Managing Prescriptions While Cruising

Managing Prescriptions While Cruising

On a cruising sailboat, it can be a challenge to manage and obtain large quantities of prescriptions while traveling for extended periods- especially out of the United States.

Often, if a couple or family out cruising internationally has a crew member with a health condition requiring one or more prescriptions, it can be difficult to obtain more than a  typical 90 day supply that your prescription insurance will cover.   It becomes critically important to obtain the necessary medications before sailing off into the sunset and living the dream.

Living the dream on MAHI

In our family, I happen to have several medical conditions that, while they do not impair my ability to cruise and sail, need to be managed with numerous medications.    Without these prescriptions, I couldn’t travel on board MAHI out of the US, so I needed to figure out how to obtain 8-12 months worth of all my medications to cover the time cruising away from my home country.

It took me a couple of seasons to finally figure out how to do this, and I would like to share this information with other cruising families/couples in the same boat (forgive my pun).  Below is my system for how I was able to do this:

Step 1:  Figure out RX Quantity Needed

Determine how many months of medication you will need for each prescribed drug.  For some cruisers, this will be 6-8 months.  For others, a year supply will be needed.

Step 2:  Schedule Your Doctor Appointment To Obtain RX Script(s)

It is important to develop a relationship with your primary care physician or the doctor writing your Rx.  Explain to them that you plan to be away xx number of months or a year and will need to bring needed medications on the boat.  Ask for written prescriptions to cover your required time period.

Tip!  Ask your physician for written scripts on separate pieces of paper.  This allows for greater flexibility of shopping around.

Joe and I are very fortunate that our primary doctor is a sailor and one day hopes to go cruising with his family.  He understands our nomadic lifestyle and is most understanding and supportive.   I recently scheduled an appointment and asked for an extra 6 month script for all my medications to cover the time we will be gone.  My specialty physician at Stanford is also helpful and understanding.

If your doctor is not familiar with cruising by sailboat, then you may need to educate them.  Ethan’s pediatrician required a more thorough explanation for what we planned to do.  He now understands,  and helps us with pediatric prescriptions for the ship’s medical kit.

Tip! Before your visit, research whether your medication is available in the countries you will be visiting.

My goal is to have a year supply of all my meds on hand when I leave the US and travel back to our boat in the Bahamas.   Research revealed that two of my specialty medications are not available in the Bahamas and in many 3rd world countries in the Caribbean.  This meant I must bring the medications with me to the boat from the US.

You might notice that I had my doctor write scripts for 6 months when I wanted 12 months on hand.  The reason for this discrepancy is due to how I plan to get them filled- which is my next topic.

Step 3: Know your RX plan and the maximum amount of medication you can obtain through your plan.

If you have pharmacy insurance, which we do, then most plans will encourage you to use a mail order or 90 day supply plan to reduce cost.  Last two seasons, the most I could obtain out of my prescription insurance plan is one 90 day supply and an additional 90 day supply as a one-time-per-year vacation override.  This equals to 6 months of prescriptions.  My advice is to use your insurance plan to fill the 90 day supply, then turnaround and get another 90 day supply as a vacation override.**

However,  I needed more meds because we plan to be gone longer than 6 months.  Previously, this meant that I would need to fly back to the US at the 6 month time frame, get the 90 day prescription filled, then fly back to the boat.  Alternatively, you could have the prescriptions filled in the US, then sent via special air freight service to your island location, and go through the headache of paying 50% duty on the medication, or worse, dealing with a shipment that never arrives or disappears.  Neither of these scenarios are desirable, so I needed to figure out how to pay for the extra 6 months of prescriptions inexpensively out of pocket.

Step 4: Find the Lowest Cash Price

Remember that paper script you asked your doctor for?  This will come in handy for the next step- locating the best cash price to fill that prescription.  This section is also important for those cruisers without insurance or cruise with catastrophic coverage only

GoodRX app and website– Start here to locate which local pharmacies offer the best price for the medications you are on.  You can print out a coupon to take to your pharmacy.  My doctor shared this app and website with me when I told him I was planning to pay out of pocket and find the best prices.

So, I visited GoodRx, searched for all the prescriptions, then printed out the coupons for all my medications.  Interesting, Costco keep popping up as having the best price.  So coupons in hand, I visited my Costco pharmacy and asked for their lowest price and if they took the GoodRx coupon.  I actually received a slightly better price than GoodRX coupon by signing up for a member benefit called “Costco Member Prescription Program.”  This program is for members who do not have insurance or whose co-pays or deductibles are too high.  Bottom line, several of my medications only cost between $20 and $30 dollars for a 6 month supply.

Before I visited Costco, I also looked online at several discount mail order pharmacy sites, domestic and foreign.  I price shopped to see who was cheaper.   The GoodRx prices beat the online websites, hands down.

I also called around to local pharmacies asking what their best price was for my needed medication.  Overall, for larger quantities, I found Costco to be the best place to go.  You do not have to buy an annual membership to use their pharmacy either.  Though, I found a membership helpful for best pricing.

Costco offers special RX pricing for members!

Other Similar Apps to GoodRX:  LowestMed , OneRX , HelpRX – All work very similar to GoodRX in that you can print out coupons and take to the lowest price pharmacy.

**Tip!When filling a prescription at a chain store (CVS, Walgreen, etc), ask questions about price.  It may be that your insurance co-pay or deductible is higher than buying it outright cash at their lowest price.   In fact, there is a class action lawsuit on this very issue.  To get the lowest price, you must ask for it.

Some medications will be outrageous in price- even at Costco and through GoodRx.   Two of my medications fit into this category.  For one, generic  Vivelle Dot (an estradiol patch), Costco quoted me $440.42 for 7 boxes- basically a 6 month supply.  A local pharmacy quoted me over $700.  A variety of online searching revealed prices above $1000 for this medication.

So now I am on a mission to find a lower price for this medication.   You must do the legwork in person, on the phone and online to find the best price.

For the Vivelle Dot, my online search revealed a US mail order source that will fill this prescription for $413.00, plus shipping.  I am currently phoning around to every pharmacy chain, and private pharmacies to locate a better price.  When I do, I will update this post.  Update: Using Good Rx app, was able to find this medication for $212.46.  It appears that the price fluctuates month to month, so when I went back and checked again, the price had dropped considerably.

**  Compare International  Discount Online Pharmacies, but with caution!

You must be careful when ordering from an international source.  While FDA cautions importing prescriptions into the US, it is a common practice by millions of Americans.  My advice is to do your research so you do not unintentionally end up with counterfeit medications.

Thus said, I had a good experience ordering from an online Canadian Pharmacy website.  When initially stocking our ship’s medical chest, I needed an OTC seasick medication called Stugeron (cinnarizine), that is not available in the US.  I used to obtain Stugeron from England.   I was happy with their service.

Tip!  Some pharmacy manufactures will offer discounts, or coupons for free or reduced medications.  Leave no stone unturned!  

Tip!  If you have a condition that requires ongoing management by a specialist,  you will also need to plan for any changes your condition might require.  This meant that last season, I brought along extra medication in case the doctor needed to increase the dose- and the medication was not available where I was traveling.  I had an increase in symptoms, so I emailed my doctor at Stanford from the Bahamas, and the dosage of the prescription was upped.  Because we had planned for this, it was no problem.

Cabo San Lucas Pharmacy

Tip!  Your best price might be in your foreign port.  Keep notes so you remember where you received the best price.  If you are on more common medications, and are out cruising in foreign countries, the best price may be in that country.  Visit local pharmacies to learn this for future purchases.  Mexico, in particular, has wonderful prices on the more common medications- and male enhancement drug, we hilariously discovered  a few years ago.

Many drugs are also available without a prescription internationally.  For instance, Tramadol is a Schedule IV Controlled Substance in the United States.  Research revealed it is available OTC in several Latin countries in the Caribbean and Central America.   This is true for many antibiotics and other medications in Mexico.

Last thoughts– Don’t forget to bring along vitamins, and any annual prescriptions for the ship’s medical kit.  I needed to restock our medical kit with Cipro antibiotic, and another frequently prescribed medication.  Best price for both was $4 each at Walmart.  This price was lower than using my insurance copay.

In Conclusion, using the above techniques, I was able to get all our medication needs met for all crew members on our boat.  Please leave a comment if this post helps you, or if you have any questions about this topic.  Regards, Carla

Postscript:  while I was filling all the various Rx for myself and family, I ran into a glitch with one medication.  All local pharmacies would not fill the prescription beyond a 3 month supply.  By working with my doctor, we were able to overcome this issue.  If this happens to you, contact your doctor and ask their help to resolve.  

October 2018 Postscript- This year, I found that it was cheaper to pay out of pocket (no insurance) using the Costco Member plan and Good RX coupons.  2 of my medications, Costco initially would only prescribe a 3 month supply.  I talked to the managing pharmacist and explained our travel situation. He finally said if my doctor would call and explain why I needed it, they would fill enough to last me for my travels.  My doctor did and my pharmacy needs were met.

7 thoughts on “Managing Prescriptions While Cruising”

  • Please do some research on Cipro!!! I was given levaquin, an antibiotic in that family, last spring. I now have permanent tendon damage in my right arm and shoulder. There are FDA black box warnings for these antibiotics!

    • Maria, so sorry to learn you were negatively affected by a medication prescribed by your doctor.

      Cipro is an antibiotic I have successfully taken in the past and doesn’t make me ill. You make an excellent point about medications and knowing potential side effects- especially if you are cruising on a boat.

      Wishing you well and thank you for writing.

    • Hi Behan, thank you for sharing so much info over the years! Hope our boats meet up cruising this year! Hugs, Carla

  • I have used “Bluesky Drugs” from Canada with great results.

    The U.S. Government is making this more difficult by not letting them take charge cards. There are work arounds though.

    Big pharma has corrupted the system for people without insurance.

  • Lots of great info here. Nice job. The real message is Rx Drugs can be purchased all over the world. Do not let the stupid American healthcare system make you think otherwise. If you need a script in a foreign country, it is not hard to get and often many times is cheaper than the USA. Don’t even think you need to fly home for drugs. This is not the case. Visit a local physician. Use Google translate if needed. Most RX drugs sold in the USA are available in every modern country in the world, often at much lower prices.

    I used Costco for years for bulk pill purchases. I would bypass insurance and just get a year at a time. It was 70% cheaper than using insurance and going to a chain pharmacy. Also, you do not need to be a Costco member to use the Costco pharmacy.

    Outside of the USA is more friendly to the needs of the patient (customer). I know of no other industry than healthcare where customers are treated so badly. Very sad part of American culture to accept this and not be outraged.

    Mark and CIndy
    sv Cream Puff

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