When Love Blooms Again: Protecting Yourself on International Adventures
The golden years often bring new chapters: a well-earned retirement, the freedom to travel, and sometimes, a second chance at love. Consider a couple, both widowed, who have found companionship later in life. Their financial affairs are meticulously in order: trusts are established, and their wills are up to date. Crucially, they have each executed healthcare proxies, legally designating their respective adult children to make medical decisions should they become incapacitated. They start making plans to travel abroad.
Then someone asks the question: "If something happens to one of us medically while we're overseas, can the other make healthcare decisions?"
The answer surprises most people—and it might surprise you, too.
The Dream Trip versus the Legal Reality
You've planned the perfect international adventure. Whether it's a long cruise, a trek through South America or an ancestral journey through Ireland, you've sorted the tickets, the currency, and the luggage. If you've also created an essential healthcare proxy (or Medical Power of Attorney) at home, you deserve to feel secure.
Why is a healthcare proxy important? It names a trusted person (often a spouse, partner or adult child) to make medical decisions for you if you cannot speak for yourself.
But here is a critical fact that many seasoned travelers overlook: The moment your flight leaves U.S. airspace, your domestic healthcare proxy may become legally powerless.
The Problem: Your Healthcare Proxy Doesn't Travel
If a medical emergency happens in a foreign country, your document, created under the laws of your home state, is just a piece of paper to a foreign doctor or judge. Would your traveling companion – the person who knows your wishes best – have the legal right to direct your care?
In almost all cases, the answer is no, at least not right away. Each country has its own laws, which may differ from laws in the U.S. Ignoring this risk can lead to devastating delays and emotional chaos.
What This Means in a Real Emergency
Imagine this scenario: You're on a dream trip to Tuscany. One morning, you collapse. Your companion rushes with you to the hospital, terrified and desperate to help.
The doctors stabilize you, but now they need to make crucial decisions. Surgery? Aggressive treatment? Life support? They need authorization. They ask your companion about your next of kin and discover that your adult children, who are back in Boston, are your designated healthcare proxies.
Now, picture what happens next:
Your children receive a frightening phone call during their workday. Through choppy international connections and language barriers, they're trying to understand complex medical information from Italian doctors, which is filtered through translators.
Meanwhile, your companion is sidelined. The person who's actually there – the one who can see you, talk to doctors face-to-face and provide context about what happened – has no legal standing to participate in decisions about your care. This sidelining can lead to critical delays.
Hours or even days can be lost tracking down the right people and coordinating across time zones. Meanwhile, doctors might simply proceed with whatever they deem medically necessary, potentially bypassing your wishes entirely.
Your companion feels emotionally devastated – and helpless. Your children feel guilty and frustrated. Everyone is doing their best in an impossible situation that could have been avoided with better planning.
How to Protect Yourself Before You Travel
The good news? You can fix this vulnerability with some straightforward planning before your trip. Five simple steps can secure your medical care anywhere in the world.
Step One: Update Your Proxy for Travel
The most effective action you can take is to make your traveling companion the primary medical decision-maker. [Note that this doesn't just pertain to travel with a new companion. Anytime you're traveling internationally with someone who isn't your legal spouse or designated healthcare agent, consider whether it makes sense to expand their authority for the trip temporarily.]
Before you travel, you should review and update your healthcare proxy (or MPOA) to reflect your travel plans:
Dual naming. Designate your traveling partner as your primary agent for medical decisions and emergencies. (And vice versa.) Specify that this person is the authority you want consulted first.
Successor agent. Keep your children (or other trusted family members) listed as successor agents. If the traveling partner is also incapacitated or unreachable, the authority then passes to the children.
Clarity of intent. Even if a foreign country doesn't fully recognize the document, having your partner named as the clear, current primary agent strengthens their position significantly with doctors and hospital administrators in a crisis. This simple act removes any legal ambiguity about your wishes regarding the person at your bedside.
Professional translations. Having your healthcare proxy, living will, and any other advance directives professionally translated into the language of every country you'll visit shows your clear intentions and can be persuasive in practice, even without legal force. (You can decide if it's worth the extra cost to you.)
Step Two: The Legal Seal of Approval, or Apostille
A U.S. notary's seal holds no significance outside the United States. To give your updated healthcare proxy greater international validity, you need a special seal called an Apostille Certificate.
The Apostille is a standardized certificate created under the 1961 Hague Convention, an international treaty signed by most countries worldwide. Its purpose is simple: it verifies the authenticity of your official document for use in another member country.
Here's how it works: After you sign your updated proxy and have it notarized, you must take the document to your Secretary of State's office (or an equivalent authority in your state) to have the Apostille attached. This certificate ensures that when your document is presented to a foreign hospital or court, it is accompanied by a formal guarantee from your government, confirming that the document is genuine and properly executed.
This step is a non-negotiable for any medical document you plan to use abroad. Without the Apostille, you risk immediate rejection.
Step Three: The Preparedness "Go-Bag"
Legal rights are only as good as your ability to present them quickly. You must create a small, easily accessible medical travel kit (a physical binder and a digital file) to carry with you at all times.
Your Go-Bag should consider the following:
Keep the original, Apostilled, signed documents with you, not in checked luggage, and a PDF copy on your smartphone.
Carry a simple medical summary, a one-page document that lists key medical information, including blood type, known allergies, current medications (with dosages), major conditions, and a brief emergency contact list.
HIPAA is a U.S. law, but a signed HIPAA authorization form naming your traveling partner (and family) allows your U.S. doctors to share your health records legally. This is vital, as foreign doctors will need this history.
For extended stays (six months or more) or if you plan to purchase property overseas, consult with an attorney in the destination country. They can advise you on drafting a simple, local-language Medical Power of Attorney to maximize protection under that country's specific laws.
Step Four: Get the Right Travel Insurance
Standard travel insurance often excludes pre-existing conditions or limits medical benefits to an amount that is too low. While it costs more, you should look into specialized travel medical insurance that:
- Covers pre-existing conditions (read the fine print carefully)
- Includes emergency medical evacuation
- Provides 24/7 local assistance services to help navigate foreign healthcare systems
- Has high enough benefit limits for serious medical situations
Step Five: Talk to Your Children
To prevent hurt feelings and distraction if something should happen to you while you're abroad, sit down with your adult children before you leave. Make sure they understand that you're traveling with someone you trust deeply. They should know how to easily reach your companion. You still want them involved in medical decisions, but you expect they'll work closely with your on-site companion – if medical decisions are needed.
Conclusion: Securing Your Peace of Mind
International travel should be exciting, not stressful. The potential for a medical crisis abroad is something we all hope to avoid, but planning for it is a profound act of love and responsibility.
The good news is that by taking these proactive steps, you can close the legal gap between your home state and the rest of the world. You ensure that the person closest to you will have the legal authority to care for you when you need it most, allowing you to focus entirely on the journey ahead.
At WH Cornerstone, we've worked with clients who have traveled or moved abroad – and we've done extensive off-the-beaten-track international travel ourselves. We are familiar with the necessary preparations to ensure you are well-equipped in the event of a medical emergency.
Please call to schedule a time to discuss your travel plans. Let us help ensure you're covered for every aspect of your journey: not just the financial pieces, but the legal protections that keep you safe while you're out living your best life.