By: Margaret.Ferté

A Guide to Medical Evacuation & Repatriation

Are you prepared if a sudden and unexpected illness or injury happens when traveling? Do you know what to do, where to go, whom to call? Do you know that an international medical evacuation can start anywhere from US$50,000? In case that happens, who is going to pay for the cost? While on vacation, it is important to plan ahead to avoid any unnecessary and unpleasant surprises.

What is Medical Evacuation and Repatriation

Should a medical emergency happen in a place where treatment is not readily available, a medical evacuation will be executed. You will be transported to the nearest appropriate medical facility within or outside the country where it happened either via an ambulance, a helicopter, an air ambulance, a commercial flight, or other suitable mode of transportation, depending on the situation.

A medical repatriation, on the other hand, is executed under the same condition as a medical evacuation, but it provides you the option of getting treatment in your home country, in a familiar environment, near your friends and family.

Having medical evacuation and repatriation in place ensures that you get access to the right treatment whenever needed.

At this point, one should not mistaken Medical Evacuation & Repatriation as a search and rescue program – being airlifted from the mountains or searching for victims in a landslide. In most cases, local emergency services are responsible for the first response.

Always read the fine prints and ensure that evacuation will be possible not only during medical emergency but also when appropriate medical facility is unavailable. Some insurers do not guarantee evacuation if circumstances are dangerous or impossible.

Also check to see who will be evacuated as well. Some providers take not only you but also all of your dependants.  In a time of crisis this can ease the stress for you and your family.

What is covered?

The coverage varies greatly from one insurer to another. Below are some examples of what you can expect:

• The transportation cost to the nearest medical facility if the required treatment is not readily available to the insured party. Mode of transportation includes ambulance, helicopter or aeroplane.
• Evacuation of insured and dependant(s) during an emergency only.
• Transportation cost of the insured and the accompanying adult returning to country of residence.
• The treatment costs incurred.
• Transportation, traveling, accommodation cost of an accompanying adult.
• Post-evacuation cost. Hotel accommodation for accompanying adult and for insured person when required pre and post hospital admission.
• Repatriation of mortal remains. In the event of death, the cover should include expenses for embalming, a container legally appropriate for transportation, shipping costs and the necessary government authorizations. For some insurers, cremation costs will only be covered if it is required for legal purposes. Some insurers may also include the expenses related to burial or cremation at the home country.

Do I need it?

Medical evacuation and repatriation is imperative for any traveler or expatriate. When you and your family are in your home country, should anything unpleasant happens, you have your support group, your family and friends, you know what to do, who to call, where to go, you are familiar with the healthcare system, there is no language or cultural barrier.

All these may not be the case when you travel or live abroad. Thus any sensible and responsible adult should ensure that help is put in place in the event of unforeseen circumstances.

Insurers' cover starts from US$25,000 to unlimited. This shows just how costly such exercise can be when executed. This is not to mention the medical cost that will be incurred. What about cost of an accompanying adult? His/her traveling and accommodation cost?

Case Study

28-year-old Peter was an expatriate working in Tokyo. He was a banker and had a bright future ahead of him. In November 2007, Yuki, his fiancée, and him were going to announce their wedding plan to his family back in UK. However, a month before, he met with a fatal accident. An accident that has left him paralyzed for life. He was hit by a two-ton truck while cycling on the streets of Tokyo. Upon admission to the hospital, the staff found his insurance card on him and called AXA. "This is a tragic accident. Taking care of our customer is our top priority. We must ensure that they receive all the support needed." Chris Campbell, AXA Tokyo. Peter's mother flew to Tokyo to accompany him throughout his repatriation journey. AXA worked with Lufthansa to provide complete intensive care unit and medical staff onboard its aircraft. In UK, Peter was immediately admitted to the hospital to receive treatment and care. The entire repatriation exercise cost US$185,000.

Important points to take note 

The reason for purchasing insurance is simple. To cover costs. Always find out how, what and how much an insurer will cover. How will the insurer pay the various expenses incurred? Will they settle directly so that there is no cash outlay on your side? Or will you have to pay first and claim later? Always ensure that you are familiar with the claim process. Dealing with an accident is already stressful, the last thing you need is a claim rejection due to lack of paper work or knowledge.

It is critical that you study the market carefully and read the fine prints before making such an important decision. If you already have an existing international health insurance, you should check with your insurer if there are any international elements included or if you are already paying for medical evacuation and repatriation. Most insurers such as AXA, BUPA, Goodhealth, CIGNA, Allianz and more, will offer medical evacuation and repatriation within their package or as an add on option.

There are numerous multinational organizations such as International
SOS, AXA Assistance, Europ Assistance, Mapfre and Mondial Assistance, just to mention a few, that provides emergency assistance. Without the assistance of these companies, travel or health insurance would be hollow.

Take for instance International SOS. It is the world's leading international healthcare, medical assistance, and security services company. It provides integrated medical, clinical, and security solutions to organizations with international operations. In China, where it has been established since 22 years ago, its team of 600 handles over 40,000 medical cases and over 500 evacuations every year. This translates to over 10 evacuations in China every week.

It is wise to work with an independent intermediary who should be able to advise you and present you with various options. In making your decision, compare not only the price but also the level of service and features. Ensure that the intermediary is truly independent and that they have professional liability.

About Expatmedicare

Expatmedicare is a fully independent intermediary that specializes in advising expatriates on their international health insurance. They provide free health and medical insurance advice. Their comprehensive service ranges from helping clients review current coverage, determine requirements, to market research, evaluation, analysis and recommendation, application process and claim management.

www.expatmedicare.com