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Touring, Health Insurance, and Tough Questions

Old 07-04-20, 01:40 PM
  #1  
jamawani 
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Touring, Health Insurance, and Tough Questions

The possibility of illness or injury on a longer bike tour has been discussed often.
It is even more germane now with the impact of the Covid-19 pandemic.
When touring internationally, many countries require proof of medical coverage.
For Americans traveling within the U.S., it has been optional.
Optional in the sense that those without health insurance could still tour.

On another thread, it has been stated that the topic is too politicized to discuss.
Why? Why can you discuss frames, shoes, tires, routes - but not health insurance?
One of the accusations levelled at touring is that it is a rich, white sport.
I have often been asked how I can afford to ride for three months.
The easiest response was to say that I am a teacher - which was half-true.

But if you look out there - at least in years other than 2020 -
you will notice that most people touring are either youngsters or retired.
And most have means - either their own or their parents.

I remember a journal over at Crazyguy were the author was amazed
that a young woman who was cashier at a c-store in west Kansas
had never been further than Wichita or Denver.
Perhaps she did not have the imagination,
but I would also suggest that she did not have the means.

Health coverage is simply another division of haves and have-nots.
For Canadians or Europeans it is unimaginable, but for many Americans it is real.
For those who have insurance - whether college-aged or retired -
it requires hardly a thought, except possibly adding a rider.
But for others it involves either enormous risk - or not touring at all.

There are many reasons touring is overwhelmingly white,
but one may be that minorities are far more likely to be uninsured or marginally insured.
The question of access to healthcare could be one means of asking,
"What needs to be done to broaden the appeal of bike touring?"
At least it should.
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Old 07-04-20, 04:48 PM
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mev
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Originally Posted by jamawani View Post
When touring internationally, many countries require proof of medical coverage.
??

I don't remember being asked for proof of health coverage in ~35 countries I've toured[*]. There were sometimes more specific requirements such as a yellow fever certificate. Also, there was an expectation that you were not necessarily covered under their health system and would need to pay out of pocket. In Quito Ecuador, I did pay out of pocket for treatment on some saddle sores. The first medical place I found wouldn't take myself as a foreigner but they directed me to a place that would. The out of pocket price was considerably less than I would have paid in the US. I had some emergency dental procedure done in Addis Ababa, Ethiopia also out of pocket and also considerably less than in the US.

Now in some of those cases I did buy travel insurance mostly to cover extra risks, though never made a claim. This coverage also included a medical evacuation rider. When I cycled with a Dutch cyclist across Russia, her national health plan in the Netherlands also did not cover Russia, but she was able to buy a rider from a government source that extended overseas coverage as well.

What I think makes medical insurance in the US particularly important is some of the costs - which can become prohibitive if you have to pay out of pocket.

I agree that lack of (affordable) coverage can be a barrier to touring - though for some folks without that coverage it can also be an issue if they bicycle in their town, staying in the same place.
[*] It might have been on the Russian visa application, but that was long enough ago, I forget whether it was there or not.
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Old 07-04-20, 07:58 PM
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Originally Posted by jamawani View Post

On another thread, it has been stated that the topic is too politicized to discuss.
Why? Why can you discuss frames, shoes, tires, routes - but not health insurance?
.
Because you are asking a political question not whether or not one would or should tour without health insurance.
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Old 07-04-20, 08:43 PM
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Originally Posted by L134 View Post
Because you are asking a political question not whether or not one would or should tour without health insurance.
I view it as a question of access.

Many in the cycling argue for safe access on roadways for bicyclists.
There are frequent discussions about hiker/biker campsites or a "No turn-away" policy in parks.
In the broader society, there is near unanimous support for universal education.
Access to healthcare is no different.
It is, of course, how you choose to frame it.
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Old 07-04-20, 10:43 PM
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It's an interesting question that I have never really had to consider because, as a Canadian, we have universal health care. To have to worry about whether one can afford to get sick or injured seems incredible, though I know it's true for some in the US. If we travel internationally, Canadians often choose to get extended coverage, but it's reasonable enough when factored into the overall cost of a trip that includes airfare, hotels, and other assorted fees. In some ways, that sort of travel is a want, not a need, so not everyone is entitled to it. Basic domestic travel by bicycle I might view differently.

It is a political question though. No way around it.

Last edited by Happy Feet; 07-04-20 at 11:29 PM.
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Old 07-05-20, 12:25 AM
  #6  
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USA system is terrible but the Canadian system doesn't seem ideal either. Default gov't plan is deliberately left incomplete so insurance companies can make $$ thru employee plans etc. I think the main advantage in the Canadian-type system (& AFAIK Germany etc) is that costs are controlled vs the USA where insurance costs much more plus hospitals & drug companies are allowed to gouge the uninsured/under-insured.

Logical system would be single-payer to cut out the insurance corporation middle-man, like UK NHS but without the deliberate under-investment.
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Old 07-05-20, 04:36 AM
  #7  
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Before bikes I spent a lot of time SCUBA Diving and in all my travels the only thing a government required of me was my passport and a return ticket. I did use medical services once on the island of Bonaire. I was seen by a doctor who would take no money and had no interest in my insurance coverage at all. Socialized medical care! I did not need a appointment called and saw the doc within an hour of the call try that in the US.
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Old 07-05-20, 04:46 AM
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it's only political if you make it so, and your post seems to be making it so.
i didn't notice any question as to availability or affordability of insurance, just another "white priblidge" rant.

you wanna tour? wanna stay healthy? buy some goldang insurance.
three months of travel insurance with covid cover will cost about a hundred bucks.
a day or two at a minimal wage job will pay for it.

instead of crowdsourcing my feelings, i contacted an insurance agent:

"Safe Travels Outbound Cost Saver will cost $101 and Safe Travels Outbound will cost $118
for three months coverage with same $500,000 maximum and $250 deductible."
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Old 07-05-20, 05:07 AM
  #9  
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Australia has decent health care.
However, when I travel to another country, I get travel health insurance.

It hasn't been required in any country I've visited so far, but I choose to get travel health insurance for the sake of my own bank account. I have had to use it once and was very glad I had it.

But in 2020 ... travel is restricted to our own countries and in my case to one island in my country. No need for travel health insurance.
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Old 07-05-20, 05:09 AM
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I think if you re-frame your question as "what are the barriers to participating in cycle touring?", lack of medical insurance would be pretty low on the list. In no particular order, other barriers that seem more likely are the cost of bike and gear, the need for time and safe places to ride in order to learn to enjoy cycling and to prepare for a tour, concerns about safety traveling on back roads, and lack of role models/mentors to introduce people to the activity.
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Old 07-05-20, 07:48 AM
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I cycletoured abroad twice a long time ago. No insurance the first time. Second involved an internship with a German company and one of the stipulations was that I must have insurance so I got some but I never needed it and would not have needed any the first time, although I did get strep throat in Italy on that trip. Insurance is cheap insurance, you might say; even if you don't need you'll probably sleep better on your trip.
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Old 07-05-20, 10:16 AM
  #12  
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I have Atlas Multi Trip travel insurance. Mine is for trips up to 30 days, which covers me for my work travel. They have other types that would cover you longer. I go through Tokyo Marine for my travel insurance. https://www.hccmis.com/compare-atlas-insurance/
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Old 07-05-20, 11:59 AM
  #13  
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Originally Posted by saddlesores View Post
you wanna tour? wanna stay healthy? buy some goldang insurance.
three months of travel insurance with covid cover will cost about a hundred bucks.
a day or two at a minimal wage job will pay for it.
If you tour for long enough, it is potentially *less expensive* for insurance than staying in the US (assuming you are allowed to travel).

For 2017 I realized I was going to meet criteria to not need a mandate to buy health insurance in the US, in particular I was not in the US for more than the limit of 35 days that year - and hence exempt. That mandate has since been repealed though my exposure to to expensive care still applied. Now as it turned out, I kept paying a policy that year (that didn't cover being outside the US) as well as a travel insurance (that did cover being outside the US). Part of the reason I continued to pay for US-based insurance was that if I got sick enough to require extended (less expensive) hospitalization overseas I would be at risk of two potential things happening (a) I might run out of time on my visa in a particular country and (b) my travel insurance had alternatives of either paying for my care or paying to return me to the US.
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Old 07-05-20, 01:28 PM
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Originally Posted by jamawani View Post
The possibility of illness or injury on a longer bike tour has been discussed often.
It is even more germane now with the impact of the Covid-19 pandemic.
When touring internationally, many countries require proof of medical coverage.
For Americans traveling within the U.S., it has been optional.
Optional in the sense that those without health insurance could still tour.

On another thread, it has been stated that the topic is too politicized to discuss.
Why? Why can you discuss frames, shoes, tires, routes - but not health insurance?
One of the accusations levelled at touring is that it is a rich, white sport.
I have often been asked how I can afford to ride for three months.
The easiest response was to say that I am a teacher - which was half-true.

But if you look out there - at least in years other than 2020 -
you will notice that most people touring are either youngsters or retired.
And most have means - either their own or their parents.

I remember a journal over at Crazyguy were the author was amazed
that a young woman who was cashier at a c-store in west Kansas
had never been further than Wichita or Denver.
Perhaps she did not have the imagination,
but I would also suggest that she did not have the means.

Health coverage is simply another division of haves and have-nots.
For Canadians or Europeans it is unimaginable, but for many Americans it is real.
For those who have insurance - whether college-aged or retired -
it requires hardly a thought, except possibly adding a rider.
But for others it involves either enormous risk - or not touring at all.

There are many reasons touring is overwhelmingly white,
but one may be that minorities are far more likely to be uninsured or marginally insured.
The question of access to healthcare could be one means of asking,
"What needs to be done to broaden the appeal of bike touring?"
At least it should.
When you speak of "means," I would venture a guess that it has far more to do with money and other practical considerations than health insurance. I don't know many people who could take the time off to do so-- either they don't have the vacation time, or they can't be away from their job for weeks or months even if they do have the leave available. They may not have the money to travel or to buy the additional supplies/equipment they would need. They may have families or pets at home that cannot be left for that length of time. Etc. Young people and retirees tend to have fewer responsibilities to hold them down than those in the mid-years of their lives.

If I were to think of bike touring, health insurance is one of the considerations that would be lower on my list, lower than the things I mention above.
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Old 07-05-20, 01:42 PM
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Bike touring doesn’t require weeks or months off. While I have taken months and weeks off to tour, the majority of my tours have been three day affairs. Just did another three-day trip starting this past Wednesday.

When I took an extended break from the working world, health insurance was a major concern. A few minutes ago I was looking at the scar on my palm that resulted from three stitches I got in Cut Bank, MT, during my cross country tour. Glad I was able to extend my coverage through COBRA. I also did (and still do) have a mechanical heart valve and thus have to take blood thinners. Thankful for my good insurance through work.

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Old 07-05-20, 04:38 PM
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Originally Posted by jamawani View Post
Health coverage is simply another division of haves and have-nots.


There are many reasons touring is overwhelmingly white,
but one may be that minorities are far more likely to be uninsured or marginally insured.
.
If you make less than $51,000 per year health insurance is $300 per month in the U.S., with a $1000 deductible. If you make much, much less Obama care is very inexpensive.

This has nothing to do with being White.

As usual, just another White person trying to be relevant. Because you see, minorities are far too stupid to figure things out for themselves. They need the help of White people.

Your attitude is racist as can be.
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Old 07-05-20, 07:14 PM
  #17  
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Before I retired, all my bike tours were one week long or shorter. Same with my canoe trips and kayak trips. It was difficult to schedule much more than a week away from work.

After I retired, had one bike tour that was only five days long because a friend organized it and he only wanted to have a five day trip, but the other bike tours were two to six weeks long.
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Old 07-07-20, 06:54 AM
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Originally Posted by indyfabz View Post
Bike touring doesn’t require weeks or months off. While I have taken months and weeks off to tour, the majority of my tours have been three day affairs. Just did another three-day trip starting this past Wednesday.

When I took an extended break from the working world, health insurance was a major concern. A few minutes ago I was looking at the scar on my palm that resulted from three stitches I got in Cut Bank, MT, during my cross country tour. Glad I was able to extend my coverage through COBRA. I also did (and still do) have a mechanical heart valve and thus have to take blood thinners. Thankful for my good insurance through work.
OP mentions "a longer bike tour" and "riding for three months." It doesn't sound like we're talking about three-day tours, here. I also am not sure why we would be discussing the consternation about health insurance for a weekend trip, as it's not a consideration most people would have.
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Old 07-07-20, 05:02 PM
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Originally Posted by jamawani View Post
The possibility of illness or injury on a longer bike tour has been discussed often.
It is even more germane now with the impact of the Covid-19 pandemic.
When touring internationally, many countries require proof of medical coverage.
For Americans traveling within the U.S., it has been optional.
Optional in the sense that those without health insurance could still tour.

On another thread, it has been stated that the topic is too politicized to discuss.
Why? Why can you discuss frames, shoes, tires, routes - but not health insurance?
One of the accusations levelled at touring is that it is a rich, white sport.
I have often been asked how I can afford to ride for three months.
The easiest response was to say that I am a teacher - which was half-true.

But if you look out there - at least in years other than 2020 -
you will notice that most people touring are either youngsters or retired.
And most have means - either their own or their parents.

I remember a journal over at Crazyguy were the author was amazed
that a young woman who was cashier at a c-store in west Kansas
had never been further than Wichita or Denver.
Perhaps she did not have the imagination,
but I would also suggest that she did not have the means.

Health coverage is simply another division of haves and have-nots.
For Canadians or Europeans it is unimaginable, but for many Americans it is real.
For those who have insurance - whether college-aged or retired -
it requires hardly a thought, except possibly adding a rider.
But for others it involves either enormous risk - or not touring at all.

There are many reasons touring is overwhelmingly white,
but one may be that minorities are far more likely to be uninsured or marginally insured.
The question of access to healthcare could be one means of asking,
"What needs to be done to broaden the appeal of bike touring?"
At least it should.
I live and work in an area where whites are in the minority. There are a substantial number of black people with the financial means to ride. Bicycle riders in this area, based on my casual observations, are over 95 percent white. I don't think means can explain most of it. I simply don't think it's something that has widespread cultural appeal. Have you done any research into the percentage of blacks that have health insurance?
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Old 07-08-20, 07:44 PM
  #20  
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[QUOTE=saddlesores;21569964
"Safe Travels Outbound Cost Saver will cost $101 and Safe Travels Outbound will cost $118
for three months coverage with same $500,000 maximum and $250 deductible."[/QUOTE]

That's surprisingly cheap--how do they offer travel insurance cheaper than domestic insurance?
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Old 07-09-20, 12:12 AM
  #21  
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Originally Posted by DropBarFan View Post
That's surprisingly cheap--how do they offer travel insurance cheaper than domestic insurance?


not a problem! barely an inconvenience!

they sell travel insurance that excludes coverage within the usa, which has the most expensivest health care in the world!

how expensive? ten years ago, my $150K in the usa heart valve replacement operation was done in india for $10K...........equal to just the hospital charge for the freakin' valve in the usa! a few years ago, i had minor sinus surgery in china for $1K.......the same charge my sister paid for the same operation in the usa as the 10% deductible.

and now?? my expat health insurance with $1 million cover, including repatriation, costs me about $1250/year. about $100/month, NOT a spring chicken, with lifetime coverage. and being overseas i never got caught up in the obamacare nightmare!

here in chinaland (or in thailand) i can buy insurance from local carriers with reasonable coverage for under $250/year.
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Old 07-09-20, 06:31 AM
  #22  
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Originally Posted by saddlesores View Post
how expensive? ten years ago, my $150K in the usa heart valve replacement operation was done in india for $10K...........equal to just the hospital charge for the freakin' valve in the usa! a few years ago.
You have a prosthesis? What type? I had a St. Jude aortic installed in August of 1990. IIRC, the hospital bill was $60K. That did not include things like surgeon fees and the cost of the valve itself, which I believe was around $2,500 back then.

Fortunately, I was a student and still covered under my mom's excellent insurance through her job as a public school teacher. Since I had been in the hospital for the cardiac cath less than 90 days before the surgery, I didn't have to pay the $500 deductible. My end of the $60K was $14 or so for the phone.

Last edited by indyfabz; 07-09-20 at 06:35 AM.
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Old 07-09-20, 07:19 AM
  #23  
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Originally Posted by indyfabz View Post
You have a prosthesis? What type? I had a St. Jude aortic installed in August of 1990. IIRC, the hospital bill was $60K. That did not include things like surgeon fees and the cost of the valve itself, which I believe was around $2,500 back then.

Fortunately, I was a student and still covered under my mom's excellent insurance through her job as a public school teacher. Since I had been in the hospital for the cardiac cath less than 90 days before the surgery, I didn't have to pay the $500 deductible. My end of the $60K was $14 or so for the phone.
i got an edwards perimount 3000. that one in dec '89 had a new anti-calcium treatment, supposed to last longer without needing replacement. and it's made of cow pericardium! now i'm beefcake inside AND out!

i had world nomads travel health insurance at the time...they gave me the runaround....refused to pay for cosmetic surgery, refused to pay for experimental procedures, refused to pay for elective surgery, refused to pay for cosmetic surgery....blahblahblah. so, um, no 5-star recommendation for world nomads from me. was actually critical, valve area had reduced to 0.6cm. when they pulled the valve, it crumbled into 7 wee, tiny, calcified chunks.

was living in china studying at university, flew to chennai apollo hospital, in-patient for about a week, then two weeks at a beach resort to recover, then flew back to china. really good doctor, had done over 4000 procedures. hospital food was most excellent, but the 5 channels of bollywood musicals on the talking box was ungroovy.

total bill including flights and resort was about $12K, put on the credit card. instead of paying it off, transferred to a 0% deal and invested in stocks. recycled over ten years and tripled the money, then finally paid it off.
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Old 07-09-20, 07:56 AM
  #24  
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I think health insurance doesn't work when overseas for an extended period, so I didn't have health insurance for 6 years since I was traveling through multiple countries. I bought travel insurance instead but never really made any claims except for lost baggage. It was around $350 per 6 months. They wouldn't cover preexisting conditions and I think only covers acute conditions, so not chronic or cancer. If you got an injury that spanned 2 different 6 month policies, the injury would not be covered in the 2nd 6 month policy because they would claim that it became a preexisting condition when the 1st 6 month policy expired.
I'm now in Europe for a few years and I think foreigners with temporary visas don't really quality for public health insurance. The private health insurance is expensive. So I bought something marketed to expats which still meets all the local mandatory cover but for only $100 per month with $1000 annual deductable, or excess as it's called in the rest of the world.
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Old 07-13-20, 08:58 PM
  #25  
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Originally Posted by saddlesores View Post
not a problem! barely an inconvenience!

they sell travel insurance that excludes coverage within the usa, which has the most expensivest health care in the world!

how expensive? ten years ago, my $150K in the usa heart valve replacement operation was done in india for $10K...........equal to just the hospital charge for the freakin' valve in the usa! a few years ago, i had minor sinus surgery in china for $1K.......the same charge my sister paid for the same operation in the usa as the 10% deductible.

and now?? my expat health insurance with $1 million cover, including repatriation, costs me about $1250/year. about $100/month, NOT a spring chicken, with lifetime coverage. and being overseas i never got caught up in the obamacare nightmare!

here in chinaland (or in thailand) i can buy insurance from local carriers with reasonable coverage for under $250/year.
Just amazing. BTW I remember the 70's or 80's when USA media did many stories about the "need" to eliminate smaller hospitals: they said if we reduced the "over-supply" of hospital beds that costs would go down but of course that never happened. 3 years ago I mentioned the 80's hospital-reduction push to a friend & said, "What happens if there's a major problem but no "excess" hospital beds?". Now with COVID the media is complaining about lack of hospital beds; of course they give no mention of their role in creating the situation.
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