# Health insurance for cruisers



## Vega27 (Nov 9, 2018)

Good morning cruisers! Can anyone direct me to a thread devoted to cruising and health insurance (as in, what company/insurers are recommended)? Or, if this is the first post on the topic, I'd love to hear how Sailnet cruisers manage health insurance while at sea. Mahalo and cheers!


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## Don L (Aug 8, 2008)

I take just enough money out of my 401k to get to the poverty line and qualify as poor. Then I get the max ACA subsidy and get an ACA plan.

There's lot of of health care threads but it's in the details of where and what you need that make a difference.


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## Dfok (Apr 11, 2010)

I worked 45 years to get to medicare and a point in my life when I could sail away without expecting other taxpayers to subsidize my cruising.


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## bigdogandy (Jun 21, 2008)

I "retired" at 55 and like Don, make just enough money in consulting work and investments to pay my bills and qualify for a subsidy under ACA. I feel like I paid plenty enough in taxes while I was working and pay enough now to have no qualms about this.

My insurance costs about $230 per month, but has high deductibles and co-pays.


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## hellosailor (Apr 11, 2006)

Vega-
As an individual you basically have no access to a national plan. A very few corporate plans offer national coverage but the norm is that you are covered by a PPO or HMO in a limited area, and everything else is "out of network" coverage. Which will be available, but damned expensive with hefty deductibles and copayments.
The other main alternative is Medicare/Medicaid if you are qualified, and even those are only good within the US, not offshore.

There have been other threads discussing mainly, for *most* boaters the answer is to pay for local medical care (most of the world is much cheaper than the US) and if you need to come home, you come home. Or carry medevac repatriation insurance as well.

The few policies mentioned elsewhere usually will cover you "if you're not out of the country more than six months" or with similar qualifications about when and where you are, so read the fine print.

Good luck finding and qualifying for anything "global".


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## VIEXILE (Jan 10, 2001)

Tilloglobe used to be pretty good for expats with a Stateside address. Google it.


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## capta (Jun 27, 2011)

At my age, sailing a boat in the Caribbean, I couldn't find any kind of affordable health insurance. My wife, who is considerably younger than I could get it @ about a grand a year, but we don't remember which company.
If you are older and going overseas, I suggest you self insure. Most medical care in the islands is much cheaper than in the states, and better, too. Lots of Cuban trained doctors down here and they are way better than US doctors.
Otherwise, if you must have US healthcare, don't forget to get the air ambulance insurance as well. Caching!


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## Minnewaska (Feb 21, 2010)

One's health is the ultimate gamble. Every bite you take, every choice you make has a little impact on the outcome. Then again, so does your genetics. It's all too much to ponder, as none of us are getting out of here alive. 

As this thread further supports, I get the sense that most global cruisers have little to no medical coverage. 

Statistically, up to some older age, one's odds of needing very expensive medical care is fairly low. The majority pay (or their employer pays) way more in premium than the the individual ever gets back. However, when the minority come up craps on that bet, the cost can be bankrupting. It's not the odds of losing, it's the amount of loss, if you lose. 

Broken bones and infections are not the concern, those always cost less than the insurance cost to cover them, even in the US. It's big surgery, serious disease, the big C that could be financially debilitating. The trouble is, most of us can not tell what our personal odds really are.


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## outbound (Dec 3, 2012)

Capta is right. Plenty of Cuban docs and plenty of Brit docs in the English speaking islands. Medicare doesn’t cover muc of anything outside the US. Get medijet or equivalent. If anything big time goes on will get you stabilized and aerovac’d to the tertiary center of your choice. Dan offers the same service if you’re a diver.


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## Minnesail (Feb 19, 2013)

It’s still many years off, but my wife and I plan to retire in our late 50s and travel (hopefully by boat).

Last year she got stage II breast cancer. Treatment went well and she’s doing fine, but there’s always a risk of recurrence and the way it spread aggressively to her lymph nodes gives an added chance of recurrence.

We will certainly never go without health insurance, and now that she has the mother of all pre-existing conditions it complicates things. Right now she can’t be denied coverage because of her cancer history, but if the courts or congress change the law regarding pre-existing conditions we’re kind of hosed. One of us would have to keep a corporate job just for the insurance plan until she reaches medicare age. 

Who knows what the future may bring, but the need to maintain health insurance looms large.


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## paulk (Jun 2, 2000)

We learned about a Cruiser's health insurance plan from Gowrie that seemed reasonable. You have to be going internationally for most of the year to qualify. Because other countries have more reasonable health costs than the U.S., the insurance is less than U.S. coverage would be. https://www.gowrie.com/USSailingPrograms/CrewMedicalHealth.aspx


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## chuck5499 (Aug 31, 2003)

We have been out 12 years and our only insurance is Medicare A/B and that does us no good out the USA. A South African friend tried to get us on his group policy a few years ago but they refused when they found we were over 65. Now at 74 I don't stand a chance - 

We have had medical issues in the Carib and Med and pay out of pocket. The Admiral had hand surgery in Colombia by a hand surgeron at 1,500 usd and pt was about 25usd per visit. In Trini I had 1/2 my nose replaced at about 1,800usd - In Tunisia I ripped a shoulder tendon and had to have surgery to put 2 screws in to put it back - cost was less than 2,000 usd and pt was in the 25usd per visit 
I have eye pressure problems and have to take drops 2x a day and in the USA the meds were in the 110usd range but in Turkey 15usd, in Germany about 30usd, and now in Israel about 20usd - and in Israel I had the best eye doc I have ever had anywhere and he was about 250usd and wow he took pics on the inside of the eye- did a complete work up and lots of test - he is certified retina specialist and incredible - 

the usa is the worst place for medical anyplace in the world - and there is no difference in quality in fact sometimes worse - I had screws put in one shoulder in the USA as an out patient - In Tunisia they insisted I stay in the hospital for a couple of days and that is in the above number -


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## Luisa Hilburn (Jul 27, 2019)

the decisions you need to make about health insurance while cruising the world will be personal ones. Talk it over with your family doctor and learn as much as you can about the options for policies out there. Then, go to an experienced broker who can steer you to the programs that fit your medical needs and cruising budget. As it is at home, the cost of insurance will end up being one of the significant line items in your monthly cruising budget, so make sure you are getting the policies you need.


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## capta (Jun 27, 2011)

Dfok said:


> I worked 45 years to get to medicare and a point in my life when I could sail away without expecting other taxpayers to subsidize my cruising.


Too bad that return on our generous "contributions" to "our" retirement care doesn't extend outside the country. I wonder if all those who retired to Costa Rica figured that one out?


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## capta (Jun 27, 2011)

Luisa Hilburn said:


> the cost of insurance will end up being one of the significant line items in your monthly cruising budget, so make sure you are getting the policies you need.


In general, I've found the island medical systems to be on a par to US ones, though considerably cheaper. The equipment may be older, but the practitioners' skill more than compensates. Actually, several of our island doctors are Cuban trained, which according to some, is a higher standard internationally than the US.
Self-insuring may be another way to go, and certainly way cheaper in the end. On the other hand, we know cruising couples who belong to the Life Flight program because the idea of visiting anything but an American doctor is unacceptable to them.
And medications? WOW!! We get most medications at a fraction of US costs. One medication which we cannot find for less than $513.00 in the US is $78.00 in Trinidad! That is for 30 days of one dose a day, and something many elderly are on for life. Most are more than 50% cheaper.


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## sarwatalp (Jul 3, 2021)

capta said:


> At my age, sailing a boat in the Caribbean, I couldn't find any kind of affordable health insurance. My wife, who is considerably younger than I could get it @ about a grand a year, but we don't remember which company.
> If you are older and going overseas, I suggest you self insure. Most medical care in the islands is much cheaper than in the states, and better, too. Lots of Cuban trained doctors down here and they are way better than US doctors.
> Otherwise, if you must have US healthcare, don't forget to get the air ambulance insurance as well. Caching!


Agree with this, I am getting quotes from different companies and most of them are expensive and thinking to self-care as you suggested, Still I'm in contact with one company which friend suggested hopefully will get some better quotes from them


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## Guyfromthenorth (Jul 2, 2015)

We sourced our insurance through World Nomads when we lived aboard for a year and were outside of country. That being said I was not happy with them at all...

They took our money and then right when the "big C" started in 2020 we were in the Bahamas anchored. They casually sent me an e-mail stating that because the Prime Minister back home made a public announcement that all Canadians should return home they would void my insurance. WHY they could opt to void my insurance based on that I have no idea. Why a pandemic should mean I don't get coverage for a broken leg still baffles my mind. They also were reluctant to refund my money until I pressed the matter...angrily...from the foredeck of my boat. Luckily I had a nurse with me, a good med-kit my family doctor allowed me to stock before departure, and we didn't get injured on the way home. The fine print on those contracts definitely allow the "house" to win and the way they could arbitrarily cancel our entire policy (as opposed to just decide not to cover a C infection) has made me re-think how useful they would have actually been should we have got hurt.

I'm not saying all insurance is a scam, but like anything be sure and read the fine print and terms.


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