the time it can take to see a doctor or specialist.

It sucks getting old ... you all stay strong and healthy and keep the Ural rubber side down! :D:D:D:D:D

Crunch can come when you land back in the USA because then you will need decent cover for astronomical hospital and medical bills.

I go back and forth on the question of medical insurance. Over the past 7.5+ years of travel I've not had medical insurance for the majority of my travels though I admit I have been lucky enough that my injuries and illnesses were not major. At most, one night in the hospital.

Ignore catastrophic injuries for a moment. For routine health issues, I find medical insurance and medical care in the majority of the world has generally fallen into one of these two categories:

1. Insurance with a low deductible covers a portion of the bill but is so expensive that medical care + insurance costs significantly more than the total medical bill with no insurance.
2. Insurance with a high deductible does not cover anything because medical care is so inexpensive, even including hospital stays and surgery.

End result: For anything up to minor surgery, insurance costs me more money than it saves, though at times I might be flying to a different country for my medical care (which I have found often is a good idea). I have found the above to be true even in the EU, where I had surgery in Germany

This leaves the rare cases of major surgery on up through life changing catastrophic events. This is where the medical bills can add up fast in a way other people on this thread are describing. For these types of scenarios, I have seen that it is all too often insufficient to have only evacuation insurance with good after-care. Others in this thread (above) have given sufficient examples of how this can be problematic so I won't belabor the point further other than to say that my own experience confirms what they are saying.

All this has left me with a simple philosophy: while I continue to travel, I will never buy medical insurance for anything up through minor surgery. If I consider my risk of major injury is significant (such as in motorcycle travel), I will buy the highest deductible plan I can find with good evacuation coverage and after-care. This keeps my medical insurance costs to a few hundred dollars a year maximum and overall has saved me a lot of money. When I am not traveling on a motorcycle I often do not have any medical insurance at all.

msamsen, I see you live in the USA. You might look into HCC Atlas Travel Insurance. You can get a high deductible plan at a reasonable price that covers motorcycle travel, includes evacuation insurance and covers the costs incurred before you can evac as well as followup care afterwords.

Good luck and enjoy your travels!

No, they have Medicare.

The topic of this thread, established by the OP, is the value of health insurance while traveling in Central and South America.

Anyone wishing to post screeds about current American political figures can feel free to do so elsewhere. Since I'm getting tired of saying the same old stuff over and over again, I'm considering doing what I'm actually supposed to do in response--which is issue infraction points which lead to temporary and/or permanent bans.

Note that this has nothing whatsoever to do with my own political opinions, of which I have many.

Thanks for your attention.

Increasingly dictatorial moderator Mark

Thanks!! It’s only the second company that I’ve found that will insure someone over 70 years old, though with a 250,000 USD benefit max. Better than nothing, for sure!!!!

:thumbup1::thumbup1:

Regarding health insurance, I have the same philosophy as Othalan.

You buy insurance for major care/ major accidents. So you select the policy that has the highest deductable. This way you save a lot of money and you are still covered in case of a big accident.

Do you need insurance for central and south america? It is a personal decision about how much financial risk you are willing to accept. I did not take any. I only visited hospitals in Argentina and Brasil. It was almost free.

Regarding road safety, I have not seen your ural but It could be a good idea to add an additional headlight as much to right as possible on the side car to make it look like a car for on coming traffic. You'll reduce the risk of head on collision.


Patrick

Thanks! Good suggestion.

It has both a spotlight and two fog lights on the sidecar, plus the bike headlamp, of course. They are all LED.

Mike

If you want to do a bit more philosophy about travel insurance, here is the way is see this:

There are two types of travel insurances:

1) the passive travel insurance: the insurance policy that you will be buy

2 ) the active travel insurance: what you can do to avoid an accident/getting injuered. Here are a few items:
- driving behavior: it is obvious, no need to add more
- bike setup:
1) bike handling: set your bike suspension to handle well with the extra load when making a sudden move, rough roads, bumpy downhill,...
2)tire selections for road / offroad conditions and how often you replace them: As an example I met a guy in Africa who was happy to have a K60 front tire because they last. Then he had a crash offroad and now he needs knee surgery. Was it worth it to save paying for an extra front tire to cover the same mileage.
3) A steering damper: very usefull offroad. May save you from a crash that could end your trip.
4) etc...

The above list applies more to two wheels bikes. You got three wheels, you can't fall. I know nothing about Ural. I can't comment on how to set them.

You may already have one but I would recommend that you add a good steering damper. You shared your age above. Physical shape, endurance at 71yo is not the same as at 41yo. It is a fact of life and it is what it is. With the damper, the ural will be more stable, you'll feel less the impacts from the on/off road on the front wheel. The riding will be less tiring on you. As a consequence, you will be more alert, will be able to react faster to a situation and at the end of the day you will have more energy to enjoy your evening!

Steering dampers are not all the same, some dampens only away front the center, some dampens in both directions, some have more adjustability. Pick what is best for you.

Have a good trip,
Patrick

There are decent clinics here in Honduras, especially here in Tegucigalpa and also in San Pedro Sula. But, the overall quality of the medical care in this country is not on par with those in the USA. A fellow teacher here went to 3 clinics for her bad knee. All three suggested surgery. She went back to the USA for another opinion and they had her do PT. She's back to kickboxing and exercising regularly just a few months later...no surgery. That's just one of many many examples of over zealous Honduran doctors that I've heard stories about while living here for the past 5 years.

If I needed any serious medical care, I wouldn't have it done here.

Thanks Patrick. Yes, I’m a fan of dampers. All my bikes have them. I put Scott’s on my KTM and BMW. The Ural has one from the factory, similar to the setup on an R1200GS.

Re: age. You’re correct, of course. But I strength train three days a week and do cardio the other days. Just got back from a gnarly power line and single track ride with some 30 somethings on my KTM. I don’t ride as fast as they, but I do complete the ride.

Good for you Mike that you are in good shape. Did you plan some workouts to do while on the road?

Last year, I did not workout while riding from North to South Africa. After 7 months on the road, I could feel that I was less in shape while riding my dr650 fully loaded with extra fuel and water in Namibia's deep sand. Riding a close to 500lbs bike in deep sand is a lot of work. My arms were taking so long to recover and I was just 43yo. Next trip, I will workout regularly while on the road.

Patrick

Patrick,

Every trip e take we "plan workouts" to do on the road. Actually doing them is a different matter. :(

It’s just a matter of our both keeping each other accountable for our morning routines...meditation, yoga, and strength work. We expect to do enough walking and hiking that we won’t have to plan for that.

If you’re interested, Lisa Thomas (Home - 2RidetheWorld.com) was a trainer before she and Simon packed it in and started their now 13 year journey. She has a video on exercises specifically targeted at daily recovery and prep for long distance MC traveling.

I already took care of my next workout routines. I have always wanted to do gymnastic.. I told myself it is now or never. So I got myself gymnastic programs for floor, rings, mini parallel bar. I love it. Much more fun than going to a regular gym and lifting weights.

I looked at Lisa's video. It is well made!

Patrick

I've worked in medical insurance the last 5 years.

If it's something serious, unless you can pay all the bills before the air ambulance arrives, you will die. The Hospitals truly don't give a shit, if you can't pay, they will throw you out on the street, so unless you can cover a minimum of a weeks medical cover, you've had it.

Bear in mind also that in order for an evacuation to take place, you have to be well enough to evacuate, even by air ambulance. If you're really sick they may not want to take that risk until you are better, fit to fly, so you could be looking at several weeks you have to pay for.

A budget of $10000 a day would be more realistic. I have seen people have to sell their houses to pay and, like I say, in some countries (including ones in central and south America) they won't treat you until either you have paid a sizeable deposit and continue to pay upfront, or your insurer has put a guarantee in place. I have had to place guarantees in 30 minutes because they were going to throw people who would die, out onto the street. They truly don't care, it's all about the money.

The way I think about medical insurance is better safe than sorry. Hopefully, you would not have to use it, but in the case of extended travels, it's likely that you will seek medical assistance. It's just wiser to have one if it were me.

I have been an expat in several Latin American countries for a few decades.

In most countries, when you show up, the clinics or the hospitals want to get paid. if they have doubts that you can pay, they would not admit you, if they admit you, you have to pay before you get release.

Buying the best insurance coverage, will not instantly solve this is issue.

On the other hand, it is mandatory to buy insurance (SOAT)when entering a country with a motor vehicle. In an event of an accident, no worries to have medical attention.

Still some foreign riders try to escape to get the SOAT ...

chill out, nothing out of place here.

Thanks for your input (and for your previous, on-topic post). If there is nothing out of place, it's because I edited out a bunch of stuff. You'll have to use your imagination.

Mark

Medicare does not cover out of country medical expenses at all. But 3 of the multiple choices of Medicare supplements do cover 80% of “appropriate” expenses (i.e NOT plastic surgery!!) up to $50k , but only in the first 60 days of travel. I have plan G.
Speaking of plastic it sounds like 2-3 paid up $50000 limit credit cards could save one’s life.

Cholo I'm afraid you are dead wrong. Ecuador, Brazil argentina soat is mandatory. There is an agreement between the countries of the Mercosur. T
When I buy the soat for the motorcycle in Brazil I'm covered when I traveled in other countries of the mercosur.
here is no such free healthcare to motorcyclist.

Ecuador had a new law that requests a vehicle be submitted to a revision before being able to buy seguro. That seguro is a must to buy the plates. This has nothing to do with a road tax. Everytime I travel to ecuador with my colombian motorcycle, I don't need to buy seguro because there is an agreement between both countries. Other vehicles extranjero must be covered by a 30 days soat.

I would like to share something. 3 years ago I buy a new MC in Colombia. I requested for a seguro. they told me no problem, but when I went to pick the motorcycle I was told that because I couldn't show my cedula de extranjero, I could not buy seguro.

I told that to my colombiana wife, she called a friend that is an insurance broker. She an insurance documento that, a passaport was a valid ID to buy seguro and I bought my soat through her. Obviously it was a lie.

Why she lied, only God knows.

be careful

You are mixed up not I. Not sure of your Spanish or Portugeese understanding? Show me any text in Portugeese and Spanish.

Looks like you have never been in these countries solo un dia when you suggest to call the embassies. You need an insurance broker, nothing less nothing more.

Colo, don't polute my mail box, write it here what you have to say. I don't give a dam where you lived, and how long . So be kind and explain to us what is the agreement between the countries of the Mercosur concerning the soat, and what happen if a motorciclist in any of these countries has an accident without the soat since you seem to say, no importa,in Brazil and Argentina healthcare is free.

I am living in Nicaragua and health care is free. I have had to go to the hospital a couple times and had excellent care. I am always surprised at the time they take and the high level of competency.

The problem is that you don't choose the situation for which you need care. If it's a broken leg then you'll need initial care and treatment (which is indeed paid for by the local taxpayers hence "free" to you), and you can then fly home.

However if you both end up in a coma for 6 months,that's a completely different story.

So, it's a risk assessment - what's the probability of the range of events which will put you into medical care, and what are the consequences of each event in the range? Lots will fall into the "unlikely and not expensive" category, but if you identify even only one which falls into the "possible and very expensive" category you should seek insurance.

We always travel with insurance - a combination of annual policies which include medical repatriation and travel policies for the length of the trip (anything up to a year) and which also include repatriation coverage. Not "cheap" but definitely "valuable".

I second Othalan - I think...

Being Norwegian where health care is free, and a country where travek health insurance is cheap, it is difficult for me to relate to you.

But I think, if I was in the same situation - I would get an insurance plan with a very high deductible, and great extraction coverage, and be self insurer for all the small to medium stuff.

I always carry a bottle of scotch and feel as though that can cure just about anything.

Can I ask as a newbie, I’m an Australian citizen looking for global health insurance that covers continuous travel, ie I’m setting off and continually traveling for several years. I cannot find any company that offers this?? Companies that offer multi-trip assume you are coming home between trips!! I’m not. Cheers.


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Has anyone checked World Nomads lately? They've been a favourite for years here and for travellers everywhere, and support HU with some dosh.

They don't insure travellers over 65.

Look at Backpackers or Gap Year policies, they normally offer longer duration trips. I found multitrip cover only allowed trips of 30-35 days before you are expected to return to your home country.

Medical Insurance
 

Of course, I would like to have a medical insurance.

But can I find one ?

If so, what do you recommend ?

I am 64 years and EU citizen.
I plan for travelling 6 months in South America.
Needs to include MC driving (fine print might exclude a lot of things)

Happy for any concrete propsals

Just checked, they have changed their providers and it looks like the don’t cover motorcycle overlanding - I have emailed to double check.

insurance
 

Sanitas International is a provider in Colombia