Health & insurance
Before You Go
The USA offers excellent health care. The problem is that, unless you have good insurance, it is prohibitively expensive. It's essential to purchase travel health insurance if your regular policy doesn't cover you when you're abroad. Even with insurance, you will probably have to pay out of pocket for treatment and then chase up reimbursement afterwards.
- Overseas visitors with travel health-insurance policies may need to contact a call center for an assessment by phone before getting medical treatment.
- Keep all receipts and documentation for billing and insurance claims and reimbursement purposes.
- If you plan on doing any adventure sports (skiing, diving etc), check to make sure insurance covers this – some policies specifically exclude 'extreme' activities.
There are no required vaccines to visit the US.
In Western USA
Availability & Cost of Health Care
- Medical treatment in the USA is of the highest caliber, but the expense could kill you. Many health-care professionals demand payment at the time of service, especially from out-of-towners and international visitors.
- For medical emergencies call 911 or go to the nearest 24-hour hospital emergency room, or ER); in other instances, phone around to find a doctor who will accept your insurance.
- Some health-insurance policies require you to get pre-authorization for medical treatment before seeking help.
- Carry any medications you may need in their original containers, clearly labeled. Bring a signed, dated letter from your doctor describing all medical conditions and medications (including generic names).
You can drink tap water anywhere in Western USA.
- Visitors from lower elevations undergo rather dramatic physiological changes as they adapt to high altitudes.
- Symptoms, which tend to manifest during the first day after reaching altitude, may include headache, fatigue, loss of appetite, nausea, sleeplessness, increased urination and hyperventilation due to overexertion.
- Symptoms normally resolve within 24 to 48 hours.
- The rule of thumb: don't ascend until the symptoms descend.
- More severe cases may display extreme disorientation, ataxia (loss of coordination and balance), breathing problems (especially a persistent cough) and vomiting. These folks should descend immediately and get to a hospital.
- To avoid the discomfort characterizing the milder symptoms, drink plenty of water and take it easy – at 7000ft, a pleasant walk around Santa Fe can wear you out faster than a steep hike at sea level.
Dehydration, Heat Exhaustion & Heatstroke
- Take it easy as you acclimatize, especially on hot summer days and in the desert.
- Drink plenty of water. One gallon per person per day minimum is recommended when you're active outdoors.
- Dehydration (lack of water) or salt deficiency can cause heat exhaustion, often characterized by heavy sweating, pale skin, fatigue, lethargy, headaches, nausea, vomiting, dizziness, muscle cramps and rapid, shallow breathing.
- Long, continuous exposure to high temperatures can lead to possibly fatal heatstroke. Warning signs include altered mental status, hyperventilation and flushed, hot and dry skin (ie sweating stops). Hospitalization is essential. Meanwhile, get out of the sun, remove clothing that retains heat (cotton is OK), douse the body with water and fan continuously; ice packs can be applied to the neck, armpits and groin.
- Skiers and hikers will find that temperatures in the mountains and desert can quickly drop below freezing, especially during winter or if you are canyoneering. Even a sudden spring shower or high winds can lower your body temperature dangerously fast.
- Instead of cotton, wear synthetic or woolen clothing that retains warmth even when wet. Carry waterproof layers (eg Gore-Tex jacket, plastic poncho, rain pants) and high-energy, easily digestible snacks like chocolate, nuts and dried fruit.
- Symptoms of hypothermia include exhaustion, numbness, shivering, stumbling, slurred speech, dizzy spells, muscle cramps and irrational or even violent behavior.
- To treat hypothermia, get out of bad weather and change into dry, warm clothing. Drink hot liquids (no caffeine or alcohol) and snack on high-calorie food.
- In advanced stages, carefully put hypothermia sufferers in a warm sleeping bag cocooned inside a wind- and waterproof outer wrapping. Do not rub victims, who must be handled gently.