Day 20: The Tale of the Broken Tooth

At around age 12, Jason fell off his bike and chipped his two front teeth. He went to the dentist and had them filled and that was the end of it. Until 2016.

We have a great dentist in Campbell, California and her name is Dr. Ho. If you need a dentist, look no further – just don’t expect to get a same-day (or even same-week) appointment. So when one of the fillings fell out of Jason’s front tooth a mere two days before we were to leave for the British Virgin Islands in April, it was an issue. With Jason concerned he’d need a root canal if he left the inside of his tooth exposed for over a week, he called about a dozen San Francisco Bay Area dentists before finding one that could take him that afternoon. The timing of it was inopportune to say the least, but thankfully, it was an easy procedure and all was well.

Fast forward to last Wednesday: Jason and I were sitting in our room in Hualien, a relatively remote area of Taiwan. The town only recently got a highway built to it so travelers could reduce the drive from Taipei from seven hours to three hours. We were based there to see the nearby Toroko National Park and had planned to continue our circumnavigation of the island the following day with a long train ride to Tainan. It was about 10:00 pm; Jason was sitting on the bed, and I was sitting on the couch when I heard “uh oh.” I looked up – the filling in his other front tooth had fallen out.

At that point we tried to figure out our best plan for Jason getting seen that next day. We have good travel health insurance and while I was pretty sure we weren’t going to reach our deductible with one filling, they have a great online resource for finding well-educated, English speaking doctors almost anywhere in the world. Unfortunately however, they only had one dentist listed in Taiwan, Dr. Jackson Liu, and he was in Taipei, a three-hour train journey in the wrong direction. This was important though, so even though it was late at night, I sent them an email requesting an appointment for the following day. We also did a bit of research online and found a couple other good English-speaking dentists, both in Taipei, that we had planned to call in the morning if we didn’t hear back from Dr. Liu. At that point, we realized that we would no longer be going directly to Tainan, and instead would be returning (temporarily) to Taipei in the morning.

All of this had taken about two hours to hash out. We were prepared with our list of dentists to start calling when we woke up, but luckily, there was no need! Dr. Liu’s office, called DentistQ, had emailed us back around 6:30 am and confirmed an appointment for 1:00 pm. We packed up quickly and took a cab to the train station. We purchased tickets from the window for the next train to Taipei, leaving at about 9:00 am.

With only about 20 minutes to spare, we arrived at DentistQ following a bus ride from the train station in Taipei. Had we missed that 9:00 am train in Hualien, we would have been late. The receptionist spoke limited English, but we filled out a form that was (mostly) translated. At around 1:15 pm, Jason was taken back for about an hour, while I watched a TV show on my laptop in the lobby.

Jason returned with his tooth looking as good as new! He said that the whole visit went smoothly and that the doctor’s English was very good. At his suggestion, I took a peek into the office, which looked more modern than our dentist’s at home. A few minutes later, they handed us an invoice for $5400 NTD, or $175 USD. They only took cash, but we were prepared, so we paid and left.

I spoke to GeoBlue, our travel medical insurer, and we’ll be sending them the invoice to apply our payment toward the deductible. I can’t give a real review of them just yet, but they were quick to pick up the phone and offer lots of help, even though it was the middle of the night for them in the US.

And there you have it, our first real medical issue while abroad. While initially there was some anxiety about who to see and how to get an appointment, it resolved relatively painlessly – in all regards 🙂

Day 15 – Long-term Travel and Healthcare: Why it’s so hard to find answers online

If I hadn’t told my dad I was writing this post Wednesday night, I would be wondering if I had dreamed up the coincidence. Healthcare while traveling is a complicated topic that few bloggers write about, so I thought it would be a good resource for others if I went ahead and shared the decisions we made – and then Jason’s tooth broke a few hours later. So, let me tell you first how we prepared for something like this – and then in order to avoid making this post a novel, I’ll write about Jason’s dental work in another post 🙂

If you’ve decided to quit your job and give up your home like we did, you probably have questions about healthcare and health insurance. You probably have asked Google what to do and not found many answers. My husband and I just left the US about two weeks and this was the single most complicated issue we dealt with when preparing for our trip. I started seriously researching it the first week in December and we finalized things on January 13th, so it took about six weeks. Despite not leaving until three weeks later, on February 4th, we still missed the delivery of our US health insurance cards by about a week – that’s how close we were cutting it without even realizing it.

(Please know this isn’t advice and you should do your own research before you make any final decisions. This is simply what we learned and the choices we made based on our individual circumstances. Also, I don’t receive any benefit for you choosing the companies mentioned in this post.)

I’m going to go ahead and make the assumption that you’ve already decided you want access to healthcare and health insurance for your trip. Not carrying health insurance is irresponsible because even the healthiest people could be the victim of a hit-and-run scooter or need to have their appendix removed. Stuff like this can be complicated and expensive if you don’t have the resources when you need them. In some areas of the world you won’t even receive treatment until you can prove that you can pay for it.

Jason and I carry two policies. Our US policy would cover us when we decide to return home or if we experienced a medical situation so serious that we’d want to be treated at home, like cancer or an injury with a long recovery time. Our travel medical policy covers us for stuff that happens while traveling, like a broken ankle, infected cut, or illness like Dengue Fever.

If you will be out of the US for more than 330 days in a year, you can purchase a single policy. However, because those plans are not ACA (Obamacare) compliant, we’d also be paying a significant fine since we are planning to be in the US more than 35 days this year. I’ll write a bit more on this further down just in case this applies to you.

Our US policy – Sutter Health Plus Bronze – pricing based on age & zip code, we pay $340 for each of us per month.

During the early planning of this trip, we assumed we’d go on the ACA Covered California website, indicate that we were not making any income this year, and be allowed to purchase a policy with a reasonable subsidy. Turns out this is absolutely not the case. If you tell Covered California you are not making any money, they will put you on Medi-Cal, which is the free health insurance for low-income Californians and not appropriate for Jason and I. We are happy to pay for our insurance and also wanted to keep our doctors. I tried having them adjust our income up to about $25,000 a year to bump us out of Medi-Cal, but they require proof of income, like an offer letter or last year’s W-2, so that wouldn’t work for us. Eventually we came to realize that we weren’t going to be getting any subsidy and started looking outside of Covered California for more options. The cheapest plan on the exchange was about $250 pp/pm, but it was a Kaiser plan that would require us give up our doctors and the cheapest with our doctors in network was a Blue Shield plan for $415 pp/pm.

Our doctors are at Palo Alto Medical Foundation, part of the huge Sutter Health system, and with a little bit of research, we found that Sutter has their own HMO, Sutter Health Plus. This was going to be the least expensive option to keep our doctors and similar to the Covered California plans, they offer four plans: Bronze, Silver, Gold, and Platinum. We went the Bronze plan for $340 pp/pm. While the Silver would have been our choice if we were staying local, we are not expecting to use this insurance plan very much and wanted to spend as little as possible.

Send me an email if you’d like our broker’s contact information or you can read more about the plans at this link: http://www.sutterhealthplus.org/about/PDFs/B-17-001%20SHP%20IFP%20Plans%20ADA.pdf

Our travel medical policy – GeoBlue Xplorer Select – pricing based on age and maybe zip code, we pay $133 for each of us per month.

Shopping for travel insurance can be confusing. I suggest you start by asking yourself “what am I actually looking for?”

Are you looking to be reimbursed for your trip if you can’t go due to injury or illness? Are you looking for money to help replace luggage if it is lost? Are you looking for rental car coverage? Are you looking for help rebooking cancelled flights?

When you’re taking a shorter trip, one where time is a limiting factor, you probably want these benefits. However, Jason and I don’t and didn’t want to have to pay for them. What we did want was rock solid health insurance that would cover medical issues (both emergencies and non-emergencies) and not try to send us home as soon as possible to then be covered by our US policy. What we realizes we were actually looking for was closer to ex-pat health insurance than the usual travel insurance.

We found GeoBlue both through an insurance broker recommended by our financial advisor (even though she doesn’t sell it) and also suggested by a cruising couple I met on a sailing Facebook group. These are several plans to choose from based both on length of your trip and whether you are keeping US health insurance or not. We have the Xplorer plan – their ex-pat plan for trips longer than 6 months. The Xplorer has 3 options –

(1) Select – this is our plan. It does not cover you in the US AND you must have US health insurance to qualify for it. This plan is for people like us that are planning to be in the US more than 35 days this year.

(2) Essential – this plan will not cover you in the US, but you don’t need US health insurance to qualify. Essentially, this means you are not planning to go to the US for a visit or for treatment of a serious injury or illness.

(3) Premier – this one DOES cover you in the US, but does not meet ACA minimum requirements. This plan would work for people who will be in the US fewer than 35 days a year AND would be willing to pay the ACA fine if you overstayed that limit.

Send me an email if you’d like our broker’s contact information or you can read more about them at this link: https://www.geobluetravelinsurance.com/products/longterm/xplorer-5-overview.cfm

FAQ:

I’m sorry this post got to be so long! Let me try to wrap it up with some questions we’ve been asked and some answers we received –

Q: So you only have travel medical insurance? What about insuring your stuff?

A: We have insurance on our laptops because they are the only really high value item we carry with us. We have a State Farm Personal Articles policy that covers both of them. If it covered cell phones, we’d include them too, but State Farm won’t allow it. Our clothing and other smaller electronics are not insured.

Q: What about cancelled/delayed flights?

A: Since Jason and I have a completely flexible timeline for this trip, we don’t mind waiting an extra day or rerouting to reach out destination.

Q: Does our travel medical cover EVERYTHING?

A: No – it has a 6 month waiting period for pre-existing conditions and it has limited coverage for some extreme sports. Because of this, Jason and I have DAN insurance for scuba diving (and if you dive, you should, too.) Also, if you hurt yourself doing something stupid, most (all?) travel medical plans reserve the right to refuse coverage.

Q: Do I need a travel medical policy if my credit card provides travel insurance?

A: Generally yes, if your trip is longer than a certain number of days. For example, our Chase Sapphire Reserve cards limit trip insurance to trips 60 days or shorter.

Q: Should I skip US health insurance and just pay the ACA fine because it’s cheaper?

A: Probably not, because most travel insurance plans I’ve found (like World Nomads) require you keep US health insurance OR pay for their plan that includes US health insurance (like GeoBlue Xplorer Premier.) If you are thinking about applying for the GeoBlue Xplorer Essential, ask yourself where you’d want to to be treated if you were diagnosed with something very serious, like cancer. Probably near your family, right?

Q: Can I be denied travel insurance due to my medical history?

A: Yes, because they are not held to the same requirements as ACA plans in the US. Jason and I had to fill out an application that included several medical questions, including one that was something like “have you ever been diagnosed or treated for anything not listed in the questions above?” However, I will tell you that I am obese by BMI and have mild asthma and was approved with no premium increase, so they are not looking for small reasons to deny you.

Q: When applying for US health insurance, what address do I give?

A: At first we were told that Sutter Health will not provide us with insurance if we would not be physically present in the state of California. I had to call them directly and speak to a supervisor to explain our situation. The ACA dictates that we had to keep insurance, so if they would not insure us, who would? I was put on hold, and then the supervisor confirmed that we should provide our current address at the time of application (we were still living in our apartment in California) and then could change our address to the mail service later.

Q: This all sounds great, but it’s too expensive for me. What’s the least I can spend and still be pretty well covered?

A: This was a question that was added after I wrote the blog and to be honest, I only have a vague suggestion of where to start. If you live (or are leaving from) Santa Clara County, I am pretty sure Kaiser Bronze HMO will be your cheapest plan. For us at age 32 and 33, it would have cost about $225 a month each. For travel insurance, check out World Nomads. This company is recommended by a lot of backpacking and low-budget traveler blogs I’ve read, but the reviews on actual claims are somewhat mixed. I’ve heard the cost is between $50-75 a month, depending on if you want extreme sports covered. This means the total cost would be around $300 a month for both – not too bad considering the consequences of skipping coverage!

If you have any other questions, let me know and I’ll add them!

I hope this post was helpful. I tried the write the post we were looking for when we started doing this research 🙂

Happy travels!

Day 11 – Sky Lanterns!

When I was asked why we were going to Taiwan first, I usually answered for the food. We had loved what we’d seen of Asia so far, the weather in Taipei would be good (at least for us – we like it cool,) and the food was supposed to be outstanding. But there was another reason – I really wanted to see the Pingxi Sky Lantern Festival, which is the 2nd largest launching of sky lanterns in the world and the timing was right.

There was some anxiety in getting there and seeing it – Taiwan has less English signage than we are used to and we knew public transit wouldn’t be as dependable for the festival – there would be just too many people going. Add to this to the fact that it’s outside of Taipei city and we didn’t know what to expect, especially because Google Maps has been less reliable here than we’re used to.

Luckily, there was nothing to worry about. The logistics and preparation put into this by the festival planners was amazing. The staffing was unlike anything we’ve seen before. It was suggested to us that we avoid the train and take special busses from the Taipei Zoo MRT (subway) station and when we stepped off the metro and onto the platform, there were already staff directing us where to go. We then followed signs (in Chinese and English!) that were placed no more than 50 feet apart to a line of people waiting for the bus. There was a shorter line if you were willing to stand for the 45 minute journey, but we had plenty of time, so we waited for a seat. We knew we’d be standing most of the afternoon and evening after the bus ride.

When we arrived to Shilin (the festival is actually in the town next to Pingxi) we walked to the Old Street with the food and souvenir vendors. As we watched several people launching lanterns individually, we ran into our Danish friends from a tour earlier in the week! What are the odds – there were thousands of people there! The four of us walked and snacked for an hour or so and wound up splitting up about a kilometer from the big launch site – they didn’t want to have to wait in a massive bus line on the way home and were happy to have a far away view. Jason and I wanted to get up close and were prepared for the bus line so we said our goodbyes.

Jason and I joined a crowd of people outside of the official launch field – you needed to have a ticket to get in and actually launch at the festival. We watched the first three launches and the entertainment in between, including a dragon dance and a pop band singing in (heavily-accented) English. We had a great time and honestly watching the launches was breathtaking – especially after it got dark.

The line for the bus back was long, but it kept moving. Again, so much work was put into the logistics that it was impressive. There were not standing/sitting lines on the way back, they just packed the busses and you got a seat if you were young or old. Jason and I stood on the way back both on the bus and then the MRT train, but we had expected to. I’ve been trying to find an estimation of the crowd, but can’t seem to – if anyone knows how many people were there, please let me me know.

Anyway, here are some pictures and videos! If you have a chance, I’d totally recommend going!

Day 4: Chinese Lanterns – The school project you’ll be glad you’ve never heard about

For months I’ve been promising pictures and finally I’m able to deliver. On Monday, Jason and I did a free walking tour in Taipei and stumbled upon a lantern competition near Ximeding during the 3 hour walk. I snapped a pic of the nearest MRT stop as we walked by it and made a mental note to return later. The guide said the lanterns would be spectacular at night – and she wasn’t kidding.

The lantern competition is divided up by age and they also have categories for teachers, families, and companies. The first competition takes place at the school level where they select which lanterns they will display for the public. The names of the artists are displayed on a tag for every lantern and the winners will be chosen on Saturday. But really, aren’t the winners all of us who get to enjoy them?

So without further ado, here are what I feel were some of the highlights. It is now the year of the rooster for the Chinese zodiac so that’s a reoccurring theme in many of the lanterns –

I posted this one first because it has a bit of a funny story – We were walking through the display with a Danish couple we had met on the walking tour, making little jokes about some of the lanterns (mostly about how most of the elementary ones were clearly worked on by adults.) At the peacock I said something like “wow, this is my favorite so far” and then the guy said “of course it is, it’s by the American school.” Honestly, I had not noticed but we all laughed really hard!

        

Jason and I have REALLY been enjoying Taipei so far – especially the food. More to come on that later.

Today we sat down and tried to figure out what we will do on Monday, since Sunday is our last night at this apartment. I was surprised how difficult of a decision it is when you have literally no limiting factors. We still don’t know, but will have to figure it out soon!

Thanks all for reading!