health insurance?...

[double u]

genetics determine your "envelope" & your lifestyle has SOME influence where you land within this envelope. getting run over by the proverbial bus (as happened to asinglehanding friend in Suva) overrules both.
not believing in the genetic "envelope"? start training until you beat some top-athlete! you'll quickly see, that the top performance you can reach is determined by your genetics, no matter how much & hard you train. this does not mean that training is without effect!

[Kenomac]

Genetics makes the single biggest difference. Fruits, nuts and veggies... over-rated. Enjoy life, eat dessert and foget about listening to those trying to sell the fountain of youth.

Ken RN

[double u]

btw: every so many years the food-recommendations are severely "updated", sometimes reversed:
did they not damn until recently all fatty foods, particularly the saturated fatty acids & as worst the poly-saturated fatty acids? - like here:
https://www.theguardian.com/lifeands...-harvard-study

"newest" "finding" though:
https://www.irishtimes.com/news/heal...udy-1.3203175:
who knows what sience will come up with regarding the influence of diet & sports on life expectancy.

[Hoosiersailor]

This is great information for me. The single biggest worry I have is on health insurance coverage. The day to day stuff doesn’t bother me and when we depart here in a few years I hope to have in excess of $20-30k saved in a HSA. However, is there a reasonable catastrophic health US insurance plan available? My wife and I plan to be the easy SE US/Caribbean cruiser so getting back to the US is a reasonable solution. But what do you do if you are out in the Caribbean and have some weird unexplained pain, go to the doctor and find you have some sort of cancer or what if one of us has a significant health event (heart attack, trauma event, etc.). I just don’t want something to happen, I die and my wife is stuck with some huge health care bill as the result.

[MikeFergie]

As far as pricing goes Africa cover is the cheapest, then comes Europe cover, then Australia New Zealand and lastly more than double the cost of the others is USA cover. This all related to cost of services in those regions. One could argue that Africa is the highest risk but service prices are much lower.

I remember when I was last in the USA at the aeromedical conference in Dallas the average cost per hour for an ambulance helicopter was $20 000. At that time we were billing about $2500 in Johannesburg South Africa.

[rwidman]

Originally Posted by hafa

......... Although rwidman does not like to acknowledge the fact, there is a difference between not wanting insurance and not being able to buy it. See this thread and this thread for evidence of his recalcitrance and accusatory stance.

I am generally healthy but if I did not have medical insurance, I would be destitute at this point in my life. A day or two in the hospital can cost thousands of dollars. My wife has had both knees replaced and that's not cheap.

Sure I pay out money every month that I would rather spend on something else, but I know I'm not going to get a hospital bill for $200K in the mail one day.

I try to post reasonable, well thought out advice, but in the end, it's your dime, you make the decision and live with the consequences.

[double u]

"...knees replaced ..."
somebody in this age-bracket would be foolish not to have medical insurance!

[rwidman]

Originally Posted by MikeFergie

Guys as someone who makes his living from emergency care and aeromedical evacuations I certainly do not recommend traveling anywhere without suitable evacuation services and medical expenses cover. Even drop your boat insurance before you consider this.

I deal with a lot of this and believe me yes it's not USA prices but for example in South Africa a bypass following a heart attack will set you back at least $50 000. I have seen cerebral malaria cases run bills of over $100 000 ( even then you might not survive). Aeromedical Evacs can cost $50000 to $100000. And they are required should you have a major illness in a remote location.

Don't leave without it if you value your families and your lives.

Sad to say even repatriating a body home can cost $10 000-$15 000

Thank you for that dose of reality. I hope folks don't just skip over it.

[rwidman]

Originally Posted by Hoosiersailor

This is great information for me. The single biggest worry I have is on health insurance coverage. The day to day stuff doesn’t bother me and when we depart here in a few years I hope to have in excess of $20-30k saved in a HSA. However, is there a reasonable catastrophic health US insurance plan available? My wife and I plan to be the easy SE US/Caribbean cruiser so getting back to the US is a reasonable solution. But what do you do if you are out in the Caribbean and have some weird unexplained pain, go to the doctor and find you have some sort of cancer or what if one of us has a significant health event (heart attack, trauma event, etc.). I just don’t want something to happen, I die and my wife is stuck with some huge health care bill as the result.

In the USA, if you are rich, you pay and don't care. If you are poor, you get to the hospital and they have to treat you for free (it's the law).

It's those of us in the middle who work for a living or used to work and saved up for retirement that get screwed. That's why we buy insurance. We'll never get rich and we don't want to be poor.

My suggestion to you is to call or visit a few independent insurance agents and see what is available for your situation.

[belizesailor]

Originally Posted by rwidman

I am generally healthy but if I did not have medical insurance, I would be destitute at this point in my life. A day or two in the hospital can cost thousands of dollars. My wife has had both knees replaced and that's not cheap.

Sure I pay out money every month that I would rather spend on something else, but I know I'm not going to get a hospital bill for $200K in the mail one day.

I try to post reasonable, well thought out advice, but in the end, it's your dime, you make the decision and live with the consequences.

This is USA centric though. Healthcare costs in many other parts of the world will not bankrupt you (assuming some substantial net worth).

In Guatemala for example, first world, first class healthcare is available in the private side of the system, at dramatically lower costs than the USA. Cases in point, I know folks who have had knee replacement, hip replacement, back surgery, cancer treatment, significant burn treatment (20% of body),etc...none have spent over $10K...all outcomes were successful.

Ive had normal check ups and minor stuff, like a dental crown, completed the same day for $250...and the fit was absolutely perfect the first time...no adjustments needed. Several years ago...zero problems.

Insurance is corresponding inexpensive, we have coverage here in Panamá for a couple (56 & 63), full PPO type plan, for $159 per month (total, not PP)...again, a fraction of what that same coverage would cost in the USA.

And unfortunately I know from experience, international death can be expensive...if you choose to repaitriate the body. My cost all total was around $15K. It could have probably been done for $10K or a little less in retrospect. However, if you choose not to repaitriate the intact body (vs cremains) then costs are dramatically less. Cremains can be transported as carry on baggage (at least they could in 2008)...makes for an interesting trip thru security, but I had no pronlems (this was on the return trip from the USA).

[john61ct]

Can't believe people spending big on a leftover bag of bones. Really?

I know big-millionares buried at sea or ashes under a rock in the back yard.

Anything else just indefensible.

For me, of course.

Ozymandias

[Mike OReilly]

Once again, the USA is really the outlier in this matter. My risk assessment is to carry additional health insurance while in America (mostly just patch-me-up-and-ship-me-home insurance). Just about anywhere else in the world acute care will be affordable. Chronic care would be something different. For that I gotta get back to Canada.

Repatriate my body?!? Forget it. Slip it over the side to feed the fish. I’ll be done with it at that point. No point wasting money moving a hunk of decaying meat around.

[DumnMad]

Originally Posted by Kenomac

Genetics makes the single biggest difference. Fruits, nuts and veggies... over-rated. Enjoy life, eat dessert and foget about listening to those trying to sell the fountain of youth.

Ken RN

https://bluezones.com/2017/08/servin...dd-years-life/

People addicted to animal fat, sugar drinks and wheat flour will always find an good reason for their self-sacrificing support of the pharmacy industry and medical insurance.

[fxykty]

Originally Posted by Mike OReilly

...

Repatriate my body?!? Forget it. Slip it over the side to feed the fish. I’ll be done with it at that point. No point wasting money moving a hunk of decaying meat around.

Easier for you, as if you would care at that point, but not so easy for your living shipmate(s) when they arrive at the next port. A charge of murder is not out of line, and you do know that in most places you need to be a medical professional to declare someone dead.

Best solution for the living is to put your probably dead body into a body bag: https://books.google.co.nz/books?id=...%20sea&f=false

Whether you can keep the body or not, document everything in the utmost detail, including photos and video. Try to cover all the bases, because you can bet the police will be very suspicious. Especially if it's a spouse and there is insurance involved.

[Mike OReilly]

OK, I’m not a physician, nor a nurse, but I have been a medical science writer for many decades. My understanding of the research is that it would be a mis-statement to assign firm percentages to genetics vs environment vs circumstances. Genetics clearly plays a large role in many “diseases”, but so does the environment, and then there’s the ‘shyte happens,’ stuff.

IOW, it would be folly to place all your eggs in one basket.

My understanding of genetics are that they suggest what chronic issues are more likely, but except in a very few diseases, this is highly tempered by environmental facts and simple accidents. I suspect (and believe from my experience) that acute health issues are more important for cruisers. IOW, it’s more likely you’re going to have to deal with a broken arm, a burn or a laceration, compared to cancer or heart problems, while out cruising. This is why healthcare is largely affordable (outside of the USA) to most cruisers.