A Tale of Two Students

This is the true story of Jane and Kathy, who are roommates going to Nicaragua for a semester abroad. They were advised to go to a travel clinic prior to departure. Jane is trying to save money and since most travel clinics don't accept insurance she went to her primary care provider. Kathy came to our travel clinic and got a statement to send in to her insurer for possible reimbursement direct to her.

Jane received a hepatitis A vaccine (cost $95 plus $30 to administer the vaccine) and got prescriptions which she filled at her pharmacy for Lariam for malaria ($204) and oral typhoid vaccine ($65). She paid her $25 copay for the visit and was told they would submit it to her insurance.

Kathy got a hepatitis A vaccine ($85 and we don't add an administration fee) and oral typhoid vaccine($66) that was packaged in a small Styrofoam cup with ice and a lid to keep it cold until she got home. She filled a prescription for choroquine for malaria ($85) at her pharmacy.

Jane said nobody told her to refrigerate her typhoid vaccine which she had left out. She looked at the small box and there was a sticker that said refrigerate it but she didn't see it. She called the pharmacy who said the vaccine was no good and they couldn't take it back or replace it. She would have to call her PCP for a new prescription and have to pay for it again.

She asked Kathy why she had a different malaria prescription. Kathy said she was told this one was less expensive and safer for someone with a history of depression. Jane is taking an antidepressant that she gets filled through her mail order pharmacy. She called the pharmacy again and asked about Lariam and depression and was told said she shouldn't take the Lariam and to call her PCP. Lariam was not returnable or refundable.

She called her PCP who agreed that Lariam might cause problems for her and that she could have a prescription for choroquine. Her PCP doesn't usually write prescriptions for malaria prevention.

Jane was not happy. She was out $270. Then she got a statement from her insurer saying that her travel visit and hepatitis A with her PCP was not covered due to her deductable and she owed them $250 less her copay. Her total cost now is up to $605.

Kathy however spent $283 for her visit and $85 for her prescription for a total of $368. Going to a travel clinic first? Less expensive, less aggravating and you get the benefit of expert travel advice.


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Get It Together Before You Go

Perhaps the most stressful part about traveling is getting everything ready before you go. Keep a checklist in a document file that you can refer to before each trip so that you will worry less about forgetting something essential.

Use a document neck holder in the airport or train stations, so that you can have both hands free but keep your travel documents safe and readily accessible at all times. Choose a wallet just for travel that is small enough to carry only essential items. Think about preventing pick pockets and keep your wallet in your front pants pocket, around your neck or in a purse slung across your shoulder.

What I need to bring

Tickets- air, bus, and/or train
Passport and any travel visas
Travel /health insurance information
Copies of my passport, Visas, and extra passport photo kept separate from originals
Driver’s license (even if you aren’t planning on driving – it’s a back up photo ID)
Copy of itinerary, address, phone number for inside your luggage tags
Send yourself an email with your itinerary, medical history/medication list, passport number, and emergency customer service numbers for your credit card company
Confirmation documents for hotel, activities, etc.
Photocopy of any essential prescription drugs you take
Copy of your eyeglass prescription

Take only the essential items from your regular wallet. Take only the credit card(s) or ATM card that you will need for this trip. Leave everything else at home.

Once you make this list, it will be a time saving tool you will use over and over again.

Costa Rica - A Snap Shot

Are you looking for a great vacation in an exotic locale with stunning natural beauty, miles of pristine beaches, wildlife, snorkeling, kayaking, nature walks and even zip lining through a tree top canopy? Check out Costa Rica.

We arrived in San Jose and spent 2 days in Monteverde in the cloud canopy. Walking on the suspension bridges through the rain forest made you feel small in the lush greenery but one with it all. The smells of moist ferns, the sound of howler monkeys in the distance and the touch of rain- vertically and horizontally were exhilarating.

Then we boarded the Pacific Explorer in Los Suenos and spent the next 10 days cruising the Pacific coast, visiting national parks, deserted islands, botanical gardens and transited through the Panama Canal under the guidance of four highly educated naturalists. We swam, snorkeled, hiked, and took photography walks with Dennis Finn, a professional photographer, who helped us see this beautiful place through light, color and composition. My point and shoot camera never pointed and shot so well!
Costa Rica is clean and the food fresh and healthy. We had our hepatitis A shots and prescriptions for ciprofloxin to be prepared for traveler’s diarrhea. We used 30 % DEET to prevent mosquito bites but didn’t need malaria prophylaxis. We actually saw very few mosquitoes and bugs in general. I did get a bite in the water that might have been a small jelly fish and used After Bite Extra right away and it worked instantly. Most everywhere we went people spoke or understood English or my limited Spanish.
So consider Costa Rica. Check with your local travel clinic to see what you would need as it will vary based on your exact itinerary and planned activities. Pura vida!