I’ve heard ad nauseam how the US health care system can be financially crippling, should you have the misfortune to get sick or injured. They don’t exactly have the cheapest doctor. Before I started traveling full-time, I frequently hopped across the border to the US to skydive, and I used to say āif I get injured, just put me on a raft and push me towards Canada.ā I figured that was ultimately safer than landing in a US hospital.
My suspicions were confirmed a few years later in Hawaii my ex made a trip to the emergency room, and walked out 45 minutes later with a $900 bill for an x-ray and some Tylenol.
Yikes.
So when I fell sick in Florida and couldn’t kick it with herbal and homeopathic remedies, it was with incredible reluctance that I made an appointment to see a local doctor.
See also: How to Stay Healthy While Traveling – Natural Preventions and Cures
This post was originally published in 2012 . It has since been updated for accuracy of links and content.
How I Use My Travel/Medical Insurance
I have expat insurance, so no medical setback should be financially life-altering. But I also have enough experience filing claims on my ex’s behalf, that it’s not a process I enjoy nor care to repeat.
So in designing my expat insurance plan, I kept my premiums low by setting a very high deductible. (And if you don’t know what all that means, then check out my very informative article about expat insurance). So the only time I ever plan to make a medical claim on my insurance is if I really….really really really need to. (And I hope I never will).
By structuring my medical insurance this way, it means that if I have minor medical problems that need attention, I āself-insureā by paying cash.
Going to a US Doctor
āI have no insurance,ā I proclaimed as soon as the receptionist answered the phone at the doctor’s office. āHow much will I pay to see a doctor?ā
I was given a vague answer of $75-$100 to see a P.A., and was told I could come in any time that day.
Expecting to wait for hours, I was shocked when I waltzed in and the doctor sat and chatted cordially with my friend and I while I filled in the standard paperwork. Before I knew it I was whisked into the examination room.
Getting an Education
My doctor was quite chatty, and provided me with all sorts of medical pearls of wisdom about how to identify a bacterial infection (which is what I had), bronchitis (which it wasn’t), and even voluntarily diagnosed a few other issues I had but thought were genetic and incurable (you mean that involuntary twitch is stress-related? Who knew). He was even open-minded to herbal and homeopathic remedies.
It was the most educational session I’ve ever had with a medical professional.
Are you Billing by the Minute?
Unfortunately throughout my little education-session, a little voice in the back of my head was suspiciously asking if this was a plot to escalate my cost with a billing-for-time model. I hadn’t confirmed my cost prior to waltzing into the examination room, and after 30 minutes passed I became nervous.
Free Prescriptions
I relaxed a little when the doctor prescribed me with free ā yes, free ā antibiotics. (This is an incentive on the part of the Publix grocery store chain to compete with other major pharmacies and get people into the store to shop).
So I figured even if I was in for a riotous bill, I was also saving a wad of cash on my prescription.
Reasonable Doctor’s Bill
My day was made (despite being sick) when I was presented with a mere $75 bill for this enlightening session. They reasoned it out by saying it was approximately the amount they’d receive from an insurance company if I had filed through one (they’d have charged more if I was covered under insurance, which begs a series of questions about the insurance industry in general, but is also a common practice worldwide). They even wrote out a receipt for me to submit to my insurance company to help satisfy my deductible if I should have further medical expenses later in the year.
Doctor’s Fee: $75
Antibiotics: free
This is probably the first time I’ve ever walked out of a doctor’s office in a great mood.
The Cost to See Doctors in Other Countries
I’ve luckily not had to see many doctors in other countries, but I’ve had a few stabs at it, and each time I āself-insuredā by paying with cash.
– worldwide costs have been converted to US dollars for ease of comparison –
Australia
37 spider bites sent me running for a doctor after a week of increasing discomfort. (At least I’d determined the offending spider wasn’t venomous since I’d have been dead by that stage).
Doctor’s Fee: $89
Antibiotics: $21
Being so impressed with the low prescription cost (in Canada ā despite also being a country with socialized health care ā prescriptions cost considerably more, as you’ll see below), I also got a few refills on my prescription for birth control.
The Pill (1 year): $31
New Zealand
I needed a refill of birth control, and in light of Australia’s inexpensive prescriptions, I figured New Zealand would be similar.
It’s not. The cost to see a doctor was lower, but prescriptions were higher.
Doctor’s Fee: $31
The Pill (6 months): $75
Canada
An episode of bronchitis took me down. Because of my long absence from Canada, I no longer qualified for any of the socialized health care benefits, so as with any other country in the world, I was relegated to paying cash. And as usual, it was time to stock up on the pill.
I was horrified at the cost of prescriptions in Canada (which was more than double the cost of anywhere else I’d been), and I’ll do my best to avoid a trip to the doctor’s office there again.
Doctor’s Fee: $65
Antibiotics: $55
Medicated Cough Syrup: $33
The Pill (6 months): $136
Travel Insurance
Some of the medical expenses above would not have been covered by travel insurance, even if I tried to make a claim. Generally speaking, travel insurance does not cover expenses like routine doctors’ visits and regular prescriptions. But you’ll be grateful you have travel insurance when something serious happens on the road – trust me, I speak from experience!
And from experience (including claims experience), I recommend World Nomads. They’re the most flexible for insurance, allowing you to apply for and renew it from abroad. Get a free quote here.
Note: If you end up purchasing an insurance policy through this widget or the link above, I will receive a small commission. This in no way affects your price, and helps me to keep The Professional Hobo going as a lifestyle travel resource. Thank you in advance for your support!
I would say your experience was not all that typical. As one who went without insurance for a few years…. Driving 25 miles, waiting hours to see a nurse practioner (no Doctor) and spending upwards of $150 per 15 minute visit is more likely.
In another instance I tore my thumbnail off and had to go to the emergency room because it would not stop bleeding. 5 minutes with the Doctor, 20 minutes with the Tech, 1 x-ray, cleaning and 3 stitches was $1100. He used the non-dissolving thread so that meant a return trip to a clinic and another $100 to have stitches removed. Antibiotics were an additional $45.
I guess it depends on where you are in the US at the time. Most rural areas have little (or no) access to health care.
That is definitely not a typical experience. I have good health insurance and rarely go to the doctor, but when I ended up with a puncture on my foot and needed a tetanus shot, every doctor within 30 miles REFUSED to see me. Apparently doctors won’t accept new patients when they just need shots, even when they are accepting new patients for other reasons. I had to go to a clinic that doesn’t let you use insurance (or give itemized receipts) and pay $95, even though my tetanus shot should have been fully covered as part of my insurance plan.
However I will say preventative/yearly exams are usually reasonable, if you can find a doctor that will accept you.
In 2009 I had an ear infection in Phuket, Thailand. Doctor’s fee was $27 and antibiotics cost $13.
When I was in NZ I was on student health insurance, so seeing the doctor was more or less free ($250 for the year?), and I think I got student rate on rx’s too. NZ$21 give or take for every allergy med known to man, $5 for Depo, or I think the pill was free to students through the health center. Physical therapy was $20 per session, give or take.
Here in Guatemala it’s about US$20 to see a doctor at the private hospital. Major hospital stuff is, I’m told, covered by the state–all except drugs–and meds are pretty cheap. I pay about $60 for a month of my medicine instead of $200.
In Wyoming I paid $85 to see the doctor for a regular visit, $4 generics at most stores, and insane prices for the real stuff. A badly sprained wrist cost me over $1100 for 15 minutes with the ortho, 3 xrays, and 6 or 8 weeks of physical therapy at $60 a pop, give or take. When it wasn’t getting better, they suggested an MRI. I like my wrist, and being able to use my hand, but not $2500 worth. It happened in January, actually, and covered my deductible for the entire year.
Also in Wyoming I paid about $1000 for one chest xray, radiologist, lab work, and general doctor time for a physical. $600 of that was the main doctor’s physical. Same thing would cost $200 in NZ.
@Diane & Rachel – I would imagine that the quality, accessibility (and consequently, price) of visiting doctors would vary throughout the US. I must have been in a well-outfitted area.
@Esa – I remember in Thailand it was possible to get numerous things over the counter (inexpensively too) which require prescriptions elsewhere. So it stands to reason that their prescriptions would be cheap too.
Thailand also seems to be a destination for people who need dental work done; with lots of cheap – and good – dentists.
@j. – So in Guatemala, without insurance, major hospital expenses are covered by the state? Even for tourists?
And those are quite some US expenses. How’s your wrist now?
We just had vaccinations in Bangkok. A family of 5 would have been $3000 in Australia ( we are Australian). It was $525 in Bangkok. Included rabies,JE,typhoid,hep A B and 2 months malaria tablets for 5 of us. BARGAIN!!
I had a motorcycle-related ear infection when I was traveling in Italy this summer. Stone deaf in one ear. I waited and waited and waited before going to the doctor because I was traveling w/o health insurance of any kind (smart! I know!). Long story short, I ended up going to the E-room in Siena 4 times over the course of two weeks for drugs, inspection, and hearing tests. I had to *beg* them to let me pay anything. In the end, it cost 15 Euros.
And they put up with my crappy Italian. š
Nora– I didn’t think they would be, but have now heard of several tourists having major accidents (falling out windows and breaking bones, falling off cliffs, running motor bikes into boulders, etc) and only having a bill for pills and stuff when they checked out. Public hospitals only, though. I suspect it’s just easier to not bill.
The wrist is… a wrist. I can type and hold things, and when it hurts I have a brace. Doc thought there might be some damage to a tendon or ligament, but even if there were, surgery would have been obscenely expensive, and I’d have been paying for the rehab out of pocket. So not 100%, but not worth 6 months’ wages.
re: dentists, I keep hearing from people down here traveling (Guate) that dentists are really affordable. Someone got a filling replaced with the white filling stuff for $20, give or take, and a cleaning and exam was less.
Nora, a good article….Medical insurance is always a sore subject in any country…When, for example, we say….Clinics or dental work is cheap in Thailand…I think this is a relative term…it is cheap for expats and tourists…but have you thought about how many local Thais could not and probably will never be able to afford these “Cheap” medical services…?
So in the end it’s all relative…and I don’t mean incest…loll..
I’m glad you had a positive medical experience in FL and I do hope you are feeling better now…Cheers, keep safe and well.
@Tracey – The best advice I ever received was to get vaccinated on an as-needed basis, and preferably abroad (as you’ve done). Way to save a ton of cash!
@Nathan – Impressive! I wondered if the European medical system was free (or inexpensive) for tourists. I wonder what they’d charge just to see a doctor for a consultation…
(PS – At least you attempted the Italian. I’m sure they found it endearing!)
@j. – Tourists falling out of windows? Oh my! That doesn’t sound good! LOL
@Baron’s – Good point. Economically things are relative. And in fact, it might be that the boon of medical tourism has raised the costs (supply and demand), and further out-priced it for locals.
Or maybe, medical tourism profits are being used to subsidize locals’ costs. In some ways, that’s what happens in general when you travel: locals get one price, and tourists get another. Maybe the same applies to medicine.
Nora, you are right and point well taken…You are right about the distinction 100%…
Berge
I got an ingrown toenail while I was living in NZ (and paying for health insurance back in the US) and just charged everything to my credit card (so they could see the exchange rate and when I got home to claim) and I got the entire thing refunded (minus exchange rate fees).
The worst was when it wasn’t healing fast enough and the ped’s in NZ couldn’t scribe antibiotics, so I had to go to a proper dr ($$$) for them to essentially look at it and write me a script (more $$$). The funniest part was, since I had been wrapping my toe up for months at this point, the dr tried to wrap my toe up after taking a look, but she did an awful job and I just said I would do it. I was faster and less messy then the dr! She commented on my great technique.
At the good Lutheran-run hospital in Arusha, Tanzania, I paid $3.50 for a doctor visit, for which I waited about 3 hours. Then I found out you could make same-day appointments and see the doctor for $5.00 and not wait at all. ManyTanzanians find the cost difference prohibitive and do not make appointments. Antibiotics cost about $3.00 to $5.00. X-rays were less than $10.00. You pay as you go, at the cashier window inside the hospital, before you receive each service. When I went in for pneumonia, the treatment was much the same as I received in the U.S.–but relied on questions and answers from the doctor, and one chest x-ray rather than the hundreds of dollars of tests and appointments I had gone through in the U.S.
@Rebecca – At least I found the cost of seeing a doctor in NZ wasn’t totally prohibitive. (And Maybe you could get a job wrapping toes!! ha ha)
Good point about charging any out-of-pocket expenses to a credit card, where you have a written record of paying. Keeping all original receipts are also very important, as they need to be submitted for most claims.
@Barbara – Do you suppose the Tanzanian way of diagnosing and prescribing (ie: your pneumonia) is a function of lesser resources for doing tests, or is the US system mired in protocol and income-generating (and not always necessary) tests?
I am in Paris and just went to the doctor without using insurance. I just needed some prescriptions, but I delayed going because I didn’t know how the system worked. Actually, I still don’t. I went in to a large medical building (no appointment), took a number, paid 23 euros, waited around 30 minutes, then got to see the doctor. As far as meds, they all appear to be very cheap here. My most unpleasant medical experience was in a New Orleans urgent care. I had a sliver removed from my foot and got a bill for $500 (this involved 10 minutes with the doctor and no special equipment aside from some magnifying goggles). And I have insurance. I never paid this bill, because to me it was just too insane. For instance, one part of the bill was a “new patient fee” of $180–my insurance agreed to pay $50. And who the hell isn’t a “new patient” at an urgent care? My one other trip to a doc in New Orleans was unpleasant in other ways. Conclusion: it is best to be in good health if you go to Nola, and if you get a sliver deeply embedded in the bottom of your foot, have a friend get it out with a kitchen knife.
Here are a few more examples from Europe. Last year in France, in Normandy to be specific, I awakened in the night feeling like someone was knifing me in the side. My husband called the ambulance but they didn’t understand our English so didn’t understand where we were telling them to come. We ended up driving 20-plus minutes to Vire with me in total agony and throwing up from pain.
Over the next 2 days, I was cared for lovingly, given everything from MRI scans to xrays to ultrasounds and what I had was kidney stones. They kept me on enough pain medicine to keep me loopy until the stones passed and then sent me home with quite a lot of antibiotics and pain meds.
The cost? ZERO! We actually do have travel insurance since we’ve been on the road for over 15 months now working our way around Europe. But they looked at my husband’s British passport, my Australian one, glanced at the travel insurance, made a photocopy of my British and Australian health insurance cards, and decided that reciprocal coverage was appropriate.
This is the wonderful thing about travelling. You frequently discover that the costs in supposedly oh-so-expensive Europe are covered by reciprocal agreements between countries where they cover one another’s citizens in an emergency for no cost.
We have friends who were travelling in Italy a year ago and she shattered the bones in one leg when a train lurched forward as she was getting off at the station. Every single cost including her physical therapy was covered since Italy and Australia are reciprocal medical providers.
The same thing applies to me when we are in England visiting my husband’s family. As an Australian, I pay nothing for doctor visits OR prescriptions since I am a citizen of another Commonwealth country.
One last item, my husband cracked a took 2 days ago here in France. He went to the dentist, got drilled and filled (a rather large filling, actually), and he has a follow-up appointment for them to polish his teeth on Wednesday. The total cost for ALL of that? 45 euros!
That same dental visit back home in Australia would have cost hundreds of dollars since even something as simple as a routine cleaning cost over $150. I had my teeth cleaned in London in October and the total cost was Ā£40 or about $60AU with the conversion rate. We’ve truly understood since we started travelling just how much cheaper it is for some things since we left Australia.
It really does pay to investigate prior to departure what countries have reciprocal agreements with your own home country. It has saved us an amazing amount over the last few years since we left Australia fully covered by insurance (mainly to protect all of the cameras and computers since I am a freelance writer and photographer) — but we also felt quite safe knowing that most European countries do not have the same attitude about billing sick or damaged people. There is a compassion and gentleness here that is quite refreshing.
Hope all of that additional information helps someone!
Deborah
Oh my — my fingers were flying and I typed “cracked a took” instead of what I MEANT to say which was cracked a TOOTH. I’m sure the readers will be able to translate though when they read the rest of the post!
Nora, I am glad you had such a good experience in the US. It is not typical, sadly–but there are some wonderful doctors in this country who take the Hippocratic Oath seriously and do their best to help people. A more typical experience–insurance less me almost accidentally steps on cat. Cat retaliates by biting big toe and refusing to let go. Several hours later, reluctantly drag myself into Urgent Care (that’s the E-room for suburban folks) FOUR HOURS LATER, doctor walks in, glances at football sized, red, pus oozing foot, says “yep that’s infected” (^&*&^*^%*%!) and charges me $400. PLus $180 for antibiotics and six doses of Vicadin. I only used one half of one dose of the Vicadin, because it made me hallucinate fire breathing dragons (not joking). That was one and a half weeks salary down the drain.
But there are PAs, nurse practitioner’s and MDs who understand that the option is die slowly of infection or get evicted for non payment of rent–and they really do try. Sounds like you ran across one of those. FYI –BC pills are hugely expensive here. If you are stuck, go to a women’s clinic. Because its expensive, often not covered by insurance and really necessary, DRs at these clinics will often reach into their desk drawers, haul out a few samples from the drug companies and stuff em in your purse. This has happened to me twice.
@Erica & @Elena – I’ve heard that at all costs, staying away from Urgent Care is imperative in the States. If at all manageable, it’s more cost-effective to visit a doctor.
I also found this to be the case in Australia (as @Deborah might attest to); when I had the spider bites, the Emergency Room of the local hospital said I’d pay $400 just to see a doctor, and more money yet for their consultation and prescriptions. The walk-in clinic down the street charged me less than $100.
@Deborah – I also had a very expensive trip to the dentist in Australia. Then again, really and truly – the cost of living in general in Oz is among the highest I’ve experienced…including many places in Europe which are cheaper.
@Elena – You make a good point about visiting a women’s centre/family planning centre for BC pills etc. They’re usually quite cost-effective to visit, and they look out for your wallet in prescribing as well.
Yes planned parenthood is good for birth control and a annual visit. I go there sometimes because it takes FOREVER to get into my doctor for those.
However, I have not had a single problems with medical issues in the US being ridiculous. I have insurance but since at one point it was a high deductible plan, I would also ask what the cost was without insurance. Most of the time you get a lower price and you can still apply it to your deductible. Also sometimes if I go out of network I file the claim myself and ask for the uninsured price (my psychotherapist was giving me a price half of his normal price).
One good thing to know is where the cheapest places are with best care around you so if you get into an emergency you are not charged an arm and a leg. And I ALWAYS say no to pain pills and extra drugs that I do not want, why pay for them? Always ask for generics and I think WalMart and Publix have low cost or free prescription, find out what those are and ask for those. Always ask about new patient procedures and costs before you go. Many pharmacies in US now have a nurse practitioner for small things and are less than $100 for just the visit I think.
However, i have never not waited hours to see a doctor.
@Laura – Thanks for the feedback, and those are great tips! Cheers.
How about Thailand? I busted my chin up and gashed my leg a bit on a motorbike accident. walked out for 600 baht, which is less than $25.
@Lana – I too, found Thailand to be quite good on getting cheap (good) medical assistance. A friend of mine had a few dozen infected ant bites on his feet, walked into a pharmacy, and received medication that would have required a prescription in North America….all for a few dollars out of pocket.
The Red Cross is amazing if you ever need medical help in an area abroad where they serve! I got my finger set and splinted (and pain medication) for just $5 in Guatemala. When I developed a strange, quickly spreading rash on my feet and legs, they diagnosed it and gave me medicine for free in Tikal, Guatemala.
I broke my toe and needed to see a doctor in Nicaragua. I couldn’t find a branch of the Red Cross, and ended up going to a small, privately run doctor’s office in Granada. That was definitely not a fun experience! He pulled my toe backwards and forwards, to the side, and then pushed in straight in. Since I wasn’t screaming in pain, he diagnosed it as not being broken. Apparently heavy bruising and the fact that my toe was sticking out at a strange angle was not enough evidence for him. On top of it all, he charged me $15! Clearly, some doctors are better than others….
One plus side of doctors visits in Central America is that you can often bargain with them if you patronize independently run doctors’ offices. My friend has asthma, and she had a bad asthma attack in Mexico. A doctor had to make a house call to our hotel, and we were able to talk him into charging half price.
@Alex – Gee…I guess in Central America you can bargain for just about anything! Can you do the same with doctors in Asia, I wonder?
Hi Nora, I am looking for a doctor with the characteristics that you described: caring!!! Would you happen to have the name of the Dr. that you saw in Florida? Thank you! Paula
Hi Paula,
Unfortunately this doctor (or rather, PA) is no longer in practice. Sorry!