Adulting is Hard: Vaccines and Insurance

It’s not all fun and games, this travel planning business. Before we figure out all the hotels and places to stay we need to get some dollars and sense in order around some difficult adult decisions. After losing my job I’ve been tasked as the primary individual in figuring out a few key parts to our adventure:

Which vaccines to get? How do you interpret a “recommended” from a “required” vaccine to know which you really need?
Where to get said vaccines?
Which travel insurance to get?
How does the Affordable Care Act work for travellers like ourselves? Do we need insurance in the US when we won’t even be here?
What about my car insurance? Keep or remove?

The further I go down this rabbit hole the more I realize there are no right answers to any of these questions. It’s not that there isn’t advice. Let’s start with vaccinations. There’s plenty advice, it’s that we don’t know what our best option really is. Spend over $1,000 on vaccines in the states prior to leaving? Spend about $40 in Bangkok when we get to an area that actually has the diseases, thus saving money but perhaps creating a medical disaster? Risk getting some, but not all, vaccinations (some are required, many just recommended)? Vaccinations can have serious side effects (limb paralysis that lasts for months is something I’ve heard of more than once), but the risks seem to be far fewer than the actual diseases that they can prevent. All of this on top of a twisted healthcare system in the US that 1. won’t pay for my vaccines via my insurance and 2. sends me to a “travel clinic” that is going to sell me a bill of goods that I can’t trust. I’m flustered by it all, to say the least.

Navigating the Affordable Care Act (Obamacare) is no better. The rule we’ve found is that if you’re out of the country 330 out of 365 days you’re exempt from health insurance. Our plan was to be out of the country for ~275 days, or over 9 months. Unfortunately, from the looks of it, we’d be paying a $1,200 penalty for opting out of insurance we won’t use or paying for insurance we can’t use. Due to the fact that I made a decent salary this year I’m damned if I do and damned if I don’t.

What would make this easier is if we could just use the international health insurance that we plan to get to cover our ACA needs. However, since the international insurance can’t meet all of the ACA requirements we can’t use it. So, we’re damned if we do and damned if we don’t. We are, by the way, getting the insurance, but it would be so much easier if we could just come back on our terms instead of Obamacare’s terms.

Lastly, my car. My precious car. I love her dearly, she’s been a trooper since 2008 and really treats me well. That said, it’s $362 for 6 months of insurance coverage for me not to drive it, or $724 per year. Since the ACA has determined I need to be out of the country for 11 months, this is basically the length of time I need to insure the care for without a presumed driver. Why keep it on the road? To make sure it doesn’t rot away. I’m not convinced that will happen. Now, the cost benefit analysis comes in of figuring out how much it will be in damages if I do nothing versus if someone drives it periodically. Again, how I don’t have a right answer here is that no one knows for sure what that cost would be. Could be a few hundred or a few thousand or nothing at all. It’s a gamble both ways.

We’re navigating these waters, like new sailors on a river we’ve never traversed before. We’re not even out to sea yet and it’s rocky. The purpose of this trip is to head toward paradise. I just hope we don’t sink before we get there.