Where Do I Find Medical Tourism Assistance?
July 6, 2023 6:30 AM Subscribe
I am living abroad and have travel/ medical insurance. I have a hospital appointment in 2 months for a CT scan to find out if I need surgery, but I might have to leave before then if my current visa renewal application is denied. So for the worst case scenario - have to leave before appointment, still need CT scan/ possibly surgery - I need to determine the best countries to move to, and this seems a complex question - surgeons/ healthcare quality/ costs/ waiting times/ language barriers - and I'm wondering if there are services which will help me navigate this?
I have US and UK citizenship - the US is my home country/ I haven't been to the UK in 20 years.
My travel insurance won't cover my home country, and I'm working as a contractor so I don't have US health insurance.
If I returned to the US and got my own insurance, I don't know if a condition I developed while abroad would be covered.
I think I need to show proof of residence to use the NHS, and I'm not sure I'd get appointments in a reasonable time frame either.
I have US and UK citizenship - the US is my home country/ I haven't been to the UK in 20 years.
My travel insurance won't cover my home country, and I'm working as a contractor so I don't have US health insurance.
If I returned to the US and got my own insurance, I don't know if a condition I developed while abroad would be covered.
I think I need to show proof of residence to use the NHS, and I'm not sure I'd get appointments in a reasonable time frame either.
Where is your residency, currently - like, your legal residency not your physical place of residence? Where do you pay taxes, e.g.?
In addition to what okayokayigive says about pre-existing conditions, you should be able to get US health insurance as soon as you establish residency in a US state. So if you currently are an official resident of, like, South Dakota you might not be able to get insurance in South Dakota, but if you moved to Massachusetts you would be able to get insurance in Massachusetts. Moving is generally a qualifying event that lets you sign up for health insurance outside of the annual ACA signup period.
posted by mskyle at 7:05 AM on July 6, 2023
In addition to what okayokayigive says about pre-existing conditions, you should be able to get US health insurance as soon as you establish residency in a US state. So if you currently are an official resident of, like, South Dakota you might not be able to get insurance in South Dakota, but if you moved to Massachusetts you would be able to get insurance in Massachusetts. Moving is generally a qualifying event that lets you sign up for health insurance outside of the annual ACA signup period.
posted by mskyle at 7:05 AM on July 6, 2023
Visiting Australia? What right do you have to Medicare?
posted by flabdablet at 7:48 AM on July 6, 2023
posted by flabdablet at 7:48 AM on July 6, 2023
It’s not clear why you wouldn’t fly to the UK and get seen by the NHS and get put on a waiting list for treatment at least. If other options pan out you can always stop that process, if not you’ll get treated there.
posted by koahiatamadl at 9:45 AM on July 6, 2023 [1 favorite]
posted by koahiatamadl at 9:45 AM on July 6, 2023 [1 favorite]
It’s not clear why you wouldn’t fly to the UK and get seen by the NHS and get put on a waiting list for treatment at least. If other options pan out you can always stop that process, if not you’ll get treated there.
OP a will need to show proof of residence in the UK to be eligible regular NHS care. In addition (my experience anyway) the NHS communicates by snail-mail letters so you will need to have a reliable postal address. It is also my experience that standards of care and waiting times have tanked since the pandemic and I would not recommend the NHS. You can’t beat the cost though.
This of course may not be the case everywhere in the UK, but therein lies another issue: UK healthcare wait times are highly variable on where you live.
posted by sizeable beetle at 9:59 AM on July 6, 2023 [2 favorites]
OP a will need to show proof of residence in the UK to be eligible regular NHS care. In addition (my experience anyway) the NHS communicates by snail-mail letters so you will need to have a reliable postal address. It is also my experience that standards of care and waiting times have tanked since the pandemic and I would not recommend the NHS. You can’t beat the cost though.
This of course may not be the case everywhere in the UK, but therein lies another issue: UK healthcare wait times are highly variable on where you live.
posted by sizeable beetle at 9:59 AM on July 6, 2023 [2 favorites]
I would do anything possible to stay out of the US in this situation. Buying insurance is going to be extremely expensive and then there’s a very good chance that it won’t cover the full cost of the scan or surgery - in fact, it’s entirely possible it will not cover either one at all. With most insurance, you will also then need to find a primary care doctor to refer you for the scan and surgery- mine is currently booking new patient appointments at the end of November and she’s not unusual. Unless you are very wealthy indeed, I’d go almost anywhere else.
posted by mygothlaundry at 4:03 PM on July 6, 2023
posted by mygothlaundry at 4:03 PM on July 6, 2023
About 2016, it took me just over a month to get registered with NHS & local GP as a New Zealander (so not even a citizen).
We needed proof of address, so took official government letters we'd received (first thing was applying for NI number - https://www.gov.uk/apply-national-insurance-number), bank statements and as we were staying in a room at someone else's house, had a letter from them saying we lived there and *their* proof of ownership.
https://www.gov.uk/guidance/using-the-nhs-when-you-return-to-live-in-the-uk
***
If you have travel insurance and your current condition is covered/eligible, I would go to a country with cheap, accessible, high quality medical care, I don't know if Thailand would work?
Until/unless your travel insurance is unavailable, I would stay in whichever country works best for that. Seriously, country shop for where will treat you most easily, you may as well.
If it is no longer an option, I would go to the UK.
***
I honestly don't know why you'd go to the USA?? last time I had a convo about this, travel insurance anywhere else in the world generally covers more and costs less than getting standard health insurance in the US.
Travel insurance that *covers* the US is ridiculous in comparison to anywhere else.
If you know what state you'll be going back to, what insurance you'll be eligible for, that you'll definitely be covered, and how soon you can be seen by a particular specialist, then maybe the US, but obviously that's not something I can answer for you. My generic answer would have going to the US very far down available options, but if you know you will be fine for that, cool.
posted by Elysum at 11:33 PM on July 6, 2023
We needed proof of address, so took official government letters we'd received (first thing was applying for NI number - https://www.gov.uk/apply-national-insurance-number), bank statements and as we were staying in a room at someone else's house, had a letter from them saying we lived there and *their* proof of ownership.
https://www.gov.uk/guidance/using-the-nhs-when-you-return-to-live-in-the-uk
***
If you have travel insurance and your current condition is covered/eligible, I would go to a country with cheap, accessible, high quality medical care, I don't know if Thailand would work?
Until/unless your travel insurance is unavailable, I would stay in whichever country works best for that. Seriously, country shop for where will treat you most easily, you may as well.
If it is no longer an option, I would go to the UK.
***
I honestly don't know why you'd go to the USA?? last time I had a convo about this, travel insurance anywhere else in the world generally covers more and costs less than getting standard health insurance in the US.
Travel insurance that *covers* the US is ridiculous in comparison to anywhere else.
If you know what state you'll be going back to, what insurance you'll be eligible for, that you'll definitely be covered, and how soon you can be seen by a particular specialist, then maybe the US, but obviously that's not something I can answer for you. My generic answer would have going to the US very far down available options, but if you know you will be fine for that, cool.
posted by Elysum at 11:33 PM on July 6, 2023
Getting treated in the UK is not an option for a non-resident who is not planning to relocate to the UK https://www.gov.uk/guidance/using-the-nhs-when-you-return-to-live-in-the-uk
Not to mention that waiting times can be in years, not months.
posted by coffee_monster at 5:51 AM on July 7, 2023 [1 favorite]
Not to mention that waiting times can be in years, not months.
posted by coffee_monster at 5:51 AM on July 7, 2023 [1 favorite]
Following earlier comment to fly to UK, it won't be enough to just fly there temporarily.
To add to the previous comment, I provided the same NHS link above, as that was the rules we came under. A flying visit isn't enough, but landing, finding accommodation and saying you plan to live there now pretty much is what you need.
Registering with the NHS at a small village GP was also prooobably quicker and less hassle than if we'd tried that first at a practice in London with wait lists.
I lived in the UK for just over 6 months in the above stint, we had intended longer but it didn't work out that way.
Showing you are resident was more like showing that you aren't just on holiday, so having accommodation and a bank account and an NI number worked - we had clearly *just* arrived in the UK but *intended* to live there etc. And once you're registered with GP etc, you're sorted. When I came back later I just changed to a new GP.
If the OP knows what kind of surgery they need, they can see what the NHS waiting lists are like (it may even determine what area they move to).
If OP can't get a CT scan in 2 months before they leave their current country, and doesn't end up getting their travel insurance to cover Thailand etc, it still might be worth paying out of pocket to get the CT scan in Thailand - https://www.health-tourism.com/ct-scan/thailand/
I think best approach is to use current medical travel insurance, which as stated, will not cover the US, so anywhere else is better, pick a well known medical tourism country.
The second option:
If you know there's some point at which your medical travel insurance wouldn't cover the full treatment depending on diagnostic results, that's where I would head to the UK.
It sounds like your travel insurance *does* currently cover the UK, as it is currently not your home country, so that would be my option if you can go there, get private care using your travel insurance, *while you are sorting out your residency*, at which point if the travel insurance isn't going to cover everything, you transition to NHS.
Going back to the US and getting insurance and then getting treatment is something you'd have to look up yourself to compare.
posted by Elysum at 12:49 AM on July 8, 2023 [1 favorite]
To add to the previous comment, I provided the same NHS link above, as that was the rules we came under. A flying visit isn't enough, but landing, finding accommodation and saying you plan to live there now pretty much is what you need.
Registering with the NHS at a small village GP was also prooobably quicker and less hassle than if we'd tried that first at a practice in London with wait lists.
I lived in the UK for just over 6 months in the above stint, we had intended longer but it didn't work out that way.
Showing you are resident was more like showing that you aren't just on holiday, so having accommodation and a bank account and an NI number worked - we had clearly *just* arrived in the UK but *intended* to live there etc. And once you're registered with GP etc, you're sorted. When I came back later I just changed to a new GP.
If the OP knows what kind of surgery they need, they can see what the NHS waiting lists are like (it may even determine what area they move to).
If OP can't get a CT scan in 2 months before they leave their current country, and doesn't end up getting their travel insurance to cover Thailand etc, it still might be worth paying out of pocket to get the CT scan in Thailand - https://www.health-tourism.com/ct-scan/thailand/
I think best approach is to use current medical travel insurance, which as stated, will not cover the US, so anywhere else is better, pick a well known medical tourism country.
The second option:
If you know there's some point at which your medical travel insurance wouldn't cover the full treatment depending on diagnostic results, that's where I would head to the UK.
It sounds like your travel insurance *does* currently cover the UK, as it is currently not your home country, so that would be my option if you can go there, get private care using your travel insurance, *while you are sorting out your residency*, at which point if the travel insurance isn't going to cover everything, you transition to NHS.
Going back to the US and getting insurance and then getting treatment is something you'd have to look up yourself to compare.
posted by Elysum at 12:49 AM on July 8, 2023 [1 favorite]
Response by poster: Just a quick follow-up in case someone finds this later: I couldn't find a service which would do this for me, so I just created a list of major/ international hospitals in neighboring countries and emailed them all directly. What I found was that the word "international" can mean different things: that is, there's a difference between "we treat local ex-pats" vs "we are familiar with the requirements of medical tourism" - i.e. the patient needs to get consultations and potentially surgery done within a specific fly-in/ fly-out time-frame.
Anyway, long-story short, by far and away the best option was Malaysia - in terms of scheduling, cost, quality of service, cost of living during the trip, and everyone I worked with spoke fluent English. I will also add that my travel insurers - WorldTrips - covered all medical expenses at 100%.
posted by my log does not judge at 9:30 PM on February 2 [1 favorite]
Anyway, long-story short, by far and away the best option was Malaysia - in terms of scheduling, cost, quality of service, cost of living during the trip, and everyone I worked with spoke fluent English. I will also add that my travel insurers - WorldTrips - covered all medical expenses at 100%.
posted by my log does not judge at 9:30 PM on February 2 [1 favorite]
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If I returned to the US and got my own insurance, I don't know if a condition I developed while abroad would be covered.
In the US, you can't be denied coverage based on a pre-existing condition anymore. This definitely used to be a thing, but I believe it went away with the ACA ("Obamacare"). Per the HHS:
Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition.
posted by okayokayigive at 6:55 AM on July 6, 2023 [1 favorite]