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| Medical emergencies can happen at any time anywhere in the world and clients need to be prepared. // Photo by Mike Machat |
It’s easier to say “no” than “yes,” when many travelers are asked by their agent if they want to buy insurance that either includes or adds emergency medical evacuation (medevac) coverage. But if your clients are injured or have a medical emergency while traveling, a medevac situation could cost them a fortune. Many clients simply do not understand that Medicare and many health insurance plans valid in the U.S. will not cover any medevac services outside the U.S.
Even if their policy does cover health care abroad, it likely does not cover medical evacuation.
Unexpected Things Happen: While the need for a medical evacuation is relatively rare, the circumstances under which it’s needed are unexpected—a roadway accident with serious injuries, a heart attack, a brush with nature such as a tsunami or wildlife incident, or the simple worsening of an illness that suddenly transforms into a major medical emergency.
Agents might have their clients take a look at an eye-opening case study (www.travelinsure.com/who/atravelingnightmare.asp) that’s written by an outdoor editor who ventured as a traveling sportsman to Cameroon in Africa. His odd accident was caused by nature—as a tree crashed into his position in a tree stand, throwing him to the ground and causing serious injury.
Prior to departure, he made a decision to forego travel or medical evacuation insurance. He thought he’d handle any needed arrangements as needed. He even looked online pre-trip and read how others had been evacuated out via commercial jet—simply by buying multiple seats to accommodate a gurney on commercial flights.
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| Medevac companies have fully equipped planes with medical staff to monitor patients. |
But, when he tried and failed to accomplish that for his own evacuation, the arrangements including use of a private medical jet with attendant cost him $122,000.
Sometimes it’s a simpler situation that occurs in a more cosmopolitan area of the globe. Clients might develop deep vein thrombosis on a flight to London with the need to cancel vacation arrangements and be transported back.
To show clients why they might need medevac services, agents may find that case studies help. Medical evacuation assistance or jet services companies have good examples online, such as FrontierMEDEX.
The U.S. Government Is Not Mom or Dad: Clients should not expect the U.S. Embassy abroad to completely and fully address their issues and handle everything needed. Yes, the embassy will do its best to ensure the safety of citizens and help evacuate them in the event of war or a major natural disaster.
They’ll also assist individual citizens in distress, such as providing the address of the nearest English-speaking doctor or hospital information. But they have no obligation to fly travelers out of the country when they’re ill or make all the arrangements to get travelers home.
“If the U.S. Embassy does [in some cases] assist with an evacuation, it bills the passenger or family for the costs,” emphasizes Sheri Machat, senior vice president, MH Ross Travel Insurance Services. “The embassy does not absorb the costs.”
Machat notes that MH Ross’ medical evacuation is included in the travel insurance policy clients purchase from her firm. The level of benefits depends on the actual policy purchased and medical evacuation benefits can range from $50,000 to $1,000,000. Check with other insurers for their specific requirements.
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| Medevac team standing by. |
The Skies are No Longer That Friendly: In the past, many airlines helped travelers who were ill or injured and needed to travel home while on a gurney. The person needing transport just purchased multiple seats in the same row for the gurney, which was strapped across the armrests of those seats. Other nearby seats held medical equipment. The passenger typically traveled with a medical attendant or two.
But that’s often not possible today. Airlines have cut capacity the past several years. Availability of such a large number of seats may not exist for last-minute travel. Even if some seats are available throughout the cabin, the airline might not desire to shift around other passengers at the last moment to accommodate a gurney.
Many frequent flyers now travel in coach. They select their favorite seat or position in the plane in advance. Those who pick an aisle seat on a long-haul flight if asked to change to a window seat may either balk at switching or complain to management. It’s a consumer hassle many airlines don’t want.
In addition, some patients being transported on flights have died en route home. Their families have sued the airlines. Thus, many carriers won’t bother with the potential legal problems of transporting people who really need medical care onboard. Those that do transport such people want to know travelers are well enough to fly, which in many cases, they aren’t or they wouldn’t need the flight home.
“Many airlines will not accept stretcher cases and if they do, it is a very involved process to proceed,” says Machat. She says the complications are why all medical evacuation companies have fully equipped planes with medical staff to expedite a serious case.
Navigating a Jigsaw Puzzle: Trying to arrange your own medical evacuation in a foreign country can be difficult and complex. Travelers can’t just do what they might at home. Laws, rules and regulations are often different. Culture plays a role in local supplier actions and obligations. After-hour options for medical care may be non-existent.
Language too can be an issue. If the client doesn’t speak the language of the country, even just trying to find an English-speaking staffer can be a challenge at times. And if that staffer speaks some English they may not understand medical terminology well enough to translate accurately.
Clients who are extremely ill or injured or spouses and traveling companions shouldn’t have to spend hours and hours calling to try to piece together an evacuation plan with suppliers and dealing with government red tape.
If clients have purchased travel insurance that includes medical evacuation insurance, they have 24-hour travel assistance resources available to them. A friendly voice on the phone which can make any necessary arrangements when you’re very ill or hurt is a big asset. So tell clients to be sure to take any insurance paperwork and travel assistance phone numbers with them on vacation should a situation develop.
Not All Hospitals are Created Equal: If clients become extremely ill or are injured abroad, they could be taken to a local hospital in a Third World country. Care may be basic at best. Some insurance may cover a flight out of a remote region to a larger medical facility. Other insurance might include a flight to a hospital in a big city or world capital such as Rome, Paris, Singapore or Buenos Aires.
But don’t assume that clients will be flown home to a hospital in the U.S. Travelers without the right insurance could be stuck in a hospital in a foreign country far from home.
Machat says clients should ask themselves the following questions to know if they have the right insurance: “If something happens during the trip, if I am taken to a hospital near where I became ill, will I then be evacuated home? When I am evacuated home, can I or my family select our hospital of choice?”
Money Talks: If clients say, “Oh, we’ll pay when and if we need such medical evacuation services,” they might want to look at average medevac costs. According to MedjetAssist, transportation from Durban, South Africa, to Boston is typically around $125,000. From Rochester, MN, to New York City might cost $16,000.
Could your clients afford that up front? Many suppliers or air evacuation firms want the money prior to providing services, such as an air ambulance, qualified flight crew or an emergency medical attendant.
Other Resources: If clients opt not to buy travel insurance that includes medical evacuation coverage, they can still get medevac protection from companies that sell only that type of product. Some have evacuation membership plans either for a limited time or for an annual fee. They have a fleet of jets available 24/7 to reach travelers in distress across the globe. The annual option is particularly helpful if clients travel a lot.
That said, medevac insurance doesn’t typically cover many things that travel insurance does, such as replacing the value of the trip should you have an issue or lost baggage reimbursement. It simply provides medevac transportation in case an evacuation is needed.
If clients don’t purchase either travel insurance with medevac coverage or, alternatively, a stand-alone medical evacuation program or membership, they should consider travel assistance coverage from firms that offer those services. These companies monitor worldwide events and provide safety and security information and medical advice to travelers. They also help in emergency situations and can coordinate evacuations.
Again, it’s extremely helpful to have a friendly English-speaking person to talk with on the phone—someone with global resources and cultural, political and medical knowledge. Yes, the client must pay for any services that are arranged, but the travel assistance firm can smoothen the way.
Ask if clients are “Premier” members of the American Automobile Association; standard memberships can be upgraded for a nominal fee to this higher level, which includes emergency travel and medical assistance services; information, referral, arrangement, ticketing and reservation services for such travel is provided without charge, but the member must pay fees and expenses charged by outside entities. Some credit card companies also offer emergency travel and medical assistance benefits.
Accidents, natural disasters, wildlife encounters and medical emergencies do occur. International medical evacuations typically cost $50,000 or more. Ask clients if they can afford not to have a safety net.