A Shot in the Arm and Pain in the Wallet

Back in April of last year, after spending hours researching and creating what I thought was a reasonable vaccine plan (see details here), the time had come to see if I was close. I called Bartell Drugs Travel Clinic (friends in Western WA can email us for contact information) and was lucky enough to begin talking with an amazingly helpful and curious pharmacist by the name of Sharon. She has helped us navigate everything from deciding which vaccines we needed depending on where in each country we expect to be traveling, to getting the longest expiration dates on our prescriptions, to fighting with our medical insurance company. She also offered to help us find reputable pharmacies and sources for boosters while on the road. We couldn’t have dreamed for a better situation. The vaccine schedule remained close to the proposal; however, below is how we fit in all of our vaccines over the past several months.

*The prices listed are the retail costs of the shots, pre-insurance.

  • Hepatitis A & B: April, May, October 2013, $130 per shot, series of 3 shots (Doug needed combo)
    • Incurable and transmitted via water and food. Preventable via vaccine.
  • Hepatitis B: April, May, October 2013, $80 per shot, series of 3 shots (Kristin only needed B)
  • Japanese Encephalitis: February and March 2014 (4 weeks apart), $250 per shot, series of 2 shots
    • Incurable and transmitted via mosquitos. Preventable via vaccine.
  • Polio: January 2014, $45 per shot, 1 shot
    • Incurable and transmitted airborne person to person. Preventable via vaccine.
  • Rabies: January (1 & 2), February 2014 (0, 7, 21 days apart), $275 per shot, series of 3 shots
    • Incurable and transmitted via animal bites which we are particularly susceptible to on bicycles and camping. Preventable via vaccine.
  • Typhoid Fever: January 2014 (every other day), $50 total, 4 doses orally
    • Curable, but likely to be exposed to the bacteria in water and food as we leave Western nations.
  • Yellow Fever: March 2014, $120 per shot, 1 shot
    • Required for entry into many of the countries we will visit.

At our first January visit, our pharmacist informed us that our insurance was no longer covering our vaccines. Back in 2013 when we started our vaccine plan, Aetna covered the Hepatitis A and B vaccines and indicated that they would cover the rest at less than $50 per vaccine out of pocket. This was great! However, in 2014 when we actually started the rest of the vaccines, something had changed. The pharmacist processed the claims exactly the same, but they were not covered. Aetna was clueless and couldn’t figure out what the difference was or why the Hepatitis vaccines were covered and the rest weren’t. The only thing they were clear on was that it wasn’t because of the Affordable Care Act. We ended up working with our pharmacist to dispute the original denial of coverage for the 2014 vaccines. This provided some refund, but we spent far more than we were planning.

  • Total billed for all vaccines and prescriptions: $3,825
  • Amount reimbursed by Aetna insurance: $2,063
  • Amount we owed out of pocket: $1,737

As for prescriptions, it is easy to forget that there are doctors and hospitals around the world that can help us. So, we are only bringing a few prescriptions that we’ll reserve for emergencies.

  • Amoxicillin – anaerobic antibiotic for dental abscess emergencies.
  • Ciprofloxacin – aerobic antibiotic for any infections.
  • Vicodin – strong pain killer, mainly for dental emergencies, but can be used for any severe pain when Advil isn’t enough.
  • Chewable aspirin – precautionary for any heart attack symptoms.
  • Syringes with needles (4) – precautionary for a medical clinic where new needles aren’t the norm. Our pharmacist put these sharps in a separate Ziploc bag with a prescription attached so they are not mistaken for drug paraphernalia.

The first aid kit has remained fairly unchanged from our original thoughts, with a few exceptions.

  • Alcohol Swabs – Replaced with Povidone Iodine which kills the same bacteria as alcohol, but also is far more effective in cleaning a bite from a rabid animal.
  • Emergency Blanket – Eliminated. We’re carrying winter clothes, gloves, sleeping liners, and comforters; enough to keep warm in an emergency.
  • Mosquito Net – Delayed purchase. We don’t want to be carrying something that we’re sure we won’t need for over a year.
  • Permethrin (insecticide for clothing) – Delayed purchase. Same reasoning as for the mosquito netting.
  • Super glue/Dermabond – Replaced with QuikClot.

So, overall, we feel that we are prepared for what we are likely to face without weighing ourselves down with too many “just in case” and “what if” items.

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About Us

We're Doug & Kristin Walsh, a couple of Washingtonians who love to travel, both abroad and in the wilds of the Pacific Northwest. We set off to travel the world in 2014, primarily by bicycle. We're back home now, but the travel bug continues to be fed every chance we get.

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