Healthcare in your second home

IT’S no fun being sick. And it’s even worse when you’re someplace where you don’t have a doctor or aren’t familiar with local health care options. Neither situation is too far-fetched for many second-home owners.

So no matter where you are in your vacation-home experience (searching for a new place, or already comfortably settled), it’s important to understand and prepare for those times when you don’t want to have to think about anything but getting better.

One of the best prevention measures is research. Dr. Julia A. Hallisy, who wrote “The Empowered Patient,” says there are a few essential pieces of information to find out about your second hometown. How far is the closest emergency room and hospital? What is the emergency response system, and how long are response times? Do first responders carry defibrillators?
There are also questions to ask about nonemergency care: Where is the closest pharmacy? Are there primary care physicians in the area? And are they accepting new patients?

Which raises an even bigger issue: insurance. Even if you have a great plan in your primary residence, the network might not extend to where you vacation. “In general you need to know what your coverage is, when you think about getting care from your second-home location,” said Joyce Dubow, a senior adviser in the AARP office of policy and strategy.

She added that emergencies were not usually a problem because, in most cases, your insurance would cover some part of that. “The distinction is really routine care,” she said. “And how emergency care is defined is significant. If you have a urinary infection and you think that’s an emergency, your insurance might not.”

Though no one enjoys the hold music and confusing answers, a phone call to your carrier can address many of your questions — if you know what to ask. “Ask the company if they offer service in the area and if you can switch to a new primary care physician in the second-home area, and then switch back when you return home,” said Dr. Hallisy, who noted that it might be necessary to change insurance companies to one with a wider network.

“Perhaps work with an insurance broker to advise you on a plan that would cover you in the second location,” she said. “This could save both time and money, as they have information and access to a greater number of plans than the average person can find on their own.”

If you are eligible for Medicare, Ms. Dubow said, the traditional program allows you to see any doctor anywhere, anytime. “Say you are a snowbird and spend the winter in Arizona and have traditional Medicare, then you can see a doctor in Phoenix, same as if you were in Maryland,” she said.

Once you’ve settled on your insurance plan, get to know the service options in your region. When it comes to a local hospital, Dr. Hallisy urged looking into whether it’s accredited by the Joint Commission, an independent nonprofit group that certifies health care facilities nationwide.

“Go to the Joint Commission Web site at www.qualitycheck.org to see if it contains accrediting information on the nearest hospital,” Dr. Hallisy said. “Check www.hospitalcompare.hhs.gov for information about how the hospital complies with recognized standards of care.”

Among other health care options like drop-in clinics, Dr. Hallisy said be sure to check that the clinic is open for emergencies as well as routine care like flu shots and stitches. If you are thinking about finding a doctor near your second home, be sure he or she is willing to share your care with your home physician and find out about house calls and how expensive appointments are, she said.

No matter what options you choose, keep two things in mind: One is that you may have to pay out of your own pocket for some care. The second, as Ms. Dubow explained, is continuity of care.
“We know that continuity with physicians is a good thing, so you need to think about how you establish relationships with your clinicians,” she said.

“If you’re in Florida for six months a year, you need to know that you’re going to someone who has access to records, who knows you. And if you live in Maryland for the other six months, similarly you want to have someone you have a relationship with there.”