Some pre-planning considerations for senior travelers

Assuming you are in the US please get a medical insurance policy. Medicare will not pay any bills for treatment outside the US or US territories

I assume you and they know that Medicare provides no coverage in Europe.

I would consider medical evacuation insurance.

It sounds sort of silly, but one thing I've noticed at 65 is that I'm more inclined to pick up summer colds when traveling than I was when younger. I found to my disappointment that my go-to zinc lozenges are (apparently) not sold in Spain; I had taken some with me, but not enough for the length of my trip.

I have nothing that I consider a mobility impairment, but my balance is not as good as it could be. I hope your mom will be willing to wear good, solid lace-up shoes to reduce the risk of a slip or fall.

I don't stay in 4-star hotels. I have encountered quite a number of perfectly nice (though not fancy) 2- and even 3-star places that had stairs (up to an entire flight) that had to be negotiated before you reached an elevator. If that would be an issue, it's something to pay particular attention to when reading hotel reviews, because it appears it is OK to say you have an elevator as long as there's one on your property somewhere.

Similarly, restaurants located in historic buildings very often have toilets downstairs. If that would be an issue, it argues for more pre-planning of meals than might otherwise be necessary.

Hi Z, a few tips that are applicable to all travelers (not just seniors):

• Find a good pair of walking shoes and break them in.
• Begin "training" for the trip, go to the mall or walk around the neighborhood until you can comfortably do three miles or so.
  
• Stay hydrated and take breaks when you need to.
• Pack light.
• Have a discussion about the changes in airport security and what to expect.

Hope you all have a great trip!

for my mom, "hurdles" that seemed to surprise/startle her were having to have change for toilets, using (& paying for) bottled water and not pulling her wallet out on the street. OH and coffee not coming w her meal,, but afterwards

While Medicare does not cover foreign medical expenses, some supplemental plans do. My Plan F supplement has a $50,000 USD lifetime limit. The added medical benefit of many travel policies is medical evacuation coverage. My former boss suffered a traumatic head injury in France on a post-retirement trip and had be be medivaced back to the States after he was stabilized. The medivac flight was a medical charter with medical staff on board. I've being buy foreign travel coverage and have not needed to make a claim.

Rick's advice on checking baggage if a connection or connections are involved is a good idea if your parents do not have the strength and/or capacity to move fast carrying or dragging baggage through crowded terminals and possibly up/down escalators. Not having a maximum legal carry-on will also speed getting them off of the aircraft if you are in the cheap seats at the back of the aircraft.

Packing light is a good idea but keeping you carry-on light is an even better idea. Do carry on medications and essentials. Legacy air carriers typically allow one free checked bag.

I went to France with my in-laws in 2013. They were both around 70 at the time and it was their first visit outside North America. Our first day was kind of stressful because they had to use the toilet A LOT. We were trying to walk off jet lag in Montmartre and luckily we ran across a construction site with port-a-potties! After that first day we were more mindful about toilet breaks.

ACraven makes a good point about accessibility. I think we've gotten so used to the changes the ADA has brought to the U.S. (doors, curb ramps, etc.) that we're sometimes taken by surprise (or simply have to remember) that accessibility differs place to place across Europe & UK. Older buildings, hotels with smaller sets of stairs along a corridor, doors to navigate while jostling luggage, little lifts that might fit one or two people at a time...it's just all stuff to keep in mind. Have a great trip!

It sounds sort of silly, but one thing I've noticed at 65 is that I'm more inclined to pick up summer colds when traveling than I was when younger. I found to my disappointment that my go-to zinc lozenges are (apparently) not sold in Spain; I had taken some with me, but not enough for the length of my trip.

Great points. I figure I'll be packing a box of TheraFlu, emergen-C and those zinc lozenges as the back-up pharmacy. I should also add some moleskin, ibuprofen, Pepto and Lactaid to the kit.

Bathroom access needs..yup, I better keep about $20 worth of Euro coins with me.

OTC medications (think allergies) are likely to be available, but packing enough for the trip saves time and hassle.

I've found I need to force myself to prepare, and use, daily itineraries for city stays. Not detailed schedules, but enough to keep me from spending exhaustive hours on foot going walkabout, which I'd happily do.

I will use a taxi to return to the hotel at day's end if I'm tired and don't want to cope with walking, subway, buses, etc.

Everyone feels awful when they lose sleep. As much as possible, keep to the same sleep habits and rhythms.

Don't carry 2-3 lbs of coins with you. Instead do what you do with kids before you get in the car - make them use the toilet. One of the most important "rules" of travel is Never Pass Up a Toilet. They are in museums, cafes, restaurants, and, of course hotels. In fact, a 4 or 5 star hotel is the best place to go if you need a toilet in the middle of a city. They will never turn you away and the lobbies are usually worth seeing.

More important than lazy days is not trying to pack too much into single days. Better to spend 1 more day in a place and sightsee at a slower pace. Don't skimp on transport, take taxis or buses instead of long walks.

Tell us where you're going and we'll tell you if senior discounts are available. For instance, Spain almost always, Italy often only for EU residents, France almost non-existent.

Medicare will not pay any bills for treatment outside the US or US territories

But some [most?] Medicare Advantage plans will.

Medicare will not pay any bills for treatment outside the US or US territories
But some [most?] Medicare Advantage plans will.

As I'm pealing the onion back on senior travel, this is major point, can you shed more light on this and what to look into, directions to follow and any advice.

Was doing an initial search, Medical Evacuation and Repatriation coverage appears to be the policy coverage to seek out, however, since both are over 70-years of age, they may be overage for various coverage plans. Also, since I'm using my points to pay for the flights, would I be the payee of their coverage?

I'm travelling with my 89 year old mother this summer; this is our 4th European trip together and I've learned a few things from past trips. Your parents are younger, and my mom is pretty mobile, but I have full responsibility for everything and basically, it's like travelling with a toddler.

Hotels: I have certain deal-breakers on my accommodations bookings:
1. I now book only hotels that have elevators, or Airbnbs on ground level
2. Rooms must have a walk in shower. European tubs are usually bigger and deeper, not worth the risk of her slipping and falling.

International flights: we pack as lightly as possible but I realize that I might become responsible for both bags at any time, so we check our baggage for all flights. We always fly into Frankfurt and I make sure to allow 3 hours before the connecting flight to make sure we can get thru immigration and navigate to the next terminal at a comfortable pace.

Inter European travel: Buses are a little easier than trains since the driver stores your bags under the bus, but we both love trains, so I usually just suck it up and realize I have to get her, then two suitcases and then myself with a backpack, up and down the train stairs. Trains with transfers or connections that are anything less than 30 minutes are verboten in my travel-planning world.

Book everything possible in advance: trains, buses, transfers, tours, museums.

Travel Medical insurance is a must, IMO. A few hundred dollars, although an OUCH, is worth the peace of mind. I have Blue Cross and she has Medicare supplemental, so medical costs outside the US are covered, but I also purchase medical travel coverage so the costs are covered up-front at the provider.

Travel Evacuation insurance is also a must. Some policies cover evacuation only to the nearest facility. I want evacuation back home to the US at our choice and to include a travel companion. You need a huge limit. There is no oversight or governance on air ambulance or medivac fees. Bills can easily, and usually do, exceed 100K.
Sorry for the elephant in the room, but that evacuation coverage needs to cover mortal remains.

Taxis, especially at the end of the day, are worth every penny, for senior travelers.

Plan everything, but be FLEXIBLE.

I'm glad to see that no one has given you the (to me) nonsensical advice that you can buy anything you need, so don't worry about bringing OTC medicines. First of all, it isn't true. I know that Peptobismol, which you mentioned, is not available in some countries, because it contains bismuth. Also, in most European countries, OTC's are available only in pharmacies. No popping into a supermarket for aspirin. The other issue about OTC's in Europe is that they are very expensive compared to here. Example: I once ran out of sudafed during an allergy attack in Italy. Yes, it was available; but each pill cost around A dollar. (The trade-off is that prescription drugs are way cheaper.). Bottom line is bring what you might need. Pills don't take up much room, nor do they weigh much.

I'm on Medicare and headed to Europe in a few weeks, and I called my health insurance company to find out if they sold medical insurance for Europe. They told me that Medicare does "cover" me in Europe. They won't pay directly, but they will reimburse me for any necessary emergency care needed while I am there.

Medical Insurance, be sure it covers consequential costs. For example, ear infection, minor problem. Doctor's visit plus medicine will not be much, hardly worth claiming. BUT, the doctor says you cannot fly for 7 days, and it is 3 days before departure.
Cost: 4 extra nights hotel for parent + yourself, plus 2xnew flights at full short notice cost. Very expensive.
I have known this happen. It was a British Person in Spain. They just took a train home instead.

I just turned 70, I make a doctors appointment, a month before my trip. He prescribes an antibodic, which I fill here.
And take with me.
I also recommend you get a generic equivalent prescription for any and all drugs they take.
This includes Advil, Tylenol, antacids, antihistamine.
Pack the amount of each drug they need, then add at least a weeks worth extra.
Check their supplemental insurance. Many policies are not covered outside the U S.

As a 75YO with a soon to be 71 YO spouse, I would say that some of the things suggested should be considered for ANY person who has not traveled internationally. We are fortunate enough to get to the EU about twice a year, and every so often I have clients visit the Italian company I rep-yep! Still employed on retainer and commission. What makes me crazy is clients(men and women) asking travel advice and then totally disregarding it! Case in point: 5 clients (and spouses) - met them at FCO, had hired a van, pointedly told them to bring no more than a carry-on and a backpack, and 3 of them came with 2 cruise-sized suitcases for us to train from Termini to Parma with a change in Bologna. Had one case of Angina(2 days hospitalized) and a 6 minute change of platforms in Bologna from what was originally posted when we arrived. We made the transfer, however, spousal "issues' occurred.
I just bring this up as all of the advice pertaining to your concerns for those over 70, which is not a magic cut-off date that those under 50 seem to assume is the dawn of rapid degeneration-it ain't anymore. A good bit of the advice should be filed to be used for any novice traveler.

They told me that Medicare does "cover" me in Europe. They won't pay directly, but they will reimburse me for any necessary emergency care needed while I am there.

Only if you have a Medicare Advantage or other private, supplemental insurance. We lived in Itlay for several years adn Medicare was a non-starter. Our BCBS plan, however, reimbursed well.

The medicare.gov website is pretty clear that health care including emergencies and medications outside the US is not covered by Medicare medicare coverage with some pretty restrictive exceptions. Supplemental coverage is private insurance you pay for yourself.

Z - Trip insurance will cover all travelers on a trip. There are many companies that cover 70+ travelers. Try insuremytrip.com to compare plans. So yes if you use your miles for their airfare you would be reimbursed for any fees associated with changing or canceling the mileage tickets for everyone.

Be sure and include time throughout the day for rest stops/breaks - maybe even time for a lay down before dinner.

I believe national health plans, like the NHS and others in Europe, will provide emergency/triage service to U.S. visitors but will not provide follow-on or long-term care without guarantee of payment. Invariably, this is insurance, whether Medicare or private. We need to contact our providers to ask, specifically, if/what coverage we would have in Europe. We need more than a generic promise of "coverage" made by a customer service rep on the phone. We need detailed written explanation of coverage, limits, exceptions, etc., and we need to know the info a European care provider would require.

Medical evacuation to a U.S. treatment facility could be prompted by any number of reasons, including rejection of U.S. insurance by a European care provider. E.g., if I am in a serious car accident and need 90 days in a rehab facility that won't or can't take my U.S. insurance, then I need to be medivac'd to one in the U.S. I can't simply assume Medicare or my private secondary insurer will fund that.

I would recommend roll-aboard bags rather than backpacks. When my parents and I traveled to Scotland when they were in their late 70's my Dad used a backpack. He did okay, but I was really worried, as I had a day pack and new I would struggle if I had to deal with his bag. My mom had luggage with wheel and she did fine.

One thing I found was that my dad was walking slower and I kept walking too fast and soon my mom and I would be yards ahead of my dad and we would stop and wait for him. It was better to try and pace ourselves to him.

My experience is that at least in the UK the NHS will treat you. So, the colds and tummy aches--which is what I had--can be dealt with. But anything need further care needs your insurance. Also, you probably have to buy your own prescriptions.

It was a great trip and the last overseas trip that they did and I am so very, very happy that we did it. I can get a bit teary eyed thinking of it a my dad has since died. My mom keep on going! No long trips, but she did come to visit my in NYC with my brother and nephew in her late 80's.

Pam

OP, if your parents have Medigap plans, check with the insurer whether foreign travels are covered, and what kind of coverage. Do so before buying any additional insurance.

https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html

During my years caring for my parents, I had hard copies summarizing their medical history and conditions, allergies, medications, contact information of me, their PCPs and other physicians, etc. When they visited a medical facility, the first thing I did was to hand the staff a copy. I also asked my parents to keep a copy with them at all times. Come to think of it, it's about time I should do the same for myself, especially when traveling.

Pamela of NYC makes a good point about having your parents using roller bags. If you use a backpack style carry-on for your own stuff, that leaves you with two hands. You can pull both of your parent's roller bags. If you yourself have a roller, that only gives you a spare hand to aid a single parent should they have difficulty pulling their own bag.

Having a backpack also helps if you need to help them load roller bags onto trains that are higher than the platform. You will have two hands free to toss their bags into the train. Same with escalator moving stairs. It's good to have free hands to deal with your parent's luggage.

Be sure to have additional coverage other than Medicare. I have Medicare plus I'm also covered by Kaiser, whose card and the Medicare card I always have on me, like the Calif Dr Lic. Factor in lazy days/down time absolutely helps. Important thing is to know how to pace yourself, whether you're going over for two weeks or longer. . In a month and a half I'm going over for over seven weeks, to be sure the itinerary has downtime or days factored in.

If you plan to use public transport such as subways, some advance research will help show where the train platforms are "accessible", which is to say have elevators or escalators. By no means do all the systems, and all the stations, make ease of access clear, but my impression is that awareness is improving.

if you want to compare a whole bunch of different insurance companies for travel insurance,
go to SquareMouth

link to squaremouth

I'm planning a trip later this Spring with my parents (78 and 80 years old); they are both quite active, and have traveled in Europe, but only on tours. Things that we have discussed, some of which are merely differences in travel styles, and not due to age.

They tend to bring more stuff; I have told them over and over they need to pack light, and it's my dad who's the clotheshorse. He asked me last weekend if the hotels will have an iron, which I didn't even think to consider when choosing our hotels, as I NEVER iron on vacation.

When me and my husband and kids travel, we primarily walk or take public transportation. My dad's not so into that, so we'll be taking more cabs or Uber. Though we will be discussing that sometimes public transport is faster and easier (like when trying to get in and out of St. Germain in Paris on a Friday or Saturday night). My dad has some mobility problems, so I'm planning everything with thoughts of distance.

My dad uses a C-PAP machine, so we've discussed that. I strongly feel the best way to handle that is for him to bring it in his carryon, preferably in a backpack. On previous trips, he brought a larger suitcase, and put it in the suitcase. I feel it would be better to carry on, in case of lost luggage (it's the one thing he can't do without).

Area of ongoing negotiations: who will drive the rental car. I have told my father I will be the primary driver, and he will navigate. He's the type who really prefers to be the driver in every situation. But he hasn't driven in Europe in probably 30 years; I am always the driver when my husband and I go to Europe. And my father is an excellent navigator; I am not.

I'm planning experiences that they haven't been able to get on their tours so much. We're staying at family-owned inns, and in one place, at a B&B. Some more rural areas, and smaller towns that tours don't get to. We've also arranged some foodie tours, which I think all three of us will like.

I'm so looking forward to our adventure together!!!

Lexma, regarding your ongoing discussion with your dad about who will drive the car, you might want to check with your car rental company. Many of them have age restrictions and at a certain age will not longer allow a senior to rent/drive a car. Several years ago, a family member just turning 71 was told his name could not be on the rental agreement and he would not be permitted to drive the car. This was in Germany, sorry I can't recall the name of the car rental agency

Lexma.....you are going to have a great trip. Of course You are rt about the cpap (& car). Those other kinds of tours (obviously not Rick Steves) with that "we'll set yr bag into yr room for you...anything up to 50 pounds and these enormous dimensions is OK" teach us some bad habits.

My mother is 85 and not really capable of traveling with me any longer. When she was early 70's, she was in good shape and went strong until she hit her wall in late afternoon, then it was time to pack her in a cab, get her some dinner and get her back to the room for sleep.

One thing I noticed was the need to manage her energy use. We didn't plan down days but we did look for every opportunity to rest on a bench rather than stand in line, sit down for 15 minutes at regular intervals, be in the shade rather than sun, keep warm/cool enough to be comfortable, drink plenty of water, snack regularly and don't miss meals. My mom wouldn't complain but if she got behind on energy, she would be done for the day. If I paid attention, she could manage well from morning until late afternoon.

As far as restrooms went. It was the same as traveling with kids. Go at every opportunity, even if you don't think you need to.

Billie Ray was our beloved 1st lady here in Iowa for 16 years. She logged, of course, a zillion personal apparences. When asked about her amazing stamina, she said never pass up the chance to use the restroom or to sit down .

My motto:
Never stand when you can sit.
Never sit when you can lie down.
Never stay awake when you can go to sleep.

HI:

I would echo what other posters have stated. Verify that their medical coverage will pay for expenses not covered by Medicare. I have been in the benefit field for over 30 years including administering retiree benefits. There was wording in the supplemental plan we provided to our retirees on Medicare that stated it would not cover any expenses that were not covered by Medicare. So look at your parent's policy in the exclusion area to see what is not covered and consider getting travel insurance. Don't assume it will cover expenses outside the US that would not be covered by Medicare.

You might also want to consider bringing a folding cane. Your parents may not need one normally, but cobblestones and other uneven surfaces may be a challenge if you are tired.

Lastly pay attention to the shoes they bring. I took a pair (I am 58) with me to Paris that had a narrow sole and it was a challenge on cobblestones when I was walking. i did much better with a pair of boots that had a wide sole. Better balance.

Zcorsair -
Having just returned from a two week river cruise (Budapest to Prague), at 67, I offer the following:
Your adventure with your parents can be divided into categories of potential outcomes - things that might happen and things that will happen. The "might happen" department is gigantic and too complicated to anticipate. Thoughtful consideration is your best preparation, here. Regarding the "will happen" department, my experience suggests....
Your parents will have their sense of "normal" disrupted. Their sleeping, eating and daily physical patterns will be altered. Jet lag has a greater impact on older travellers, changes in eating, resting, exercise and time zones are more challenging, too. Be prepared for these - they will happen.
Check-in with your air carrier as early as permitted to select the best seating opportunity. I recommend all aisle seating if you can get it. I recommend compression socks for air travel, and don't remove shoes while in-flight.
Be prepared for digestive disruptions.
Road test walking shoes on uneven pavement surfaces - many European cities have cobblestones.
Bring easy to hand wash clothing.
Most "over the counter" medications will be found only at a pharmacy - and they will be expensive. Bring your own aspirin from home.
The other side of "things that will happen" - you and your parents will have an absolutely wonderful time. Never lose sight of how special every moment of this adventure is.
When we landed in Budapest, my wife and I kissed the ground - amazed by the obvious - we we actually there!
Sweet Dreams Are Made Of This.

my dad always brings a cane-seat with him. He got it in a sporting goods store. its meant for use on a golf course. It has opens to a tripod and a tiny seat/perch. It gives him a place to 'sit' while we are on lines. A side benefit has been that many times he has been moved to the front of lines or allowed on the elevators.