This is part of my unconventional interview series, designed to demonstrate the wildly varied ways we can live, work, and chase our dreams. Please keep in mind that, since these are interviews, the opinions, methods, and websites contained within do not necessarily reflect my own views or experiences. (Which is, in my opinion, part of what makes them wonderful.)
Lately, there’s one travel question that’s been coming up over and over again. Can you travel full-time or long-term if you need medication? After all, it has to be hard to secure prescriptions across continents, to transport temperature-sensitive meds, to get through customs unscathed…right?
Because this is an issue that impacts so many people and because one of the most important things I try to do here on the blog is show that travel (even long-term travel) isn’t just for people with perfect situations, I’ve asked two lovely full-time travelers, both with ongoing medical conditions that require medication, to tell us about their experiences and help us understand how they navigate full-time travel while also taking care of their health.
The first interviewee is Daniel Schwarz, who you can find here, and the second has asked to remain anonymous. And both have a lot to say about travel with a medical condition.
And in addition to these two travelers, I’ll be adding some of my own experiences in the somewhat more minor matter of getting birth control on the road.
Without further ado, then…
First, tell us about you. What do you do? Where are you from? What’s your story in a nutshell?
Daniel: I was a self-taught designer/developer from London, but nowadays I’m a location-independent writer. I love design, make no mistake, and that’s what I write about (mainly), but after freelancing for several years and eventually starting up a design studio, I became frustrated with having to deal with clients and also the quality of life in rainy England.
So now, at the ripe old age of 24, I travel with my wife around Europe (and someday the world) and write about design.
Anon.: I’m a digital marketing consultant and data analyst originally from Germany. During and after my university studies, I lived and worked for a few years in Shanghai. After that, I moved on to Edinburgh for another couple of years. Now I’m just travelling without a home base, usually staying three months in a place at a time.
Gigi: Hey all – it’s me. The author of this site. I’ve been traveling full-time for three years making a living as a writer.
When did you first start traveling and what made you fall in love with it?
Daniel: Growing up in London we had easy access to Spain, so that was the destination for our family holidays, but Greece was common too and Paris was only a coach ride away. I really enjoyed it, but I didn’t fall in love with traveling until I took my first unsupervised trip around Europe with a buddy in my early 20s.
Something about it was different, but I’m not sure what; maybe it’s because we stayed in hostels and we travelled by train? Whatever the answer, it was an adventure: me, a backpack, some train tickets, and about 10 cities on our itinerary. I’d never felt so free.
Scared, but free. During the following three years I would save up some money, try my luck at full-time employment, waste it all on living expenses, meet my future wife, and finally cave. We started our journey in Barcelona a few months ago.
Anon.: I guess you could say I started traveling when I left Germany five years ago. But even before that, I always enjoyed being anywhere but in my home country. Traveling meant I could constantly re-invent myself, meet new people who would influence me and slowly grow into the person I wanted to be.
What kind of medication do you take and how often?
Daniel: I have Type 1 Diabetes Mellitus, a life-threatening (sorry, don’t mean to sound so bleak!) condition that requires intravenous medication at every meal or snack.
Anon.: I take Armour Thyroid on a daily basis.
Gigi: My only daily meds are birth control pills.
How often do you need to refill your prescriptions? How often do you need to see the doctor?
Daniel: I don’t actually see a doctor, like ever. I’m speaking only from experience in the UK, but they’re rarely helpful, and so I’ve been swayed from seeing them a little. Everything seems to heal by itself with time; I’m stubborn I know! Prescriptions can be offered to last up to three months, and since I visit family every now and then I always remember to refill while I’m there.
Anon.: I need to refill about every three months, but I’ve stopped seeing a doctor to get my prescription and just order them online. I should be getting a blood test every 6-12 months…but it’s been a while since I got my last one done and I’m considering the option of just ordering a blood test and doing it myself.
Gigi: Whenever possible, I get six months worth of birth control at once. Sometimes I have to settle for buying three months at a time.
Do you need to go to your home country to refill your prescriptions? How often do you generally go back for that purpose?
Daniel: I don’t need to, or at least I haven’t yet, but I can make my medication stretch to last up to 5 months if needed.
Anon.: Yes and no…it would be more complicated to get the medication in Germany (where I’m from originally), but I can just get it sent from the US to the UK without large complications. So I usually order the meds regularly from a US pharmacy to a friend’s house in the UK, and then either they send it on or I or my boyfriend pick them up when we happen to be in the UK.
Gigi: I’ve gotten birth control in the US and Switzerland (both countries where I’ve lived) and in Germany. I’ve never had to return to the US for the express purpose of getting BC, but I definitely have made it a point to pick up some while I’m there.
If you do have your prescriptions filled internationally, can you talk to me about the process? Can you fill an international prescription at the pharmacy or do you have to see a doctor beforehand? How do you find a doctor?
Daniel: All countries have their own rules, and sometimes it really comes down who serves you at the counter and their willingness to help you. A quick Google search can help you access instant advice, but you should expect to find contradictory remarks.
Pharmacies usually have at least one English speaker, and from my experience they’re always very happy to explain your options to you (if you don’t have a helpful Airbnb host, that is!), and this is the overall consensus:
Non-essential medication is hardly ever free unless it’s birth-control (which is only free in some countries). Prescriptions usually allow you to reduced-cost medication, especially if the country has a treaty with the country that you’re from; for example, if you’re from the EU and you’re visiting another EU country.
Essential medication is sometimes free, but only with a prescription. However, if the cost is not an issue, you can usually buy something (in my case, insulin) over the counter without issues. That said, this could be quite costly, and health insurance doesn’t typically cover you for a situation like that.
Anon.: I’ve never had a prescription filled internationally, but this is the process of how I actually get my meds: through a loophole. In the US you can only get my medication (Armour) on prescription, but in the UK (where I used to be health insured and where my condition was diagnosed) you can’t get Armour at all. Instead you’re pushed onto some dodgy sub-standard medication.
However, you can order Armour in small amounts from a US pharmacy to the UK without a prescription. Being unhappy with my standard UK medication and knowing that it would be difficult to maintain a steady flow once I was on the road and not a UK resident anymore, thus not health insured in the UK anymore (since I’m a German citizen), I decided to take matters into my own hands, pay privately for the medication, and am basically now self-medicating.
Gigi: I find that generally, at least in Europe, if you can show them your prescription or even your birth control box and explain you’re traveling and ran out, most doctors will quickly and painlessly write a prescription assuming your doctor at home knows what he or she is doing prescribing it to you in the first place. In Switzerland, this is how it went for me. I showed them the box and pills. They looked up the equivalent brand here in Switzerland and ordered some for me. In Germany, it was a little tougher because I didn’t have my box with me, so I had to beg the doctor to prescribe some. She eventually gave in, but not without some cajoling.
In an emergency situation (such as leaving the meds behind, losing them, or having them damaged), what do you do?
Daniel: My first reaction would be to freak out, which I have done, but my advice would be to calm down and ask your Airbnb host or another native-speaking friend/connection to help.
Anon.: Luckily that never happened. I have no idea what I would do! I try to distribute them between carry-on and checked baggage so that I still have some in case anything gets lost on the road. If I were in a country where Armour (or another brand) is actually available, then I would consider going to a doctor, explaining the situation, and hoping they would be willing to prescribe me at least a small dosage.
Gigi: Well, obviously losing BC isn’t a life or death thing, but to get a little TMI here, the reason I’m on it is because when I’m not I end up in debilitating pain once a month. Pain so bad that sometimes I literally can’t leave the house. So making sure I have some with me is pretty important to my well-being. And so I would do what I did in Germany: head to the hospital/clinic, wait however long it takes to see a doctor, explain the situation at length, and beg for a prescription.
Do your medications need any special care (climate control, for example)? If so, how do you manage or plan for this while traveling?
Daniel: Liquids freeze in the hold carriage of air-based flights, so carrying insulin with me at all times is a must, especially if I need to eat on long flights. Insulin and some other medications also have to be kept at cooling temperatures; for short flights it may not be an issue, but for longer flights I highly recommend these Frio Cooling Bags.
Anon.: It says not to store them above 30°C, but I’ve been relatively careless with that and just usually put them in a dark cupboard or drawer… I usually stay in Airbnbs, so I might just consider storing them in a fridge if it does get really hot.
Gigi: I don’t think there are special instructions, but I do generally try to keep them in dry, cool, dark places (e.g. inside a small bag inside my bag).
What about airport security? Do you have to do anything special in order to take your meds on a plane?
Daniel: You simply cannot take medication onboard a flight without an explicit note from your doctor, but that being said, I’ve never (ever) been asked for my note. Perhaps if the medication doesn’t violate the 100 ml liquid rule it’s okay with them. I’ve also never been queried about carrying needles with me. (So strange!)
Anon.: Nope, they’re just pills, so not considered dangerous.
Gigi: Ditto what anon. said.
Is there anything special you have to do when going through customs?
Daniel: See above.
Anon.: Some countries, especially the US, require me to have a prescription along with the meds – which I don’t, so I just always hope for the best. I have, in the past, however filled them into different bottles to make them look like vitamins.
What are the biggest challenges of traveling with your medications?
Daniel: For me, it’s finding that balance between obeying airline rules and my own convenience. You should always leave medication in its original box (security concerns, blah blah), but three months worth can be quite large, especially when you only have a backpack. Another annoyance is the doctors note; they’re quite costly (especially considering it takes approximately 60 seconds on the doctors part). It feels like a gamble not to have one, but the bigger risk is always you having to turn back at the security and customs. Always be over-cautious, even if your brain tells you otherwise.
Anon.: The biggest challenge is to make sure I always have enough and knowing when and where I can pick up my next refill. Because I don’t have a prescription, this can be considered illegal depending on the country I’m currently in, so I can’t just get my medication sent wherever I want.
Gigi: Navigating hospitals and clinics in a foreign language is the worst of it. In Germany, a total miscommunication landed me (feeling somewhat offended) in the maternity wing of the hospital…uh, no.
Do you have any advice for those who long to travel long-term but are nervous about their meds?
Daniel: Prepare. Prepare. Prepare. Oh, and always take extras.
Anon.: Just make sure you have enough with you and keep it in both your carry-on and checked luggage (if you have checked luggage), in case anything gets lost, stolen, or taken off your person at the airport. If you have international health insurance, it would also be wise to check with them beforehand if they will replace any lost or stolen medication, and go over the process of how you would get new medication with them.
Gigi: Research. You’ll feel a lot better if you know where the nearest clinic or hospital is, whether your meds are available (and whether you’ll need a prescription) in another country, and whether your doctor has specific instructions for traveling with your specific meds.
And for birth control, you can often get up to six months worth at a time, which can make your life a lot easier.
Do you have any resources to recommend for finding doctors/pharmacies/care facilities abroad?
Daniel: Google Maps. Hospitals will show up immediately; doctors will show up if you search for them. Always remember to check their website first. Private doctors will be exponentially more expensive, although a country will likely have a website that indicates all government-approved doctors surgeries.
Pharmacies are the same, and unless you’re in a very remote location, you’ll find one within about a minute’s walk.
Anon.: I’m afraid not. Whenever I needed a doctor, I just asked friends I had in that place or looked in location-specific expat forums.
Gigi: I call my insurance and ask where the nearest facility is and/or I ask local friends.
Are there any places you wouldn’t travel to due to lack of availability of your medications or the appropriate facilities?
Daniel: Hmmm, that’s a hard question. I’d probably go pretty much anywhere, but I’d be extra-cautious and take crazy amounts of medication. Worldwide health insurance wouldn’t go amiss either. I don’t use it in Europe.
Anon.: No, I don’t think so.
Any places where you feel very comfortable and know you’d be able to get your meds easily if something happened?
Daniel: I lost my medication in Barcelona and arrived in Lisbon without it. I know for sure I can buy it over the counter and I’ve a suspicion that most of Europe employs the same rules. So I suppose Europe, or more accurately, EU countries are on my totally-okay list.
Anon.: Definitely the UK, even if I’d still have to wait a couple of weeks for a shipment from the US to arrive, at least I could get on a substitute in the meantime. The US, Canada, and New Zealand are ok too, even if I would need to jump through several hoops and probably pay lots of money to see a doctor, get a blood test done to confirm my claims, and then finally get a prescription.
Gigi: Switzerland. The doctors all speak perfect English and getting new birth control has been a breeze. Plus, the cost is about 1/3 of what I was paying in the US (since I left, it has supposedly become free in the US, but I haven’t been able to take advantage of that yet).
Is there any additional research you do before planning to go to a new place (do you, for example, have hospital and pharmacy numbers on hand before you land?)?
Daniel: Aha, no. But I really should. All the advice I’ve offered today comes from experience, but I’m terrible at taking my own advice.
Perhaps if I went to somewhere more exotic, I would. Definitely.
Anon.: Before going to a new place, I do research whether it is legal to ship Armour from the US to that country without prescription. If so, I put the order in a week or so before I arrive at my new destination, so it will be there in time.
Anything else you’d like us to know about traveling with meds? Any other tips for those thinking of following in your footsteps?
Daniel: Pro-tip: split up your medication into several bags and locations, and if you’re travelling with a friend, ask them to hold onto some as well. Plan ahead for emergencies like this.
Anon.: I would make sure to be as independent from local doctors, hospitals, and prescriptions as possible. This entirely depends on your condition(!), but if it is something you can manage and possibly monitor yourself (and often those who suffer from a condition know just as much – or more – than their doctors), it can be worthwhile doing it. Every country has its own regulations and standard medication for various health issues. I was prescribed three different medications by three different doctors in three countries – find what works best for you and make it work internationally, independent of what country you’re currently in.
Gigi: Plan ahead. Make sure you have appropriate international health coverage. And try to find doctors that speak your language. Trying to explain in pantomime about something as important as medication can be incredibly stressful.
Huge thanks to our full-time traveler interviewees.
Any questions for them?
Please keep in mind that we are not medical professionals and this is not legal or medical advice. It is the experiences and personal choices of the three above people. In regards to your own conditions, I encourage you to speak with your physician about the desire to travel long term. He or she can offer real medical advice specific to your case.
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