WASHINGTON -- An international vacation typically involves months of advance planning, from renewing passports to finding flights and booking hotels. But even the most carefully planned itinerary can be knocked off course by an unexpected health problem.
If you're traveling in a country where you don't speak the language and your insurance isn't accepted, even a basic errand like filling a prescription can become a complicated ordeal.
Last year nearly 61 million Americans traveled abroad either for business or pleasure, with trips peaking at 6.8 million in July, according to the U.S. office of Travel and Tourism Industries. The most popular overseas destinations included Europe, the Caribbean and Asia, which together accounted for nearly 80 percent of all trips outside North America.
Here are some tips on getting the medical care you need, no matter where your travels take you:
PRESCRIPTIONS: Travelers who rely on a prescription medication should plan on doing some extra research and planning before traveling outside the U.S. Generally, it's far easier to bring an ample supply of medication from home than to try and get it refilled overseas.
If you're going to be traveling for a few weeks, for example, most pharmacies will give you an extended supply of medication if you show them your travel itinerary. All prescriptions should be kept in their original bottles that clearly display your name. This is important when traveling through foreign customs where your baggage may be searched.
"Generally speaking, any medication that is prescribed to you must be identified as such and be in the properly marked bottles," said Dr. Sal Pardo, vice chair of emergency medicine at the Long Island Jewish Medical Center. "That's the most reasonable and fail-safe way to travel with medicine."
If you have any kind of narcotic-based pain medication, for example codeine, you may want to check with the U.S. embassy in the country you're visiting to make sure the drug is not considered illegal. A listing of embassies and consulates is available on the Department of State's website at http://www.usembassy.gov/.
If you lose your medication or need a new prescription abroad, most pharmacies will honor a fax or email from a U.S. physician. However, some countries do not even require prescriptions for common medications. In Mexico, for example, antibiotics, pain medications and other common pharmaceuticals are dispensed at the pharmacy without a prescription.
DOCTORS: Sometimes you'll need more than a prescription refill to get your trip back on track.
Let's say you're swimming on a beach in Ecuador and get stung by a jellyfish. A small rash develops into a larger infection and you want to find an English-speaking doctor who can diagnose the problem and prescribe the best treatment. Your health insurance does not cover overseas travel and your Spanish is limited.
Fortunately there are several organizations that offer free help finding qualified physicians.
The American Board of Medical Specialties keeps an authoritative directory of board certified doctors around the world. They even have a toll-free number: 1-866-ASK-ABMS.
Another group, the International Association for Medical Assistance to Travelers, maintains an online database of licensed, English-speaking doctors in 90 countries: http://www.iamat.org/doctors--clinics.cfm.
If you don't have access to the Internet or a phone, most major hotel concierges keep a list of English-speaking doctors in the area. In some cases, they'll have a doctor on call who can see you in your room.
Doctors recommend that travelers with chronic conditions, allergies or rare blood types bring a form with their medical history. The American College of Emergency Physicians offers a medical history form on the website www.er101.org, and your doctor can help you figure out what to include.
This is something you will want to keep in your wallet or purse, not in the luggage that stays in your hotel room.
INSURANCE: Most government and employer-based health plans do not cover medical care overseas. For this reason, many travel agencies recommend customers purchase some sort of travel health insurance.
Along with covering the cost of canceled trips or travel delays, companies like Travel Guard, http://www.travelguard.com, provide a range of health coverage options, from basic medical expenses to medical evacuation.
Depending on the country and the condition of the patient, an international medical flight can cost $50,000 or more, making an insurance policy a smart financial decision. Adventure travelers who face a serious risk of harm can even be covered for the repatriation of dismembered limbs and other remains, according to Laurene Taylor of Liberty Travel, a New York-based travel agency.
Travel insurance prices vary depending on the cost of the trip and the age of the travelers. For example, a 30-year-old traveler purchasing coverage for a trip that costs $1,500 might pay $80. But a 70-year-old traveler on the same trip would pay $160.
Dr. Pardo recommends such policies for both older patients with established health issues and younger patients.
"Most of the time the people who get into trouble are those that don't think about it: the young, healthy group that travels abroad for three months and can't anticipate anything ever going wrong," Pardo said. "Suddenly they're in a situation where they really need these services."