Your medical records when you live abroad
Imagine you are in a clinic in a new country. The doctor asks about your last heart test and your medicines. What do you have in your hand?
In the United States, the HIPAA Privacy Rule gives you a right to your health records. You may inspect them and get a copy from your doctors, hospitals and health plan.
Getting your records under HIPAA (US Department of Health and Human Services)
| Question | Answer |
|---|---|
| How fast must they respond? | Within 30 calendar days |
| Can they take longer? | One extension of up to 30 more days, with a written reason |
| Can they charge? | A reasonable, cost-based fee only. HHS says copies should be free where possible |
| What if the records are electronic? | A flat fee of $6.50 is allowed in place of calculating actual cost |
The 30 days is an outer limit. Providers are encouraged to respond sooner.
The timing matters. A request made at the last minute may not arrive before you leave. Asking a few months ahead leaves room for the extension.
Why have copies? Medicare is one reason. Original Medicare generally does not cover health care outside the United States, apart from a few narrow exceptions. Medicare drug plans do not cover prescriptions bought outside the United States.
So care abroad is paid for another way. A new doctor will need your history to treat you well, and it may take time to get from afar.
Many retirees keep ties to doctors back home. A review of research on retirement migration reports that older British people in Spain kept a strong dependence on the United Kingdom for health care. It reports that US retirees in Mexico often traveled to the United States for medical care.
Health also drives some moves back. In the Dutch study of retirees abroad, poor health was linked to returning home. Records that travel both ways could help then.
People could ask for several things. Examples are a list of diagnoses, medicines with doses, recent blood tests and heart tests, imaging reports, surgery notes and vaccination records.
A medicine often has different brand names in different countries. The generic name, which is the active ingredient, is usually the same.
What would you want a new doctor to see first? Tell us in the comments. Someone may be putting their own file together.
Sources we read
US Department of Health and Human Services, Individuals' right under HIPAA to access their health information. https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html
HHS, Right to access and research, frequently asked questions (fees, $6.50 flat fee). https://www.hhs.gov/hipaa/for-professionals/faq/right-to-access-and-research/index.html
Medicare.gov, Travel outside the U.S.. https://www.medicare.gov/coverage/travel-outside-the-u.s.
Review of the literature on international retirement migration, Demographic Research, volume 48. https://www.demographic-research.org/volumes/vol48/9/48-9.pdf
Spaan and others, Population Europe summary of Dutch retirement migrants' return. https://www.population-europe.eu/research/popdigests/unexpected-return-international-retirement-migrants
Tell us in the comments