3 steps to avoid health care hassles on vacation

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By TOM MURPHY, Associated Press

Five hospitals sit within an easy drive of my Indianapolis home. It's comforting to know, considering that my wife will deliver our second child in late August.

But that information will become temporarily useless next month when we take our annual family vacation to Holden Beach, N.C., a strip of Atlantic Ocean sand about an hour's drive from even a small city. The lack of beach-side maternity services won't keep us from making the trip. It just requires planning and prudent steps that doctors recommend for all travelers, regardless of whether they are great with child.

Here are some health care considerations to think about before hopping in a car or plane for your summer vacation.

1. DO A LITTLE RESEARCH

If you're staying somewhere for more than a few days, do a quick Internet search to learn what health care help might be available, especially if you have a medical condition. In our case, a new medical center with birthing rooms and a nursery is located roughly 30 minutes inland from the beach house if the baby comes early.

If time and my wife's contractions allow us to drive farther, we might be able reach a hospital in Wilmington, N.C., that provides a neonatal intensive care unit equipped to handle premature babies.

It's not enough to just know what's available. Know which hospitals are in your health insurer's provider network. Costs can pile up quickly for care outside the network.

Depending on the plan, a patient may have to pay a separate deductible. You also could pay a higher co-insurance percentage. That's the amount of the bill leftover after the deductible is met.

On top of all that, the doctor or hospital can bill patients for the balance between what they charge and what the insurer pays, something they can't do for in-network care. All this can add up to thousands of dollars in extra expenses.

Big insurers like UnitedHealth Group Inc. or Cigna Corp. maintain national provider networks, but don't fret if you have coverage through a small insurer. Check to see if they offer the use of a larger insurer's network under certain conditions.

Most insurers have a smartphone app that can find in-network health care providers in a pinch. You can also try calling the phone number on your insurance card and wading through the automated voice system for help.

2. PACK SMARTLY

Make sure your prescriptions are updated and filled. Bring more than just the medicines or vitamins you take daily. Include things like an inhaler if you have occasional bouts of asthma or Benadryl if that's your go-to treatment for an allergy flare-up.

Bring a form with your medical history if you have an ongoing or chronic condition, allergies or something unusual like a rare blood type. 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.

You may also want to bring your doctor's contact information and a list of medications with specific doses. Patients with heart conditions also should pack a copy of results from their latest electrocardiogram, or EKG, which measure a heart's electrical activity.

My wife's form might include a summary from her doctor detailing how the pregnancy has gone so far and how the last one went with our first child. Any complications like a C-section should be noted in a summary like this.

Aside from that form, we're also packing an infant car seat and base, just in case.

3. AVOID WAITING TOO LONG

Don't let your desire to relax and have fun on the vacation prevent you from acting quickly if necessary.

Seek emergency care immediately if you have a history of heart problems and wake up one morning with chest pain, if you have a terrible headache that leads to blurry vision or if you have signs of a stroke like a sudden numbness on one side of the body.

At the very least, ask the hotel's front desk for the phone number to a local emergency room. Many have a nurse who can offer advice.

Don't worry about finding an in-network provider if a serious emergency hits on vacation and you haven't done this research. But Cigna spokesman Joe Mondy recommends contacting your insurer after you are stabilized to let them know what happened and steer clear of future billing complications.

If your problem isn't urgent, seek other options beside an ER trip that can sock you with a $150 co-payment. Drugstore health clinics can handle relatively minor problems like the flu or a sinus infection. Urgent care centers frequently are staffed by doctors and can offer a deeper level of care by handling some broken bones or lacerations.

Dr. Shay Bintliff has treated tourists for years as an emergency physician in Hawaii, and she's seen many patients wait too long before seeking help because they don't want to interrupt their hike up the volcano or day of sunbathing.

The consequences from waiting too long are obvious when a woman goes into labor. Not so much if you scrape your skin on coral.

If the scrape becomes red and swollen, that could be a sign you have a methicillin-resistant staph, or MRSA, infection. Bintliff said she's seen patients die or lose limbs due to these severe infections.

"When you've spent all the money people spend to come all the way to Hawaii, and you have all the wonderful things you want to do, sometimes good sense doesn't take over," she says.

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