Under what conditions is a medical repatriation possible? This question is probably posed by many patients who have been seriously ill or have had an accident during a stay abroad. Depending on the situation, different aspects play a role: medical factors determine the feasibility of a patient transport. However, the conditions under which their insurance company will cover the costs of medical repatriation are equally important for some patients. Last but not least, organisational conditions must be met, where necessary. Let us take a closer look at all these questions for you.
Medical requirements for a medical repatriation
A basic requirement for any medical repatriation is that the patient is fit to travel. In the case of ambulance flights, doctors often refer to the need for a patient to be ‘fit to fly’. In other words, the patient's state of health must permit safe transport. This is almost always the case for medical repatriations by ambulance aircraft or helicopter. Medical repatriations in a scheduled airliner are subject to more comprehensive medical requirements.
Medical repatriation by ambulance aircraft or helicopter
Both ambulance aircraft and ambulance helicopters are fitted with medical equipment that is similar to that of a modern intensive care unit. As a specialised medical doctor accompanies the flight, the patient is expertly cared for at all times. This means that a safe medical repatriation is possible for many intensive care patients.
Even if the changes in air pressure during a regular flight would cause health problems (e.g. in patients with pneumothorax, anaemia or severe pneumonia), a patient transport in an ambulance aircraft or helicopter can take place without any issues: a helicopter flies so low anyway that there are no significant changes in air pressure. In an ambulance aircraft, on the other hand, technical measures can be taken to adjust the air pressure of the cabin to be close to the ground level air pressure. A Sea Level Flight like this enables the transport of patients whose condition would worsen at a lower air pressure.
In practice, an ambulance aircraft is usually used for transporting severely ill patients. Helicopters have a significantly shorter range, so they are most often used to fly short distances.
Medical repatriation by ground ambulance
Modern medical equipment is also standard in a ground ambulance. This means that in many cases patient transports are possible, but the journey time is an important factor. Since the medical repatriation journey takes considerably longer than by air, the patient is exposed to a higher level of stress. Therefore, it is much better for critical intensive care patients to be transported in an air ambulance or helicopter.
Medical repatriation in a scheduled airliner
Carrying out a medical repatriation in a scheduled airliner is subject to additional conditions. The scheduled airlines reserve the right to thoroughly check the patient's health status and to refuse transport if there is a risk to the patient or other passengers. Therefore, only patients whose health condition is stable are suitable for a medical repatriation in a scheduled airliner – either lying down on a patient bed or sitting in a Business Class seat.
Further stipulations for medical repatriations by scheduled airliner are:
- The medical repatriation must take place on a direct flight as it is almost impossible to coordinate a patient transport efficiently on connecting routes. In addition, transferring between flights is too much of a burden for the patient.
- The flight must be a medium or long-haul flight: on short routes, the aircraft usually has to take off again so soon in the opposite direction that there is no time to install a patient bed. Since Business Class on short-haul routes often consists of regular rows of seats in which the middle seat remains unoccupied, in many cases there is not enough room for manoeuvre to allow the medical staff to care for the patient adequately during the flight.
- Medical repatriation in a scheduled airliner requires a lead time of 1 to 2 days. The airline requires this amount of time to decide whether it will accept the patient.
Stipulations for the insurance company taking over the costs
For many patients, deciding on a medical repatriation is not only linked to health considerations but also to financial obstacles. Most patients hope that their insurer will take over the costs in full, or at least in part. However, this is often tied to conditions that are set out in the insurance policy.
First of all, it is important that a valid international travel insurance policy (with sufficient health cover) is in place. Anyone who hopes that their private health insurance or statutory national health insurance will cover the costs is likely to be disappointed. Medical repatriations are not covered in most countries.
But even your travel insurance provider will not automatically take over the costs for every medical repatriation. Depending on the exact wording of the insurance policy, the costs will be covered in medically reasonable cases or only in medically necessary cases. A medical repatriation is considered medically reasonable if better treatment outcomes are to be expected in the patient’s home country than in the country they are staying in. This is often the case because familiar environments can positively influence the patient's recovery process.
On the other hand, the stipulation for a medically necessary medical repatriation is that appropriate treatment is not possible in the country the patient is staying in. This is much less common, because the healthcare systems of many countries have now progressed to the point that most diseases and injuries can be treated in principle. However, the quality of medical treatment abroad is often well below the standard that the patient is used to in their home country. Nevertheless, a policy that stipulates that medical necessity is required for medical repatriation often allows insurers to refuse to take over the costs in an emergency.
Important: in most cases in which the insurance company refuses to cover the costs, a medical repatriation can still be carried out. Just contact us and we will advise you on your options.
Organisational requirements for a medical repatriation
The organisational elements of a medical repatriation are extremely straightforward if you have an experienced partner like Medical Air Service at your side. As with any trip abroad, you will need a valid passport. In addition, you will need confirmation from a hospital in your home country that you can be admitted there. If you have not selected a hospital yet, we will gladly take care of the search for a suitable hospital for you.
In fact, you can rely on us to relieve you of the burden of organising all aspects of the medical repatriation. We will take care of every detail in planning and carrying out the medical repatriation, so you don’t have to spend time worrying about the organisational requirements.
If you find yourself in need of an air ambulance, our team is available 24/7 to provide you the support you deserve. You can contact us: