A difficult question and one that generates lots of questions and conversations amongst cruisers. Many cruisers decide to go “bare” and either hope for the best or work with local medical professionals. Many islands have very good medical care at drastically reduced prices (compared to the U.S.). We’ve been told by many cruisers that you can get a dental check up for under $40 cash and a broken arm can set and fixed (including an x-ray, several visits, cast, and all) for only a few hundred dollars. So there is certainly reason to believe that this is a good decision for many people.  Plus, if you are an American citizen and live outside the U.S. for 330 days you do not have to pay the ACA (Affordable Care Act or for those of you who think it is called “Obamacare”) penalty.

But those who know me, know that I would worry every minute of every day if I did not have medical coverage. First because I am a world class klutz! I bruise if you look at me funny and cannot seem to make it one day without some injury (big or small). Second, I used to work in the insurance business and truly believe in being prepared for the unforeseen events life brings you. And most importantly, I am a cancer survivor and although I believe I am cancer free and took all necessary precautions to prevent it from returning – you just never know. So, the search begins for healthcare (h/c) alternatives.

My previous company spoiled me rotten with amazing H/C coverage, low deductibles, choice of the best doctors, and supplementary options. Of course, when I made the decision to “retire” that all went away, along with Matt’s coverage as he was covered under my insurance policy.

I must admit that I am envious of our European cruising friends and their universal h/c coverage (yes, I am sure they have their own unique drawbacks, but at this time of my life it seems appealing).

We had three options to consider (since I had already ruled out going “bare” or without coverage (not naked you pervs :)).  1) We could go on my COBRA plan which was $1,350/mo for both Matt and I to continue our current coverage, as is or $642 for me alone.  2) Healthcare.Gov which had several plans ranging around $350-$650 for me alone with incredibly HIGH deductibles, restricted coverage, and restricted doctor selection. 3) Christian Health Ministries (CHM) which is a cost sharing non-profit program, not an insurance plan.  Please note that Matt had opted to go “bare” if I went with either Option 1 or 2 due to cost and the mere fact that he doesn’t go to the doctor.

The one thing I knew we were going to do for sure was to sign up for Divers Alert Network program which is for divers/sailors and provides insurance that provides transportation to bring you back to the U.S. (not necessarily to your home state, but back to the U.S.) for medical treatment.  Basic membership is $35 solo or $55 for Matt and I each year.  In addition, they have an additional coverage plan, “Dive Accident Insurance Plan” that provides additional transportation, housing, and $10k supplemental medical coverage – both the membership and additional coverage plan, for both Matt and I is at the low price of $205 annually!  No brainer, done!

After much research on the different ACA programs and discussing my options with an extremely knowledgeable and helpful friend (thanx Pete), I decided that the ACA programs were not for us – too expensive, ridiculously high deductibles, and too many restrictions.  My care team, medical doctors and prescriptions would NOT be covered under the plans we were considering — plus there is the Trump factor.

So COBRA or CHM???   COBRA was awesome and to be honest, not horribly priced for a COBRA plan (thank you TDC).  But we don’t need that much coverage – in fact over 90% of that coverage would go unused so it was really hard to justify spending almost $8k on this h/c plan.  I did a lot of research on CHM and talked to a few CHM members who are part of the cruising network. The CHM program is a cost sharing program and not an insurance policy.  Meaning you pay for your h/c services up front and submit the expenses for reimbursement based on their qualifying guideline.  They have been around for 30 years and have over 300k members.  General checkups, dentistry, and vision are not included (fine with us as we don’t need those services while cruising).  The kicker is my pre-existing condition.  They do have caveats with pre-existing conditions meaning if you are cancer free for 5 years it no longer is considered pre-existing (of course I am 2 years cancer free so that doesn’t apply to me) and if you have other h/c conditions and are symptom free for a year you are not considered to have a pre-existing condition.  So, what does it mean that I am considered a pre-existing member?  If, I have a recurrence specific to my breast cancer, they will still cover the treatment based on a tiered reimbursement plan.  Well, I am considered a LOW risk since I had everything lopped off and am on medication to prevent a metastasis and I had really good genetic results so I am ok with this plan.  Matt and I signed up for their top tier Gold Program at $150 pp/per month and I signed up for their Brother’s Keeper (a catastrophic additional increased reimbursement plan) at $240/year for both Matt and I.  So, our total annual h/c coverage, for both of us, will be $3,840.00.  I can live with that.  And the bonus part is that they will help you negotiate your medical bills since you are considered a cash paying patient (usually you get 40-50% discount).

Have to be honest, it is a relief having made this decision and knowing that we have the coverage we need for our current lifestyle.

Guess where we will be..

Three tomatoes are walking down the street- a poppa tomato, a momma tomato, and a little baby tomato. Baby tomato starts lagging behind. Poppa tomato gets angry, goes over to the baby tomato, and smooshes him… and says, Catch up.

So its been a while, but we are still safe and having a blast.

We arrived Sint Maarten (Dutch side) and haven’t really strayed very far. It is almost like last year, where we spent almost 6 months here getting the standing rigging replaced. Tho this time is very different.

Sunsets do not suck

Simpson Bay

Christine went back to the states  and I returned to work (remotely) only to find out that my job required an Austin presence, mid-life retirement kicked.

Had already run into our friends. the Princess, the Ogre, and Ho Aloha that we met here last year, they took care of me while Christine was away. So started boat projects, all the oil was changed in all 4 engines. The Dinghy engine (gear oil), the 2 main Volvo engines, and the Honda generator (used for making water and electricity when not wanting to run the diesels). Washed the boat several times, cleaned the engine rooms. Sewed a dinghy gas cover, it was just baking in the sun so I channeled my inner Betsy Ross and it turned out okay – but it still needed some love later when I had more time. That time came, and now it has a velcro opening for refilling the tank and holes for the tie downs that keep the tank from sliding around in the dinghy. Works pretty good, for using scraps of Sunbrella Christine picked up last year.

First cut on gas cover

Just before Christine returned, I had had to clean up the boat and fill up the tanks with the water maker so I went for a sail. Solo. I had moved the boat solo a few times and anchored without too many issues, including a motoring Jib sail to La Semmana, and trip to Phillipsburg to pick up 700lbs of replacement ceiling material, so why not try sailing. Nice ‘green’ day, meaning less than 20knots of wind forecasted so prefect day for full sails and what else am I gonna do. Pulled anchor went out a way from boats and raised the main sail with no real issues, other than making sure all the reefing lines ran free as I wasn’t sure what reef we had in when we last had the sail up. Set a course for Saba, an island about 25miles a way. Pulled out the jib, turned off the engines, fired up the Honda, and started the water maker.

Awesome square rigger

Sailed about 18 miles toward Saba and the Port tank was full, and I just made some lunch, so perfect time to turn around. I was trolling fishing lines too, but no bites on the way out – definitely none on the way back. I went to tack the boat using the Auto Pilot’s tack feature. Well that didn’t go as smoothly as one would have hoped, I didn’t get all the way around and ended up in irons. Hmmm.. I was doing 8knots, I guess that the Auto Pilot 100 degree tack needed to be a bit more so, fell off and got it going again to try again, this time with the dagger boards down and and extra turn of the wheel. Again didn’t quite make it, but this time I was also drifting backwards and the fishing lines and teasers all ended up under the boat and around the rudders. Grabbed the dock hook and was able to untangle the mess as it never made it to the propellers. But in the process broke the dock hook, in half again – had fixed that last year too. Got the lines straightened out, and fired up the starboard engine to get around and back on course back to the anchorage. Then turned it back off and started sailing toward St Barths and noticed a couple squalls (rainstorms) on the way. Now I had full sails up and rain storms normally bring more wind and looking at the water, I could see more white caps, so pulled a reef in the main, and no sooner then the wind jumped to 26knots, pulled a little jib and all was good. No fishing lines in the water tho, thus no bites. Made it back the anchorage, full of water in both tanks and full of electricity – a great day. And now we have a new boat hook that is made from one piece of aluminum instead of one put together with a an old broom handle.

Saba in the distance

Reworked the rain catchment system on the bimini, they were forever getting taken out by flapping jib sheets because they hung down too low, found some 90 degree sprinkler fittings that were able to be customized to a hose connection and epoxied in place, so far they have lasted an should be out of the way of the flapping jibsheets when taking and rolling up the sail.

Rain catchment

Might have found the port engine staring issue as the negative connection on the starter wasn’t giving enough juice to spin the engine over, the solenoid would throw but unless there was perfect star alignment wouldn’t always engage. I had brought an automotive remote starter button so that I wouldn’t have to hot wire the connection while in the engine room, or go up and use the key. When using the remote starter I was able to hear / see the the little arc that was happening on the negative side of the starter – pulled off the wires, re-ordered them after sanding lightly, to where the biggest wire was on first to make the most connection and hasn’t been a problem since – tho now that I talk about it, its bound to happen again. We do have that extra starting battery onboard too.

Remote starter button

Always sunny

​​Picking up the ceiling material was an adventure in its self, I ordered 12 4×8 foot sheets of 3mm PVC sheets, 6 in beige and 6 in white from a sign company in Puerto Rico. PVC will not mold, can get wet, should last a life time, but nothing really sticks to it. After motoring the big boat from La Semana over to Phillipsburg and frantically looking through the cruising guide as to where to anchor (as we had never been there before), found a spot that seemed good, and ran off in the dingy to find the shipping company. Walked to where the containers were, asked the guard and he pointed back down the street a half mile where I came. Then a semi truck stopped and said get on, he was going there. On? Where? He pointed to the back where the trailers get connected. I jumped up there with my dolly and held on, he dropped me at the Front office, of course lunch time had just started so I had an hour to wait till they opened up in some industrial park. Luckily it was shaded, and then I spotted a convenience store. Walked over even though it was going out of business they still had a cold beer, but only Bud Light – oh well it was hot outside, the beer was cold, and it was lunch time. After lunch when they re-opened, I went in and paid $80 for the shipping,  not bad at all, but the invoice said 700 lbs? Uh this little dolly isn’t going to work with 4 foot by 8 foot panels weighing 700 pounds. Its gotta just be the packing right? Went around to the back and the guy looked for the package. It was on the floor on two pallets. Uh-oh. Luckily, they said they deliver, so back around to the office to see about delivery. Lady in the front was so nice, but wasn’t sure when they could deliver, when I informed her the guys in the back said they could do it today as I was only a short distance away, they loaded it up with a fork lift and we took it in a truck down to the place I had left the dinghy. The driver helped me load the sheets into the dinghy, the sheets were so big that was almost no room left for me in the dinghy but made it out to the boat without the wind blowing the sheets into the water. Now back to the boat, how to unload to the mother ship? Two sheets at a time and used the blowing wind against the sheets as a kite, all aboard, then to find a place to store em. The boat is big, but finding 8 foot in a single location was a challenge. Each sheet weighs in at 15 lbs, so the actual weight is closer to 200lbs, not too bad.

There is a dinghy under there some where

Cockpit is full

All you get is a Bud Light

Hiked to top of hill,

View from the top, that is the boat right there.

swam a shore went for a walk.

La Semana

And of course celebrated the last day of work

Celebration