Health & Insurance Prep for Long-Haul Slow Travel

A one-pager for anyone planning months on the road across multiple regions. Not medical advice — book a travel-clinic appointment 6–8 weeks before departure and confirm everything there.

Vaccinations

Baseline (check they're current): Tdap, MMR, COVID/flu, Hepatitis A + B (the single most-recommended travel pair).

For a Southeast Asia base: Typhoid (street-food eaters especially — often the whole point of going); Japanese encephalitis if spending 1+ months in rural areas or rice country; rabies pre-exposure worth discussing for long stays (street dogs, monkeys at temples, and post-bite treatment is a scramble in remote areas).

For Africa and the Amazon: Yellow fever — required for entry chains involving Kenya, Tanzania, or Amazonian Brazil, and the certificate is genuinely checked. Malaria prophylaxis for the Okavango, the Serengeti and Kilimanjaro, the Amazon, and rural Southeast Asian border regions (Bangkok, Kuala Lumpur and urban Thailand are essentially malaria-free); doxycycline or Malarone, decided with the clinic.

Altitude: Cusco and Machu Picchu (11,150 ft), Uyuni (12,000 ft), La Paz, Everest Base Camp — discuss acetazolamide; build 2–3 acclimatization days into any itinerary above 9,000 ft. Travellers over 50, and anyone with heart or lung conditions, should raise altitude plans with a doctor specifically rather than assuming a standard prescription covers it.

Insurance

Regular domestic health insurance mostly does not follow you abroad — US plans in particular rarely cover care outside the country. Two layers:

1. Travel medical insurance for stays of months — the long-stay/nomad products (SafetyWing, Genki, IMG Global-style) run roughly $50–150/month depending on age and US-coverage add-ons; premiums rise noticeably after 50 and again after 65, so price your own age band rather than the headline rate. Check: emergency evacuation included, adventure-activity coverage (diving, trekking above set altitudes are often excluded by default), and whether home-country visits are covered.
2. Emergency evacuation matters more than routine coverage: an ICU airlift from a remote island runs six figures. Verify evacuation limits of at least $250k for anything in Africa, the Amazon, or the Himalaya. Divers: DAN membership is cheap and the standard for dive-accident coverage.

Also: trip-level coverage (cancellation and gear) often comes free with the credit card that bought the flight — check before buying it twice.

The practical kit

Prescriptions: a 6-month supply where the insurer allows, carried in original packaging with a doctor's letter; check legality per country (some common US medications — Adderall in Japan, codeine in the UAE — are controlled substances). An antibiotic for travellers' diarrhoea (azithromycin, prescribed ahead) plus oral rehydration salts. Good private hospitals worth knowing in the main long-stay regions: Bumrungrad and Samitivej (Bangkok), Gleneagles (Kuala Lumpur and Penang), Raffles (Singapore), ABC (Mexico City) — Bangkok and Penang are genuinely world-class and cheap enough that expats fly in for care. Travellers over 50 should also ask their clinic about shingles and pneumococcal vaccination and carry a copy of a recent ECG if they have any cardiac history.

Before departure checklist

Travel clinic 6–8 weeks out (some vaccines need a series or lead time) · Yellow fever certificate stored with the passport · Insurance active with the policy PDF saved offline · Dental, vision and physical done at home · Blood type and allergies card · Embassy traveller registration (STEP for US citizens, equivalents elsewhere) · Scans of passport and prescriptions in cloud storage plus one paper set.