Expat health care while traveling without insurance

Last Updated on May 27, 2023 by Ellen

Hey. It’s Ellen. Typing with one hand due to the broken wrist I got in Thailand. Thought I’d share yet more personal experiences with expat health care while traveling. This time, it’s an emergency room visit in one country for a broken bone, and that bone reset by a respected orthopedic surgeon in another country.

If you have ever wondered what a broken bone might cost during international travel — without insurance — this article is for you.

I’m even gonna share an itemized bill from another country! Bet you haven’t seen that too often.

Long-term readers know we Earth Vagabonds have a lot of experience with health care overseas since 2015 – everything from dental work to my double mastectomy.

This time, I was hit by a car (not my fault) in Hua Hin, Thailand, a week before our tourist visas expired. Theo, my husband, previously wrote about that unfortunate experience.

This article details the costs in Thailand, where the accident happened, and Malaysia, where I had the bone reset.

In Malaysia, went to Gleneagles Hospital in Kuala Lumpur. It is a private hospital owned by IHH Heathcare — a giant international company. I had a previous visit at Gleneagles in 2018 with an oncologist I really liked.

Remember: Earth Vagabonds is an independent site, without sponsors or affiliates, and we get absolutely nothing in return for reviews.

Expat health care while traveling: More examples

We didn’t extend our Thailand visas to have my wrist fixed at the Bangkok Hospital branch in Hua Hin. This is mainly because I had a long-desired appointment with that Gleneagles oncologist. I hadn’t seen him in 3.5 years due to the pandemic.

On quick background, I’m a former breast cancer patient who had a double mastectomy for early-stage cancer in Zagreb, Croatia, in mid-2018. That was the third year of our global budget slow travel in early retirement.

My excellent oncologist recommended Dr. Abdul Jamal and two other doctors in the hospital’s orthopedic department.

As luck would have it, or as the Universe guided me, I met with Dr. Jamal who gave me three choices, with three price range estimates.

Broken bone options: expat health care while traveling

I had a relatively rare Barton’s fracture at the end of the radius bone in my right arm.

My options:

1. Plate and screws with surgery, second surgery in nine months to remove them. Estimate: $4,600 – $8,600 (depending on how in-patient surgery went); 95% use of my wrist after short recovery.

2. Reset the break using an X-ray machine during an out-patient procedure (I was put under). Estimate: $1,150 – $2,700 (depending on how it went while I was under); 80% – 90% use of my wrist regained after 4 – 6 weeks in a cast, and another few months of recovery.

3. A cast placed on the arm in the doctor’s office with no reset. Estimate: “Substantially less” (exact amount unknown); 80% (maybe ?) use of my wrist after several months.

Which one would you pick?

Guess which one I picked….

My choice

We have no idea where we will be in nine months, and a second surgery would push that estimate up even more. Option one was out.

In order to try to get more use out of my wrist, I went with option two, as opposed to option three.

Dr. Abdul Jamal understood my reasons. We explained we are budget slow travelers in early retirement. As such, our monthly spending goal is $2,000.

The final bill for the reset $1,450. I was thrilled the bill was at the lower end of the estimate. (Further down, I share the itemized breakdown.)

I am even more thrilled that this doctor took his time to answer all my questions, and ask his own questions about my mindset on each option to help manage my expectations.

Option #2 cost more than a simple set and cast because the doctor used a “live” X-ray machine to align the bone pieces, and because I was under general anesthesia.

I look forward to seeing Dr. Jamal again next month to remove the cast.

Gleneagles Hospital in Kuala Lumpur is nicer than most American facilities I can recall. Seriously. They are so clean and new we felt under dressed in our shorts and T-shirts!

Wrist reset charges in Kuala Lumpur:

• Orthopedic surgeon consultation: $67
• X-ray for above consultation: $29
• COVID test at hospital day before bone reset: $36.50
• Hospital bill for wrist reset (including follow up check with doctor two days later): $1,443

Tap photos below to open each document of the itemized hospital bill in a new window.

Note the last page accounts for the 5,000 ringgit ($1,136) deposit that had to be paid before I went under, which was the minimum charge.

Total: $1,575.5 – in Kuala Lumpur

But wait – there’s more.

Bangkok emergency room bill

My emergency room bill in Thailand was just over 14,250 baht ($400). Plus a follow up doctor visit with another X-ray before we left that country cost another $40.

There was no ambulance needed. The driver who hit me literally knocked me off my bicycle practically in front of the Hua Hin branch of Bangkok Hospital.

I did consider staying in Thailand longer to get further treatment there, which would have been cheaper than Malaysia. But I had my long-overdue oncology appointment, and frankly didn’t feel like navigating the immigration hassle since our tourist visas expired shortly after the crash. Plus, the doctor spoke English, but not everyone else did.

As Theo posted previous pictures and details of that hospital experience, I’ll point you back there for more details.

So how much did this broken bone cost?

$440 (Bangkok Hospital charges), $1,479.50 (Gleneagles Kuala Lumpur bone reset), $96 (KL orthopedic consultation and initial X-ray).

That’s $2,015.50.

It could have been less, as you saw I had options. And Malaysia isn’t the cheapest country for expat health care while traveling – but it is high quality.

What about the Thai driver?

Will we get any reimbursement from the driver or his insurance? I wish — this wasn’t my fault and the experience sucks no matter how ‘nice’ or ‘cheap’ or ‘affordable’ it is.

I have pictures of the driver’s license plates, which are green with white writing. In Thailand, that means he was a tourist taxi driver of some type and is required to carry insurance. But does he?

It has been challenging to work with the police on this — they don’t speak English and rely on a volunteer translator.

All I can do is try to recoup something. We’ll see.

Travel insurance, or no?

These health care examples are meant to give Americans an idea about what health care is like for routine checkups and an emergency such as a broken bone.

I would recommend Gleneagles KL to fellow travelers. Quality doctors and equipment, every word on every bill is in English, accommodating schedule for foreigners like us — though of course you pay for this.

If you have great health care insurance in the U.S., these prices I’ve shared might seem high. More likely, you pay more than this in deductibles every year.

Long-term budget travelers in early retirement who are too young for government entitlements like Medicare, like us, either have to buy pricey insurance policies or have some emergency funds and hope for the best.

Our emergency fund took major hits with my double mastectomy, and now this.

The only time we bought a short-term travel policy was to cover our three months in Vietnam, where we went to remote areas far from any medical care — not even a town doctor.

For now, we will continue to enjoy early retirement around the world on a budget, and pay out of pocket as needed for health care while traveling.

Just know you can’t predict cancer, and accidents happen.

I”ll save my oncology visit and tests for another post.

Thanks for reading, “Expat health care while traveling: More examples.”

Ellen is not eager to go back to Thailand. Earth Vagabonds also had another crash on a previous visit — the fault of a cable company. Initially told by Thai doctors nothing was broken, she later affirmed four broken ribs after a long, painful double-decker bus ride on the top level.

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