Hospitals
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Decide if local is good enough
When people learn they have a serious disease, their first reaction is often, "Where's the best place in the world to go for this?" They're often willing to travel anywhere, and they assume that's what they'll have to do. Finding a good doctor and, if necessary, a good hospital are indeed essential when you're seriously ill. But for the vast majority of illnesses, even serious ones, you can usually find excellent care fairly close to home, especially if you live in or near a big city.
Traveling for health care, however, may offer advantages in certain cases. For example, you might have a rare condition that's adequately treated in only a few institutions worldwide. Maybe you need an unusual or difficult procedure or operation that your local doctors don't perform often enough to keep up their technical skills. Or perhaps you want to enroll in a clinical trial that's taking place far from your home.
In those cases, here are the main challenges you'll face and how to overcome them:
- No or limited insurance coverage Your insurer might force you to use specific hospitals and turn efforts to go elsewhere into protracted battles. You could try switching to a plan that allows more choice, though most people have that option only once a year at open enrollment. A preferred provider organization (PPO) is more likely to have a national network than a health maintenance organization (HMO), and is also more likely to let you go out of network for care. If you are on Medicare you will have no problem if you are in original Medicare, but will likely be in a geographically restricted network if you have a private Medicare Advantage plan. You could also try to appeal your existing plan's restrictions. Most managed care plans have provisions for going out of network for situations that require very specialized care, and the Affordable Care Act will also soon require all heath insurance plans to subject themselves to binding external review of care denials.
- Health insurance rarely pays for travel and lodging However, such costs might be tax-deductible as medical expenses. You can also contact the hospital's social-service department, local charities, or disease-specific support groups about the availability of free or low-cost lodging.
- Isolated care Without your primary-care doctor nearby, you're particularly susceptible to disjointed care from unfamiliar specialists. So it's especially important to have a trusted friend or family member with you to act as an advisor. Also ask the hospital's admissions department if there's a "hospitalist" on staff, a doctor who serves as a temporary primary-care physician. See what records or paperwork you'll need, and ask your local primary-care doctor to help you gather and send them. To ensure appropriate care when you return, involve your local doctors beforehand and ask them to recommend a local specialist, too, if necessary. Finally, make sure you or your friend or family member comes home with copies of all your treatment records and test results so you can make sure your local doctors have them for follow-up care. Too often, even if you request the hospital to forward your records to your local doctors, they don't.
