Those of you following along with the Facebook or Instagram may recall that I spent most of July in the “good old” US of A. I can’t write quite as much about visiting home as I do when I’m on an adventure, but I’d still like to open a little window into my life. In the next two posts, I’m going to share the ups and the downs of travel in the US as an expat. Because I like to finish on a high note, I’m going to start with the downs first. It’s OK to laugh, schadenfreude is healing.
Why Go to America?
Although there are a lot of wonderful things about America, recently I struggle to recall what they are. I have no intention of moving back, and I don’t really dream of “visiting home” with any kind of heartfelt nostalgia. Mostly it scares me.
I have a lot of anxiety about visiting America. I will admit that not a small amount is fueled by the news: will I have to punch a Nazi? Will border patrol get unreasonable about letting me in? Or out? What will I do if I’m adjacent to a mass shooting? What if I need healthcare? It’s enough to drive a sane person crazy, and I’m not terribly sure I started on the “sane” side of the goal line to begin with. So why go at all? Glad you asked.
It’s our favorite game: Bureaucracy!
The main reason I needed to return to America this summer (as opposed to exploring Iceland or something) was to renew my driver’s license (DL). I needed a new license so I could drive in Ireland in August, and so I can vote in the upcoming 2020 elections.
What’s the Word for Negative Serendipity?
Of course, I came to this conclusion through a hilarious series of unfortunate events. When I went online to try and fill out the application form for an IDP (International Driving Permit), I realized I could NOT FIND my DL! Anywhere! I remembered having it on the way back into Korea from Malaysia in February, so I knew I hadn’t lost it in some random country, but I could only imagine it fell out of my wallet in a taxi or shop in Korea and was gone forever.
The Other Bad News
Back to the DL. So there’s me in a panic because we’re planning a ROAD TRIP for Ireland, and my mom does not know how to drive on the left. I HAVE to have a DL, and according to recent EU laws, an IDP too. I go back to the WA DOL website to replace my license and it says I’m in range to renew, so I think “hey, might as well”. I go to renew only to find out that I have to come in person every OTHER renewal… so that 2 year lottery really bit me in the bum. The good(ish) news is that I have the ability to get to the US before Ireland. The bad news is that WA has the licenses printed out of state and they take 2-4 weeks to arrive by mail. Only. By. Mail.
Sidenote: I never was able to get anyone in the DOL or DMV or USPS to explain to me how a homeless person gets a license. What if you’re living out of your car? Even if you don’t drive, the license is the primary source of ID in America used for benefits, employment eligibility and voter registration. Yet one more untenable obstacle to make a path out of poverty impossible.
The OTHER bad news is that according to the internet the EU is taking this IDP thing pretty seriously. It used to be you could just show up with a US DL and rent a car, but laws change, I guess. So it’s looking like I could be in big trouble for not getting the IDP and I have to have a valid DL in hand to get an IDP. So. I applied online for a replacement DL (still expires in 12/19) to be sent to my friend’s house where I’m staying in WA so I can pick up up when I arrive, then go first to AAA to get the IDP with the soon to expire DL then run over to the DOL to renew in person and get a DL that I won’t have to show up in person again for 12 more years.
Except. It can’t be that easy.
The Problem with the Post Office
The DL is returned as undeliverable and shredded. I’m told if you aren’t “registered” with the post office, then your official gov’t mail will not be delivered. I thought that mail would be delivered to the address written on the envelope, silly me. Now we’re registering with the post office. (BTW, when I did the DL renewal back in 2016, this was not an issue. The postal service delivered it to my friend’s house with nary a qualm. Clearly this rule is optional.)
Regardless, you’d think it would be easy enough for me to just have this sent to the address that the post office has on file for me, right? No again! My US apartment is a shitty run down poor-ppl apartment, so the mailbox is not safe AND frequently the mail carriers deliver mail to the wrong box, or just decide not to deliver it. This happened so often while I was residing in the US, that I started having anything I cared about sent to my office instead.
In addition, there’s no way to “register” multiple addresses with the USPS. In the end, I did a temporary address change for the period of time necessary to accomplish this and had the DL sent out again.
In the end, I got it all to work, and I got my updated DL and my IDP and then literally no one in Ireland even cared about the IDP. The rental company and the guard (name for Irish police) were only and exclusively interested in the American licence. So much for getting your info from the internet? But seriously, don’t take my word for it if you’re going to drive abroad it’s better to follow the laws as written, even if the locals don’t enforce them.
What’s Up Doc?
Since I now had no choice but to visit America, I had this dream of seeing my primary care provider (another weird American eccentricity that doesn’t exist here) to get refills for my prescriptions that are either uncommon or not available here in Korea (not illegal, just not here). I go to a sliding scale clinic in Seattle because when I was poor and unemployed (which in America means also uninsured) it was the only place I could afford at 15$ a visit. When I got insurance, I kept going there so they could bilk my insurance company for as much money as possible to put toward their operating budget. My care provider of many years actually left America shortly after I did and joined DRs Without Borders (cool!) which sort of means the only health care professional that knows anything about me is AWOL. But at least the office has records, right?
But if any of you have heard anything about American health care it’s about the cost. Some of the (if not THE) most expensive health care and prescription drugs IN THE WORLD. In order to afford it, I would need insurance.
I have great coverage in Korea, but it is ONLY in Korea. Generally speaking, traveler’s insurance DOES NOT cover the country you reside in… or the one you are a citizen of. You know, in case those are different. Even though I live, work, and am insured in Korea, traveler’s insurance policies would not cover me in the US because of my citizenship. Foreigner’s visiting America can get traveler’s insurance. People who live in the US can get regular insurance. But Americans who live overseas? Well, heck, that should only be military personnel, no private citizen could POSSIBLY want to live overseas and come home on holiday while still being exempt from medical bankruptcy! /sarcasm
Some expats can get insurance when going home by signing up for a short term insurance plan. Because of the way that insurance is linked to employment, a lot of these are available for ppl who are between jobs, but often exclusive to ppl who are between jobs, such that, if your insurance has lapsed for too long, you are not eligible. There are still some generic short term insurance policies around, but it turns out that’s another state by state law and it’s not allowed in WA state.
Sometimes I really do think that the countries of the EU have a more stable and interchangeable system of rules than the states in America. I don’t really understand how you can have health insurance in only one state. I wonder in retrospect what would have happened if I’d signed up for short term insurance in another state and then presented it in WA… probably I would have been told I was out of network.
With regular “short term” plans off the table, and regular travel insurance ineffective, I found exactly ONE expat insurance plan for my situation: short term visit to my country of citizenship but not residence. However, it excluded so much (pre-existing conditions, reproductive health, most prescription medicine, the list goes on) that it was basically useless. All too often people buy these policies without realizing what they don’t cover.
In the end, I decided against getting an additional plan. I have good US car insurance, so anything involving a car (even me as a pedestrian) would be covered by that, anything else would probably be covered in liability. For things like a cold/flu it’s cheaper to go to a drug store than a doctor anyway, and for emergencies? Well, car, crime, and accident would be covered and that basically leaves things like aneurysms, and I decided that if that was going to happen, it’s just my time. ‘Murica!
The Price of a Pill
I was able to see the doctor in Seattle, and after some awkward explaining of my situation re: employment, income, and insurance they decided to give me the sliding scale rate. I have to say I was pretty happy with the way they treated me overall, the doc was invested in my whole well-being not just “why are you here today” and was happy to help me get refills that would last me until my next bi-annual visit. The challenge came in filling those.
Even if I had gotten that expat health insurance it wouldn’t have covered the prescriptions. I found a website called “GoodRx” that does coupons (oh the insane dumbness of THAT process) and was able to cut the cost down. This still ended up being a multi-week, multi-state process because they could only use the coupon on 2 doses a day and I needed 8. I ran out of time in WA and had to finish in TN, and good on those pharmacy reps for going the extra mile to help me, but ffs would it KILL the US to just sell prescription drugs at affordable rates? I bought the same medication in Thailand for pennies on the dollar what it cost even WITH the coupon in the US. The only reason I didn’t do that again is that factoring in the airfare to Thailand it ends up being more, and I’m not planning on being there any time this next year or two.
On the other hand OTC drugs are sold like gummy bears over there. In Korea, I have trouble getting basic things like acetaminophen, naproxen, and ibuprofen, as well as Sudafed and Claritin. In some cases they need a doctor and have to be refilled CONSTANTLY because the Korean docs don’t give long prescriptions. In other cases you can buy them at the pharmacy OTC, but like 5 pills at a time. I’ve actually had Drs prescribe Tylenol that is weaker than the American OTC stuff I had at home. Maybe the locals who haven’t been overexposed and built up some kind of pain med immunity can get away with that, but I cannot.
Plus, whatever weak-ass decongestant they sell here cannot attack the portal to the mucus dimension that opens in my face when I get sick. Only that good pre-meth ingredient Sudafed stands a chance. Hence, my desire for Costco sized bottles of all of those meds, and in the case of Sudafed, however much I can buy before I end up on a meth-cooker watch-list. The last refill I got was 2-4 years ago (I got a couple on the 2017 visit but some were from 2015). One short trip to Costco with my mom later and I was 100% restocked for under 50$.
Ladies and gents, the US pharmaceutical economy:
2 years of birth control = 500$
2 years of the top three NSAIDS + allergy meds +cold meds = 50$
This is what I did from April until July. I fought with banks, government offices, and healthcare providers because the US does NOT want it’s citizens to live abroad, or travel, or be healthy.
The “ex” in Expat = extra paperwork, extra hassle, I swear.
Had enough of complex bureaucracy, crazy international systems, and general complaining? Me too! Stay tuned for the next episode where we explore all the happy and wonderful things I got to experience on my visit to my homeland. Good friends, good family, good weather, good food, so much goodness it will turn your brain to sugar! Coming soon: Expat life: When “Home” is a Holiday.