DULUTH — Are you traveling to Mozambique on safari? What about a mission trip to Haiti or are you heading to Machu Picchu? In the season of travel, experts weighed in on how to ensure we’ve covered our bases for a safe and healthy trip.
Sherry Johnson works with people before they hit the road, sky or seas, and about 99% of patients are traveling internationally. As a nurse practitioner at the St. Luke’s Travel Clinic in Duluth, Johnson’s primary role is to answer questions and medically prepare travelers.
Stopping into a travel clinic six weeks before your trip is recommended because certain vaccines, such as hepatitis A and B series, require a second dose.
But “it’s never too late,” Johnson said.
During an intake, a patient reviews their itinerary, and Johnson refers to the Centers for Disease Control and Prevention, and the World Health Organization for alerts. She reviews when a patient is traveling and the duration of the trip — and the rest is similar to a routine medical visit, she said.
Johnson also checks allergies, chronic disease and patients' current immunization status to see if they need updates. “Sometimes, people are surprised they didn't have their tetanus booster in 15 years,” she said.
A lot of what’s discussed depends upon the nature of your travels; what you’re doing and where you’re going can dictate specific health risks.
“If someone was traveling to Africa on a business trip, I’d recommend different vaccines for them than for someone spending a month in Africa on a service trip or at an adventure travel lodge,” she said.
Commonly, the concern is about sanitation and water-borne illnesses in many countries, such as typhoid, yellow fever, Japanese encephalitis, also Dengue fever and Zika. Getting vaccinations and packing insect repellent are important, Johnson said.
Also, we’re not as careful about what we eat and drink when we’re traveling. We’re complacent, especially in the northern part of the world, where we have access to safe water and food, Johnson said.
Traveler’s diarrhea comes on very rapidly and very severely, and you can become pretty ill and dehydrated. Rehydration can be difficult if you’re in an area without the greatest access to safe water.
Use filtered or bottled water, avoid brushing your teeth with faucet water, bring a water filter or hydration powder. Johnson also recommended judicious, careful consideration of what you intake.
Avoidance is best, and Johnson said to be careful of buffets: “Are the foods still hot? Are they still cold if they’re supposed to be cold?”
Traveler’s diarrhea is bacterial, so Johnson might prescribe an antimicrobial treatment beforehand.
If it does happen, “the best advice is to let the diarrhea run its course,” Johnson said.
If you have a chronic illness or condition, consider carrying some type of card that names the condition and any medications you’re taking. And if it’s appropriate, consider a medical education bracelet that can speak for you if you can’t.
Be sure to pack your medications.
If there is a pre-existing condition, it’s important to develop a plan about where you might receive medical care at your destination. The quality and affordability is variable, she said.
For people visiting the travel clinic from out of state, Johnson recommended bringing along a health history.
As far as aftercare, there isn’t much to do if you’re not symptomatic. As far as jet lag, be proactive. Think about the time zone you’re visiting and try to acclimate by going to bed a little bit earlier leading up to your trip. Also, bookend your visit with an extra day to recuperate and adjust.
As far as health care during your trip, Johnson recommended calling your insurance company to see what’s covered. “It doesn’t hurt to ask," she said.
Clients want to know if their insurance plans cover them abroad. “The straight answer is, it depends, but there are options people can do to eliminate that uncertainty,” said Jeremy Hoglund, director of the Duluth retail center for Blue Cross Blue Shield of Minnesota.
During domestic U.S. travel, you should be covered by your normal health plan policy, but that’s very dependent on where you go, when you go and what’s covered.
Most insurance plans aren’t going to support you outside the U.S., and they’re not going to pay the hospital directly. That means a patient pays up front and gets reimbursed, Hoglund said.
He has seen medical transport flights from the U.S. hit six figures. Medical insurance policies don’t cover that, but yours probably covers your medical care while travelling internationally, he said.
During a health event, or if a pre-existing condition flares up resulting in an emergency abroad, travel insurance would come into play.
BCBS defines emergency as “life or limb,” as in, your life is in danger or you have a broken limb. BCBS doesn’t offer travel policies, but they do offer them through a third party, Hoglund said.
Travel insurance is commonly calculated based on your length of stay, age, destination and what you’ll be doing. A scan on insuremytrip.com showed prices ranging $130-$180 on policies for a month-long trip to Spain. That covers flight, hotel, train rides and emergency medical and evacuation benefits.
Hoglund purchased travel insurance for $21 (per child) for his kids during a recent three-week stay in Sweden. They didn’t have to use it, but it was money well-spent, he said.
When traveling domestically, make sure you have your health insurance card and that your policy and premiums are up-to-date. Consider your health care needs, and plan for the unexpected, Hoglund said.
And you don’t want to rely on federal- and state-funded plans to cover you internationally, said Megan Halena, program director for Generations Health Care Initiatives in Duluth. “Conclusively, the health insurance you buy here regarding programs through MNSure and Medicaid … they will not work overseas,” she said.
Domestically, a policy purchased here should be covered in the event of an emergency — a car accident, sudden chest pains — while nonemergency care likely would not be, she said.
While Halena doesn’t deal with them professionally, she also recommended a supplemental policy for overseas travel.
Travel insurance can help in the event of a cancellation, a missed flight due to a delay, and it’s generally inexpensive, said Natasha Perkerwicz. As a travel agent at Divine Destinations in Duluth, she does recommend it to clients, and she has purchased it herself.
Another good rule of thumb for travel is “you have to pack your sense of humor,” Perkerwicz said. Everything’s not going to go according to plan with airlines, fellow passengers, and such, so you have to roll with the punches.
Many of those working in the travel and health care industries have dabbled themselves.
Perkerwicz is heading to Dubai in August, and Germany in November.
Halena has traveled to England, Scotland and Belize. She has purchased travel insurance, but has never had to use it.
Hoglund visited London and Italy, and he’s headed to New Zealand in January. “I adore learning about other cultures and seeing how people live," he said.