Before you dust off that passport and pull out your suitcase, it’s important to take a look at what you’re covered for on an overseas trip (if at all) and how a medical evacuation would be coordinated and paid for if you become suddenly ill or get injured while traveling.
Let’s start with a few important facts:
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Health insurance plans have limits to how far they extend and most do not provide coverage for any medical treatment received outside the U.S. borders.
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Even if you have health insurance, your insurance may only provide reimbursement for some portion of your expenses – you’ll have to pay everything out of pocket first.
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The language barrier is often a problem and can severely limit the efforts of friends and family back home who are trying to coordinate your evacuation.
A traveler may be in a remote area where adequate medical care is just not available, or their injury or illness may be so severe that they need specialized medical treatment. If this incident happened back home, there would be ambulance services to call and qualified doctors on hand to treat the medical emergency. Even if the traveler falls ill in a first-world country, their medical bills may or may not be covered by the kind citizens and taxpayers of that host country.
When a Medical Emergency Strikes a Traveler
While every traveler’s desperate story is unique, this is the gist of what happens in every one of these chaotic and dangerous situations:
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Traveler becomes suddenly ill or badly injured and is usually unconscious
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Locals carry traveler to a nearby medical facility that may or may not be adequate
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Traveler is in desperate need of a medical evacuation as their medical bills mount
As the traveler’s medical bills begin climbing fast, it becomes very apparent to everyone that covering them may be impossible in this lifetime. Getting the traveler home – back to their health insurance network and the support of family and friends – becomes more critical by the minute.
Here are just a few of the vacation-turned-nightmare stories from the news media and our blog:
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Anna Leibenko, a 24-year old on life support and in a coma with internal bleeding after a fall while her family tries to arrange for an air ambulance
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79-year old Alfonso Acosta visiting relatives in Mexico is left untreated in a government-run hospital for weeks
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Elissa Merritt languishes in a Costa Rica hospital after an ATV accident as her husband tries desperately to arrange an evacuation using his credit card
Financial Upheaval Quickly Follows the Medical Emergency
Some family members and friends may be tapped for cash, others start online campaigns to raise the money but none of this happens quickly.
An emergency medical evacuation is not cheap – in Elissa Merritt’s case (see above), her husband had to raise over $30,000 just to get her from Costa Rica to Miami (their home state is Minneapolis). Her medical bills were another price tag that had to be paid by credit card. In the case of Alfonso Acosta, his children arrived to pay cash for all his medical care while he was in Mexico. Later, they managed to coerce a pilot to transport him home and paid the pilot over $12,000 in cash. Anna Leibenko’s transportation home was reported to have cost over $80,000 and that doesn’t include her hospital bills back in Croatia.
The Flight No Traveler Wants to Take – a Medical Evacuation
According to the U.S. Travel Insurance Association (UStiA), thousands of travelers every year find themselves taking the flight no traveler wants to take – an emergency medical evacuation. Travelers requiring medical transport typically fall into one of the following categories: cardiac, respiratory, surgical, or orthopedic trauma.
While an emergency medical evacuation rarely costs over $100,000, there are a few factors that influence the cost:
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the traveler’s condition
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the traveler’s location
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the distance to adequate medical facilities
In addition, the coordination of a medical evacuation is controlled by a range of local and international laws. When a U.S. citizen is ill or injured abroad, their family may want to have them returned home immediately, but the U.S. embassy or consulate cannot make those medical decisions about the patient. Local law determines who is entitled to make those decisions. Usually the attending physician is involved in determining whether the patient is stable enough to travel.
Airlines and air ambulance services usually will not transport a patient if their condition could be further harmed in flight or if they are not expected to survive the flight.
Financing the Medical Evacuation – Be Prepared with Travel Insurance
The U.S. government offers financial assistance through emergency evacuation loans and repatriation loan programs, but only in limited circumstances – usually in a situation where a crime has been committed. The traveler (or their beneficiaries if the traveler dies) must repay the federal government for those costs. Guarantee of payment is required up-front.
Travel insurance companies – on the other hand – are skilled at handling these types of emergency medical situations. They have staff who can handle language translation, for example – a big problem in these situations and the travel insurance company will:
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Ensure that escorts for medically ill patients are on board as well as the medical equipment necessary.
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Coordinate with the host country, local authorities, and the traveler’s physician to determine the best method of transporting the traveler.
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Manage payment and timing of the services while keeping the family members back home informed of the schedule and their progress.
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Handle immigration documentation, flight clearances, and coordinate ground transportation on both ends of the evacuation as well as entry to an appropriate medical facility on the receiving end.
In many cases, travel insurance companies have their own emergency transportation services because local air carriers may refuse to transport a patient.
What it Costs to Insure a Traveler’s Medical Evacuation
While most travel insurance plans come in two main varieties: comprehensive package plans and travel medical plans, there are a few speciality plans that isolate their coverage to emergency evacuations. Both package plans and travel medical insurance plans include emergency medical evacuation coverage and here is a simple example of how much it would cost to cover a trip with these details:
2 travelers (45 and 48 years old)
New York to Cancun for a week
Total trip cost $4,800
When we run these trip details through our travel insurance comparison tool we get:
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Package plans (with trip cancellation coverage) starting at $191 for both travelers and including $250,000 for emergency medical evacuation.
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Travel medical plans (without trip cancellation coverage) starting at just $21 for both travelers and including at least $300,000 for emergency medical evacuation.
As you can see, with a comprehensive plan that covers trip cancellation, the premium is higher (to reflect the costs the travel insurance company may have to pay out if a cancellation occurs). The cost of a travel medical plan is quite affordable and when you consider the cost of medical evacuation, it seems a small price to pay for the luxury of a safe, medically staffed ride to your hometown hospital for treatment.
