I tried to ship a 3-month supply of Adderall from the US to Japan. Not only did customs seize it, but I received a letter threatening deportation for “importing stimulants.” I called my insurance to see if they would pay for a local Japanese psychiatrist to re-prescribe it. They said, “We don’t cover maintenance medication or the legal fees for your customs issue.”
Key Takeaways
- Shipping is Illegal: You generally cannot mail prescription drugs across borders. Customs will seize them. Insurance will never pay for the lost drugs or the shipping costs.
- “Maintenance” Exclusion: Nomad insurance does not pay for your monthly refills. It only pays for new meds prescribed for a new injury/illness.
- The “Formulary” Gap: Drugs like Adderall (amphetamines) are illegal in Japan/Thailand/UAE. Insurance won’t help you navigate this. You need a local alternative.
- Lost Meds Coverage: If your bag is stolen with your meds, some policies pay to replace them. But you still need a local doctor to write the script.
The “Why” (The Trap)
The trap is “Import Laws vs. Medical Necessity.”
Just because you need it doesn’t mean you can import it. Insurance policies explicitly exclude “contraband” and “loss due to customs confiscation.”
- The Cost: You must pay out of pocket for a local doctor to prescribe a local equivalent.
The Investigation: I Called Them
- Cigna Global: They have a “Pharmacy” add-on. I asked, “Can I get meds in Japan?” They said yes, if the drug is legal there. They would pay for the local doctor visit and the pills. They would not pay to ship my US pills.
- SafetyWing: “We do not cover prescription refills for pre-existing conditions.” So, if you have ADHD, you pay 100% of the cost.
- PillPack / Expat Pharmacies: Specialized services exist to ship meds, but they are expensive and restricted by country.
Comparison Table: Medication Coverage
| Feature | Nomad Insurance | Global Health (Cigna) | Paying Cash |
| Monthly Refills | NO | YES (With add-on) | YES |
| Shipping Costs | NO | NO | NO |
| Lost/Stolen Meds | YES (Replace only) | YES | NO |
| Local Doctor Visit | NO (Maintenance) | YES | YES |
[IMAGE: Photo of a customs seizure letter next to a prescription bottle]
Step-by-Step Action Plan
- Check Legality: Google “[Drug Name] legal in [Country].” If it’s Adderall/Opiates, assume it’s illegal or restricted.
- Bring a 6-Month Supply: Carry it in your carry-on with a doctor’s note. This is the only reliable way.
- Find the Local Generic: Don’t ask for “Adderall.” Ask for “Methylphenidate” (Ritalin) or whatever is available locally.
- Pay Cash for Local Scripts: In Mexico/Turkey, many meds are OTC or cheap. Don’t waste time with insurance claims for $20 antibiotics.
FAQ
Can my mom mail me my meds?
Do not do this. It looks like drug trafficking. It will be seized.
Does insurance cover insulin?
Global Health plans (Cigna) do. Travel insurance does not (unless your pump breaks or you go into shock).
What if I lose my meds?
Go to a local doctor immediately. File a claim for the visit (as an acute issue) and the replacement meds.