Getting medical care as an expat in Prague

I haven’t had any major medical issues in the time I’ve been living in Prague. I’m relatively healthy, and I can usually kick even a severe cold in a couple of days without major incident. Until this week. Let me tell you about my adventures with the healthcare system in Prague.

My quasi-medical emergency

When I’m not traveling and blogging, I am teacher. And maintaining my travel habit is expensive, so I teach a lot between trips. Sometimes up to 7 hours a day, and often at least a few hours on Saturdays and Sundays if I have the time. That tends to wreak havoc on my voice.

I had been fighting what I thought was your average throat ache and hoarseness since last week. And without any other symptoms, I didn’t think much of it. But then earlier this week, the pain dramatically worsened and to my horror, I realized it wasn’t just a throat ache, but some unidentifiable and extremely painful swelling in the middle of my neck. This made it hard to talk, swallow, and eventually move my neck. And then I’m pretty sure I got a fever.

So I had to give in and take the Czech healthcare system for a test drive. Here is how that went.

Canadian Medical Care: the expat holy grail

It seems one of the most trusted places for expats to get medical care is the Canadian Medical Care, because they are a private clinic with English-speaking doctors. Even though they are notoriously more expensive than state doctors and hospitals, everyone raves about it. I was under the impression that it was something like an urgent care center, so I took my painful, burning neck protrusion out to Prague 6, which is around 35 minutes on the Metro from city center.

The building basically looks like a small castle, complete with an outdoor bistro. Inside, there is a cozy lobby with a stone fireplace and modern chairs around small coffee tables. So it looks more like a spa than a medical center. But when I asked to see a doctor, they had no appointments available. So fuck me for not calling first. You can even make an appointment on their website.

So I ended up getting an appointment with an ENT for the following morning at another CMC location. And I’ll get back to that.

Home care and over-the-counter treatments

In the meantime, I tried to deal with my problem the only way I know how, with soups, ice cream, and warm teas with honey. I went to Tesco so I could stock up on warm foods, by which I mean ramen, because that’s the closest thing to soup I know how to make and costs 16 cents a packet.

I also wanted a thermometer in case my fever got so high that I needed actual emergency care. Tesco is like the local equivalent of Target. It’s two massive floors of home goods, clothes, and groceries. They have 6 double-sided aisles of alcohol, but only one fucking thermometer in the whole place. And when I got home, I realized the box was empty, so I’m pretty sure my blind rage burned out whatever fever I may have had.

Then I went to a pharmacy. This isn’t a Czech thing, but a European thing. You can’t get any medicine anywhere without going to a pharmacy and asking for it. Not even lozenges. Luckily I have a pharmacy downstairs, and the sweet attendant was kind enough to find someone who could help me in English. I asked for an at-home swab test to check for strep so I could at least rule out spontaneous cancerous growth, but they had none. Because I guess Europeans are super committed to medical experts doing all the diagnosing.

So I went to see a medical expert.

Finally, real medical care

The only upside to waiting until the following day was that I could see a specialist right away, no referral and no 3-month wait list. I just needed to survive the night. And in case I didn’t, Canadian Medical Care along with many hospitals make house calls 24 hours a day. Or of course, I could go to the 24-hour foreigners’ department of a local state hospital like FN Motol or Na Homolce. But I stuck to the Canadian Medical Care, based on the recommendations of many expats.

Medical Insurance

So I finally made it to my appointment. When I got there and they took down my insurance information, they realized I needed to get pre-authorization from my insurance company for the visit since they are a private clinic. So I was sure I was about to get screwed.

I’ve had medical insurance for the Czech Republic and the entire Schengen area since I got my visa. You need to have coverage for the full duration of your stay before they even let you pick up your visa. It was fantastic; one year of medical insurance cost me $65. Naturally, I assumed it would be garbage, but I also didn’t think I would ever need it, so I didn’t care.

So I nervously called AXA and explained my situation, hoping they wouldn’t tell me I was on my own. But instead, they sent the authorization electronically to CMC in less than 5 minutes. A few minutes later, about 10 minutes after my appointment time, my doctor came out to greet me and apologized for being late.

The visit

He took me into his office which looked like the office of a graphic designer at Google. He was wearing baby blue skinny jeans so he looked the part, too. He did a routine examination. Then used a fiber optic cable to look at my throat through my nose. Based on the location of my pain, he suspected it was the thyroid. So he quickly did an ultrasound. At this point, I was freaking out because of what I assumed this was going to cost.

Between the fear and the blinding pain of having the ultrasound wand pressed into my fake Adam’s apple, I almost passed out. The doctor put a warm cloth over my forehead and brought me water, like I was about to get a massage up in there. Then he explained that I have a bleeding fluid-filled cystic nodule in  my thyroid gland, and I would have to see an endocrinologist. There was absolutely no way this was a weird health care scam because I could clearly see the giant mass in the ultrasound.

After the exam, he wrote up a detailed report in 10 minutes, which he gave me to take home. And he prescribed me antibiotics and something to aid my thyroid function until I see the endocrinologist. He scheduled the appointment for me himself 3 days from now and apologized that it couldn’t be sooner because one of the specialists is on vacation. I immediately received a text confirming the appointment. I mean, this is some bougie medical service. I’ve never experienced anything like it.

So how much did it all cost?

A little less than 5000 crowns or $200, including my two prescriptions. But “Don’t worry,” the doctor assured me. “Your insurance will probably cover all of it.”

I know I’m always bitching about how awful the US is, and even I’m tired of it. But I pay monthly in the US what I paid here to insure my health for a whole year. And that’s because I have Obamacare, which Republicans thankfully failed to repeal recently (That’s right, Paul Ryan, it’s easy to be against things, but a lot harder to actually do something that’s better.) And I’ve definitely paid more than $200 as a copay on my shitty US insurance for someone to listen to my heartbeat with a stethoscope.

So suffice it to say, I’m eternally grateful this issue came up in Prague. I have never felt happier to live here than I do today. Though my diagnosis ended up being far worse than I expected, I’m surprisingly calm about the whole thing. Maybe it’s because I’ve grown up learning to worry, not about my actual well-being, but about how much treating a serious illness costs. Because what doesn’t kill you could bankrupt you for life. I guess I never thought about how ridiculous it is to panic when you need something so simple like an ultrasound.

I could definitely get used to this. And I can now personally vouch for how amazing Canadian Medical Care is. Hopefully I will continue to be impressed by their service when an endocrinologist is sticking a needle in my neck to drain this thing. Wish me luck! (Also, please don’t tell my mom. She would have a fit over this.)