While overseas, travelers may seek medical care ranging from treatment for self-limited minor infections to care for chronic conditions to sophisticated medical management of major illnesses or injuries. Because insurance plans may not cover emergency health care received abroad, travelers should check with their carriers before departure to confirm the limits of their coverage and to identify any additional coverage requirements. For example, travel health insurance alone does not usually pay for the cost of an emergency medical evacuation or an altered itinerary. Travelers may buy specific policies to cover these expenses, understanding that such policies often do not cover expenses related to preexisting conditions. Supplemental medical insurance plans purchased prior to traveling often furnish access to preselected local providers in many countries through a 24-hour emergency hotline (see Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance in this chapter, for more details). At a minimum, travelers should be prepared to pay out-of-pocket at the time services are rendered (in some instances, even before care is received) and then afterward provide insurers with copies of bills and invoices to initiate reimbursement.
The level and availability of medical care around the world varies from country to country and even within countries. Before going abroad, travelers should consider how they will access health care during their trip should a medical problem or emergency arise (Box 6-1). Encourage those likely to need health care to research thoroughly and identify potential health care providers and facilities at their destination. Dialysis patients, for example, need to arrange appointments in advance at a site with appropriate equipment. Pregnant travelers should know the names and locations of reliable obstetrical medical centers. More choices are generally available in urban areas than in rural or remote areas.
Travelers, particularly those with preexisting or complicated medical issues, should know the names of their condition(s), any allergies, their blood type, and current medications (including generic names), ideally in the local language. They should carry copies of prescriptions, including for glasses and contact lenses, and wear medical identification jewelry (such as a MedicAlert bracelet), as appropriate. Any number of mobile applications enable travelers to download their medical records, medications, electrocardiogram, and other information so that they are accessible when needed.
The following list of resources can help international travelers identify health care providers and facilities around the world. CDC does not endorse any particular provider or medical insurance company, and accreditation does not ensure a good outcome.
People who receive health care abroad may require ongoing care or experience complications afterward. They should request documentation of any medical care received, including a list of medications received, and share that information with any health care providers seen subsequently.
Advise travelers to self-evaluate before leaving home to ensure they are healthy enough for their itinerary, and to self-monitor for illness during their trip. Traveling while ill increases the chances that a person will have to interact with an unfamiliar, and—in some locations, at least—inadequately equipped health care system. Moreover, ill travelers pose a risk not only to themselves but also, potentially, to other passengers and travel partners. For a variety of reasons, then, traveling while ill is best avoided.
People may be reluctant to postpone or cancel travel, however, due to loss of financial investment. Make travelers aware that some airlines conduct scans of people in the waiting area and during boarding; if a passenger appears visibly ill, they can be prohibited from boarding. Trip cancellation insurance can protect some or all of an investment in a trip, and may increase compliance with the recommendation not to travel when ill.
The quality of drugs and medical products purchased abroad may not meet the same regulated standards established by the US Food and Drug Administration. Worse yet, they could be counterfeit and contain no active (or even harmful) ingredients (see Perspectives: Avoiding Poorly Regulated Medicines and Medical Products during Travel, later in this chapter). If a traveler’s original supply of medication is lost, stolen, or damaged, he or she should take steps to try to ensure that the replacement medicines they buy are safe and effective.
To minimize risks associated with substandard drugs and pharmaceuticals, travelers should:
A medical emergency abroad, such as a motor vehicle crash or other trauma, could require a life-saving transfusion of blood or other blood components (e.g., platelets, fresh frozen plasma). Not all countries accurately, reliably, and systematically screen blood donations for infectious agents, putting recipients at increased risk of transfusion-related diseases. CDC recommends that travelers to developing countries receive transfusions of blood and blood products only when critically necessary. Although it can be difficult to ensure the safety of the blood supply, travelers can take a few measures to increase their chances of a safe blood transfusion, if needed:
All travelers should consider receiving hepatitis B virus immunization. This becomes especially important for travelers who frequently visit developing countries, longer-term travelers to developing countries, those with underlying medical conditions that increase their risk of requiring blood products while traveling, and travelers whose activities (such as adventure travel) put them at higher risk for serious injury.