Two EMS parademics assisting an individual on a stretcher into ambulance during ahealth crisis abroad

Navigating An Expat Health Crisis

We boarded the plane to the Dominican Republic with eagerness and excitement. We shipped almost everything we owned to the apartment we rented in La Vega, DR. Our friends lived in the same building. Our plan was to stay in DR on our 90-day tourist visa provided via our US passport. Upon arrival, we discovered that the Dominican government had changed residency requirements. We decided it was best to retain an attorney to start the residency process that would allow us to stay in the country for more than 90 days legally. To beat the holiday traffic, my husband left our apartment on December 31st at 8 am to go to the bank to send payment to our attorney in Santo Domingo.

During the week, we had purchased our appliances, and there were still many boxes to unpack. I got to work unpacking and organizing our kitchen. I remember thinking around 11 am that he should be back soon. Around 40 minutes later, I received a call from my friend. My husband had been in an accident, and he had been transferred from the public hospital to the trauma hospital located outside of the city.

Since I had managed benefits as an HR professional, I knew it was imperative to maintain health insurance in the US because the quality of care did not meet our personal standards in the Dominican Republic. How glad I am that we had a plan in place. The best way to navigate a health crisis abroad is to plan ahead.  

How to prepare before a health crisis hits:

Health care costs. Stethoscope and calculator symbol for health care costs or medical insurance
  • Designate a representative with a health care power of attorney in the US. This will allow the person to make decisions and arrangements for you in your home country if you are unable to do so if you must return home.
  • Ask a local friend to serve as your emergency contact.
  • Prepare a document in the local language and your native language identifying:
  • Your local emergency contact and contact information.
  • Your designated health care representative in the US and contact information.
  • List of medications you take and your most recent vaccinations.
  • Identify any allergies or chronic illnesses you have.
  • Keep a copy of your most recent passport with this document.
  • Keep this document on your person.


  • Provide your health care power of attorney representative with your local emergency contact’s information and vice versa.
  • Provide copies of your insurance policies to your health care power of attorney representative.
  • Have a credit card or an easily accessible emergency cash fund to pay for emergency care. If you do not have local healthcare coverage, you will most likely have to pay for your medical care in full before leaving the hospital.
  • Update your vaccinations with your family doctor before leaving the US.
  • Keep your family and friends locally and abroad updated on your location.
  • Maintain a travel insurance policy that will cover an emergency caused by a pre-existing condition or accident in your new country until you have access to local healthcare.
  • Purchase an emergency medical evacuation policy. Without such a policy, an emergency medical evacuation event can cost up to $50,000 per Allianz Travel Insurance.
  • Check if your life insurance company will honor your policy in the case that you pass away while living abroad.
  • Inform your immediate family of the decisions you have made. They should know your designated US and local emergency contacts and how to contact each person.

Many US citizens assume that the US embassy will care for them in the case of an emergency. The US Department of State says this on their website “If you or a US citizen loved one become seriously ill or injured abroad, we can:

Assist in locating appropriate medical services.

Inform your family or friends, with your permission.

Help transfer funds to the US citizen overseas.


We do not pay medical bills. Payment of hospital and other expenses is the patient’s responsibility.”

It is best to put a plan in place that best suits your desires and designates people you trust to represent you.

Thankfully, my husband and I had discussed the possible worst-case scenarios. He spent three months in a Miami hospital. By putting a plan in place, we were able to avoid astronomical medical bills.

Remember, it wasn’t raining when Noah built the ark. Take the time to make a plan. You will have less decisions to make and it will be easier for those who care about you to help you in your time of need.

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