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Medical care around the world: key considerations

Whether you have a pre-existing medical condition or not, it is important to know what to do should you need medical attention abroad. Getting the right treatment or prescription that you need can be tricky when you’re in an unfamiliar country or aren’t near local amenities. This article will give you all the advice and information that you need should you require medical help abroad.

Medical care in the UK

In the UK we are served by the NHS when it comes to medical emergencies. Starting up in 1948, the NHS serves over 1 million people every 36 hours! If you are between the ages of 18 and 60, you will have to pay for prescriptions from the NHS (exceptions are available here) so make sure you know what it is you need during your time away.
We recommend travelling with one or two copies of your prescription in case you need medication while you’re travelling. Carrying these will enable any local doctors to help treat you should you require more of your medication or need emergency help. We also recommend asking your doctor to write a letter which outlines your prescribed medication including any general names that there might be for them (they may be called something different in other countries).

Before you travel

Before you set off on your travels, you will need to check with your GP to find out if they will prescribe enough medication for your trip. Usually they will only do this if they feel that you will need the medication while you’re away. In some cases, if your GP agrees that you may need your medication while you’re away, they may give you a private prescription which means you will need to pay for it.
When packing your medication, ensure you have enough to last the full length of your trip including several extras in case your flight gets delayed, some get lost, or there are any other hiccups in your journey. Make sure that you pack your medication in your hand luggage in case your suitcase gets lost, you don’t want to be without it!

Specialist and prescription medication

You will need to check before you go that you can take your special medication into the country you’re travelling to. Some countries have bans on certain drugs, and the last thing you want is to have your medication confiscated! This also goes for checking the maximum quantity of your medication you’re allowed to take as some countries have a controlled limit that you can bring with you.
If you need to take any medical equipment with you, for example needles or syringes, keep them in their original correctly labelled packages with your medicine, as well as a copy of your prescription. You should also ensure that your medicines will stay in date during your trip. If your medicine has special requirements, such as having to be kept at room temperature or in a fridge, you should ask your pharmacist for advice. Travelling to hot countries with medicine with these requirements can require special attention so it is always wise to take precautions such as storing in an ice pack or cool bag for hot countries.

In case of emergencies

If you find yourself in a medical emergency, the best thing to do is not to panic as you could end up causing yourself more harm. In the UK, ambulances and treatment are free on the NHS; however this is not the case in other countries. Countries such as the USA charge for ambulance callouts and you could find yourself with a large bill should you not know about this.
If you are a UK citizen, ensure you have your EHIC card with you while travelling as this entitles you to discounted or sometimes free treatment in the European Economic Area (EEA). This includes countries in Europe, including Switzerland and will cover you until you return to the UK. However, it is important to remember that this isn’t an alternative to travel insurance. It won’t cover you if you need to fly back to the UK or need rescuing from mountain ranges, nor will it cover lost and stolen property.
It is also a good idea to keep some money in a bank account or on a credit card, in case you incur any charges should you get into medical trouble. This way you can pay off any hospital or transport bills that you may need once you’re out there.

Language Barriers

When travelling to a foreign country, it is always a good idea to learn a few phrases to help you when you’re there. This can be very beneficial if you get into a medical emergency or require assistance as a small amount of the local language can go a long way.
Learning to ask individuals if they speak English or if there is someone you can speak to who knows the language will help you greatly. In more tourist heavy areas you will be able to find someone that you can speak to, as a lot of places will use the English language. Ask your doctor to write down your medication and any allergies that you might have so that you can show these to a medical profession whilst abroad. You can also research before you go to see if these have other names in other countries.

Key considerations by continent

When you are travelling to another country, you should always check the countries’ healthcare costs and services. Checking for any recent outbreaks or epidemics will also prove useful as there may be some extra precautions that you need to take.

Europe

Healthcare in Europe is provided via a different range of systems, all of which are funded primarily through public taxation. As previously mentioned, often European countries offer their citizens EHIC cards which allows them to obtain free or subsidised medical assistance in other European countries.
It is important to note that possession of an EHIC card will not always cover you for medical costs incurred whilst abroad. Having a travel insurance policy can also protect you from the expensive costs of ambulances, the costs if you have to stay overnight in hospital and some tests which would otherwise contribute towards a hefty medical bill, even though your EHIC card could ‘pay’ for the emergency treatment.

Asia

When visiting Asia, mosquito-borne diseases are the most common ailment that travellers pick up. Diseases such as malaria, dengue fever and Japanese encephalitis are among the illnesses that you won’t find at home but can pick up in Asian countries. We recommend that you take out travel insurance for when you travel to any Asian country as you will be required to pay for treatment if you require it. You will also need vaccinations before travelling to Asia. It is best to consult your doctor at least two months before travelling to ensure you receive all jabs you need.
To avoid being bitten by insects, it is best to ensure you’re covered with light clothing around dusk and dawn as this is when mosquitos are most prevalent. You should also wear a mosquito repellent and keep it with you in order to reapply on a regular basis. In your accommodation, make sure that you have mosquito nets around your bed for when you sleep or ensure that there are mosquito screens on your windows. You should also only drink bottled water as most of the local water in Asia is unsafe to drink.

Australasia

The Australian Government has signed Reciprocal Healthcare Agreements with the UK which means if you are a UK citizen and have applied for a Subclass Visa 410 before 1 December 1998, you are covered for the duration of your stay in Australia.
This healthcare will cover you for any necessary medical attention – for example if you fall ill or injure yourself when in the country. You will also have access to subsidised medicine (under the Pharmaceutical Benefits Scheme (PBS)) as well as Medicare benefits for out-of-hospital treatment, such as the doctors.
If you did not apply for a Subclass Visa 410 before 1 December 1998 then you will need to take out travel insurance for your trip in order to cover yourself in case of accidental injury or illness.

Africa

You will need to pay for any medical treatment while in Africa, so it is important that you have travel insurance which will cover your health, as well as any emergency funds in case you are required to pay any bills. You should also contact your GP two months before travelling in order to obtain the right vaccinations for the area of Africa you are visiting.
Water in Africa (depending on which area you are visiting) is sometimes not safe to drink. If you’re unsure then you should stick to bottled water that you are familiar with. You should also carry mosquito repellent with you in order to avoid malaria. You should also familiarise yourself with the most recent epidemics in the area you’re visiting. For example, Ebola and HIV are very common in parts of Africa so it is important that you know what signs to look for should you feel unwell.

USA and Caribbean

In the USA and the Caribbean you will be required to pay for any medical assistance that you may need. This includes medication, ambulances and hospital treatment. It is highly recommended that you take out travel insurance when you travel to these destinations as healthcare costs can be very pricy. For example, in the USA, ambulance call out costs can range anywhere from hundreds to sometimes thousands of dollars. You should also be sure to check when your travel insurance covers you. Sometimes you won’t be covered if you are under the influence of drugs or alcohol.
There are occasional breakouts in some places in America – for example mosquito-borne diseases such as West Nile Virus (WNV). These can also spread to the Caribbean, where viruses such as Chikungunya are a common problem.

North America

You will need to pay for any medical attention in North America, the same as you would with mainland America. Malaria is not a threat in North America unless you have contracted it elsewhere. We advise that you consult your GP 8 weeks before travelling in case there are any vaccinations that you may require, such as tetanus.

Cruise ships

If you become ill on a cruise ship you may feel like you’re helpless, but this isn’t the case. When boarding your ship, make it known to the medical team if you have any medication that you need to take or have any special health requirements. If you have an accident or suddenly feel unwell, you should consult a member of staff immediately and they will be able to help you.
Most cruise ships have a fully equipped team of medical professionals who can help you in an emergency. Cruise ships have equipment such as x-ray machines, ventilators and will also be able to do blood tests. However, more advanced technology such as MRI and CT scans are not readily available. If you need these you may be air-lifted to the nearest hospital. For more information on cruise ship health emergencies, consult our page here.

In summary

In summary, we recommend consulting your local GP before travelling to another country, to ensure that there are no vaccinations that you require. You should also take copies of your prescriptions to prove they are yours and to help any pharmacies or doctors whilst you are on your trip. You should also check where your EHIC card is valid and take out a good level of travel insurance that will cover you and your pre-existing medical conditions.

Travel Packing Tips

1. Know the rules

  • Take a note of the number of bags you can check-in at the airport. In most cases it’s one piece per passenger, but make sure you’re not over the weight allowance – on EasyJet you can check in up to eight pieces of luggage but their combined weight isn’t allowed to exceed 20kg (44lb) and if it does you’ll be asked to pay a hefty fine for the extra weight. Weigh your luggage on a scale before you leave home so you aren’t greeted by any unexpected costs.
  • You’re allowed to take more than one piece of hand luggage with you on a plane, but size restrictions still apply. For British passengers, bags larger than 56cmx45cmx25cm are forbidden. For further information, please visit www.dft.gov.uk
  • If placed in your hand luggage, any gels, liquids, creams and pastes have to be in containers of no more than 100ml and placed in a transparent resealable plastic bag no larger than 20x20cm.

2. Buy the right suitcase

  • Size is crucial. If the bag is too big, your case might not fit into the boot of the hire car or taxi; too small and you’ll have to sit on the lid to close it, which makes it more susceptible to breaks. An expandable case can help solve most space issues.
  • A hard shell on a case can add up to 10lb of dead weight, but it does offer the contents of your luggage more protection from damage, thieves and sudden downpours. A soft-shelled case will look smarter for longer and is easier to manipulate in terms of storage space.
  • 70% of suitcases on any given luggage carousel are black. Make yours stand out – but just to you. Don’t advertise your bags to thieves, but make your case easy to identify.

3. How to pack and unpack

  • Whether you fold, roll or bundle or wrap in tissue or plastic, the key is not to over-pack. Squashed clothes are creased clothes and the same is true of clothes that are too loosely packed, as they crease from rolling around inside the case against one another.
  • Don’t put wrapped gifts inside checked luggage. If your case is opened for inspection, wrapping will have to be removed.

4. Keep it safe

  • A suitcase is easily parted from its luggage label. Always put on more than one with details of your flight and destination inside.
  • If two or more people are travelling, split belonging between checked luggage so if one case goes missing, each of you will still have a change of clothes.
  • If you’re late to check in, the chances are your luggage won’t make it onto the flight, even if you do.
  • Always lock your checked bags – an unlocked suitcase could invalidate your insurance.
  • If you are travelling to America, you must use cases fitted with Transport Security Administration-approved locks, or a TSA-approved padlock or strap. For further details, please visit www.tsa.gov
  • There are loads of tracking services for luggage available, research some and see if they would suit you.

Remember, should the worst happen and you lose your luggage:

  • 85% of all lost luggage is found within 48 hours
  • If your case has not appeared by the time the carousel stops, check the tag of any unclaimed case similar to yours, someone may have mistaken your case for theirs.
  • If your luggage is missing, even if you’ve been told it’s on the next flight, you have to fill out a Property Irregularity Report before you even leave the airport.
  • Check your travel insurance to see if lost or delayed luggage is covered.

Travellers Checklist

With so many things to remember before you travel, it can be hard to think of everything. insurancewith have created this travel checklist to give you a helping hand:

  • Check the travel alerts from the FCO of the country you intend on visiting. Follow @FCOtravel on Twitter to get the latest travel updates and advice
  • Find out where the nearest embassy will be
  • Sort out travel insurance – insurancewith provide cover for customers with pre-existing medical conditions, allowing you to go on holiday without having to pay excessive premiums.
  • If you’re travelling within the European Economic Area, get a free EHIC (European Health Insurance card) for free or subsidised emergency medical attention. However, you still need full travel insurance, as the EHIC won’t cover costs such as delayed departure, cancellation or repatriation costs.
  • Check with your doctor whether you’ll need any vaccinations before you travel
  • Make sure you’ve got the correct visas for the country you intend to visit
  • Most importantly, check your passport is valid at the time you intend to travel – it takes up to six weeks to apply for or renew a passport, so checking well in advance might save time later on.
  • Tell friends and family where you’re travelling to and leave them your contact details, travel insurance policy details and your itinerary as this will make it easy for them incase of an emergency
  • Make sure you have enough money to cover emergencies
  • If you intend on driving abroad, make sure your licence is current and valid. Make sure you’re aware of the driving laws in the country you intend on visiting.
  • Sort out your hand luggage
  • Check with your airline for flight delays
  • Keep all tickets, visas, foreign exchange and passports safely in a travel belt or bag and keep these with you at all times.
  • Check your house is safe before you leave – check all switches are off, water is turned off to prevent pipes from freezing, and securely lock all windows and doors.

Travel Money Tips

When it comes to your holiday money, there are plenty of options. For added security and flexibility take a mix of currency, cards and cheques – that way if you lose one, you have other options.

Credit and debit cards

  • Only take the cards you intend to use with you; leave others at home.
  • Check that your type of credit card is valid in your destination.
  • Tell your card provider that you’re going away so they don’t block your card. If they notice foreign activity, they’ll normally assume it’s fraudulent and block your card.
  • Before you go, make a note of your credit card numbers and expiry dates. Leave this at home or with someone you trust.
  • Take 24-hour emergency card cancellation phone numbers with you.
  • Remember that using your credit card for big purchases – for instance booking flights, hotel or car hire – gives you extra financial protection if goods are faulty or not delivered.

Fees

  • Check your card provider’s fees. Some charge a loading fee of around 3% foreign exchange commission (giving you a low rate) besides a 3% fee on ATM withdrawals, and immediate interest on cash withdrawals, whereas some cards charge spending fees for every purchase.
  • If you travel frequently, consider choosing a card with no charges or a very competitive rate.
  • Remember it’s often cheaper to withdraw a chunk of cash at the beginning of your holiday rather than small amounts as you go. This way you avoid paying withdrawal fees each time you draw out cash or make a purchase. Any money you withdraw in the local currency can always exchange back when you return home.

Currency

  • Exchange rates and commission vary on the high street and online, so shop around to find the best deals.
  • Exchange some cash at least a week before you go – this can be cheaper than drawing out money once you’ve arrived and it means you’re prepared for taxi or bus fares on arrival. Once in your destination, if you’re given the option to be charged in pounds or the local currency, choose the local currency – you will get a better exchange rate.

Money safety

  • Don’t carry more money that you need when you’re out and about.
  • If you need to carry a big amount of cash, split it with a family member or travelling companion.
  • It’s also a good idea to divide your cash; keep some in your wallet, some in a money belt and some in an inside pocket. If you’re leaving cash in a hotel room, lock it in your room safe – along with credit cards, traveller’s cheques and passports. (Don’t forget to check the safe in the hotel room is secure)

Prepaid card tips

  • A prepaid card is a pay-as-you-go card that you top up before leaving the UK.
  • Buy prepaid cards from banks, the high street or online; you can add euros, US dollars and sterling.
  • Some prepaid cards mean you can avoid ATM withdrawal charges.
  • Use them in shops and ATMs where you see the Visa or MasterCard logo.
  • A prepaid card helps you stick to a holiday budget.
  • Check the card’s fees, terms and conditions.
  • If you lose your card the money is protected but you may have to pay for a replacement card.

Traveller’s cheques

Traveller’s cheques are pre-printed cheques for particular amounts in pounds or foreign currency. You can use them to pay in hotels, shops etc. or to exchange for foreign currency at banks and bureaux de change. Traveller’s cheques don’t expire, so if you don’t use them all on one trip, you can hang on to them for your next holiday.

Traveller’s cheques are secure because you sign each one on receipt. When you use a cheque you sign it a second time, in front of the person accepting the cheque. Each cheque is also numbered; make a note of these serial numbers to keep separately. Lost travellers cheques can be replaced as long as you have a note of the serial numbers.

Remember that in some countries, travellers cheques aren’t widely accepted; you may have to cash them in. You may also find that some banks won’t exchange them, as more and more travellers use credit and debit cards instead.

Traveller’s cheques do incur commission fees if you’re changing them into currency and some banks will charge an additional fixed minimum fee per cheque. Exchange rates vary so compare before you buy. You can also buy travellers cheques in currencies including euros and US dollars, which may save you paying commission.

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