The Challenges of Emergency Evacuation and Medical Repatriation
For expats who are working or living in remote locations where medical facilities are either lacking or not up to standard, it may be important to include emergency evacuation and medical repatriation cover in their health insurance.
In this Pacific Prime Hong Kong article, we’ll discuss what emergency evacuation and medical repatriation are, the challenges, and why you should think about including them in your global health insurance plan.
The Importance of International Health Insurance Providers During an Emergency
Emergency evacuations and medical repatriations are becoming increasingly important in the international private medical insurance (IPMI) industry as more international companies, such as mining companies, have staff and workforces working abroad, possibly in remote and dangerous regions.
Therefore, companies looking to expand internationally realize they need to provide their staff with international health insurance, as, in fact, health insurance is a legal requirement in many countries, but domestic coverage may not be as comprehensive as IPMI.
IPMI covers medical costs in treating illnesses and also provides coverage for medical emergencies such as emergency medical evacuation, political evacuation, natural disaster evacuation, emergency reunion, repatriation of mortal remains, and emergency travel assistance worldwide.
Moreover, comprehensive IPMI plans often include language assistance services, and being able to communicate with the insurance providers in their native language is a huge advantage for anyone living away from home.
What is Emergency Evacuation and Medical Repatriation?
While emergency evacuation concerns transporting an injured or seriously ill person to a fitting medical facility, medical repatriation refers to when the insured person is sent back to their home country for ongoing treatment, as long as it is medically appropriate and can be done.
To elaborate, emergency evacuation is implemented when a person gets seriously injured or ill where local treatment is unavailable and has to be taken urgently to the closest medical facility that is appropriate.
For example, insured clients are often evacuated from a rural clinic to a city hospital or from a country with limited trauma care to a country with advanced medical infrastructure.
Medical repatriation, on the other hand, is when the insured, who had received initial care in the country they fell ill in or were injured, gets repatriated to their home countries to continue their recovery in a familiar environment, provided the journey is deemed safe and suitable.
Typical Costs for Emergency Evacuation and Medical Repatriation
Costs for emergency evacuation and medical repatriation can undoubtedly be high, but they also depend on several factors, including your location, the resources available at the location, the distance to the nearest suitable medical facilities, and the severity of patients’ conditions.
With that being said, here are the expenses for an average air ambulance trip from various locations to the US.
| Routes | Estimated Costs |
| Caribbean and Mexico to US | $15,000 to $25,000 |
| South America to US | $40,000 to $75,000 |
| Parts of Europe to US | $65,000 to $90,000 |
| Asia, Australia and the Middle East to US | $165,000 to $225,000 |
As is evident, the prices are extremely expensive, especially for distant locations, if you have to pay out of your pocket. In addition, if onboard medical teams and supplies or a nurse escort are required, the total price could reach higher.
The Challenges of Emergency Evacuation and Medical Repatriation
It’s not hard to imagine that emergency evacuation and medical repatriation on a global scale come with their own set of challenges. Various factors, including remote locations and lack of medical facilities, can hinder a successful and timely evacuation.
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Remote location and lack of medical facilities
Many expats live and work at remote locations, where there are no hospitals well-equipped for comprehensive medical emergencies. While insurance companies do their best to locate the closest medical center, the local ones may not always be the most suitable.
For example, a person in Papua New Guinea needed medical evacuation because the nearby hospital in Port Moresby lacked adequate medical facilities. As a result, they had to be evacuated to the closest center of excellence, which was located in Cairns, Australia.
In addition, poor communication and lack of transportation infrastructure further complicate evacuations; limited telephone or internet access makes it difficult for medical rescuers to evaluate the situation, and a lack of roads or nearby airports makes it challenging to move the patient.
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Medical and clinical challenges
Conditions of the patients play a huge role in determining the result of the evacuation. Some patients need to be stabilized before transport, which requires the local facilities to cooperate. Without adequate expertise and the right equipment, conditions may worsen, and evacuations may be riskier.
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Cultural and language barriers
When many parties from different cultures are involved, differences in medical practices, patient preferences, and family involvement can result in a delay in decision-making.
Moreover, language barriers between different parties, including the patient, local staff, insurer, and the evacuation team, can affect the timeliness of the communication or, even worse, cause misunderstandings.
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Environmental and weather conditions
Adverse weather effects are one of the recurring hindrances for safe and timely evacuations. Tropical storms, monsoons, and snowstorms can delay all modes of transportation.
Moreover, during earthquakes, floods, or hurricanes, the scale of the need for emergency medical services will likely overwhelm the capacity of the local staff and facilities that are necessary in aiding the evacuation and repatriation process.
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Financial and insurance-related challenges
As mentioned, evacuation and repatriation are undeniably expensive, and lack of proper insurance can lead to financial issues that delay or reject either of them.
Moreover, insurance claims can be complicated, as some companies have strict terms and policies, exclusions for some countries and conditions, or caps on total coverage amounts.
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Political and legal barriers
In some war zones and politically sensitive areas, overflights and landing permissions may be denied, which will force the team to take a long detour or rely on ground transport through dangerous zones to reach the patient.
Moreover, visa and immigration issues are no exception to medical emergencies. A passport copy, along with a permit or visa for the country they are being moved to, is required before a person can be evacuated. Visas are often difficult to obtain, especially when there’s a tight deadline.
Having said that, experience and perseverance combine to make global insurance providers adequately prepared for these types of challenges. Still, individuals would benefit most if they secure insurance from trusted insurance providers and plans that particularly suit their needs.
What You Need For an Emergency Visa
The following items are required to apply for an emergency visa.
- Medical report from the treating physician, which includes a justification for requiring treatment in the country of choice.
- Invitation letter from the admitting medical facility in the country of choice, which confirms the acceptance of the patient, willingness to give treatment, the estimated length of stay, and estimated costs.
- Letter from the insurer or the patient’s family/employer confirming financial means for medical, transportation, and living expenses.
The two scenarios that may occur after the application is approved are:
- Emergency visa is issued on arrival.
- Emergency visa is issued, but a family member or representative has to visit the embassy or visa application center and apply on behalf of the patient.
Luckily, technology has helped insurance providers overcome many difficulties associated with emergency evacuations and medical repatriations, thereby increasing the survival rates of evacuees.
Advances in technology are evident in all stages of the evacuation process, from communication and portable medical devices to the actual air ambulances. Thanks to technology, air ambulances are capable of flying at speeds and altitudes that reduce the chances of medical deterioration.
Pre-trip Planning and Risk Assessment
For expats and travelers heading to remote areas, taking proactive steps to prepare for unexpected health situations can offer peace of mind and potentially make all the difference at a critical moment.
Here is a list of what you should do before traveling to a remote or underdeveloped area:
- Pre-trip medical evaluations: Before embarking on your journey, it is highly recommended to get a comprehensive medical evaluation. The goal is to identify any pre-existing conditions that might occur or be worsened during your travel and your time at the destinations.
- Local facility assessments: Understanding the medical infrastructure at your destination is a crucial step. This process includes knowing where the nearest clinics and hospitals are located and what level of care they can provide. The information helps assess what level of coverage you may need from your insurance plan.
- Knowing the evacuation protocol: Every second counts in the face of emergency health situations; therefore, learning your coverage rights and the protocol to follow in case of medical emergencies can make a drastic difference.
- Having copies of medical documents and passports ready: Having personal and medical documentation on hand, whether in the form of digital or hard copies, will help ensure that medical staff and insurance providers are able to manage your conditions effectively.
Tips for Choosing a Plan with Medical Evacuation Coverage
The appropriate health insurance plan that includes evacuation coverage should have the following features:
- 24/7 emergency helplines
- Global hospital network access
- Air ambulance inclusion
- Evacuation options: Nearest center of excellence or Home country only
- Repatriation of mortal remains
International Private Health Insurance VS Local Health Insurance
While some individuals may be drawn to acquiring local health insurance at the destination because it is generally cheaper, international private health insurance, or IPMI, is specifically designed to cater to expats’ needs.
With expats as their target customers, IPMI plans offer benefits like evacuation, repatriation, and multilingual support services, which address the specific needs of people living abroad. Additionally, IPMI plans often provide custom options that help adjust the plan to serve individuals’ needs.
Overall, while local insurance may be cheaper, IPMI plans that provide comprehensive protection may be more worth it in the long run when emergencies may unexpectedly happen at any time and specialized treatment can be financially overwhelming without adequate coverage.
Securing Emergency Evacuation and Medical Repatriation Coverage
Experiencing illness or injury in a remote location can have critical consequences. Having the appropriate insurance coverage ensures you have immediate access to high-quality medical care when you need it most. However, making the right decisions for insurance needs can be hard on your own.
With over 20 years of experience, Pacific Prime is a reputable insurance broker that can help you find the best health insurance company and plan in Hong Kong that balances your requirements and budget.
Contact us to receive a free quotation, plan comparison, or impartial advice today.
Frequently Asked Questions
Is repatriation the same as evacuation?
Repatriation involves transporting patients back to their home country after receiving initial treatment to continue care in a better facility. Evacuation, on the other hand, refers to the urgent transfer of patients from the site of injury or illness to the nearest suitable medical facility.
Is there travel insurance that will just cover medical repatriation?
Generally, medical repatriation is only included as part of the benefits of travel insurance alongside medical expenses, trip cancellations, and lost luggage. However, it is often available as an additional purchase to other existing insurance plans.
How much repatriation cover do I need?
Repatriation coverage needs vary by destination, age, and medical history—a minimum coverage amount of $100,000 is typically advised. Many insurance providers also offer a high amount of coverage for a small extra cost, which is worthwhile in case of traveling to remote areas.
Who decides if I need to be repatriated?
The insurance providers decide on the repatriation. They will assign a specialist to assess your conditions together with the doctors from the medical facility in which you are being treated. If they deem the repatriation safe and necessary, patients will be transported back to their home country.
Jantra curates and reports on the results of Pacific Prime’s monthly newsletters, as well as manages Pacific Prime’s Deputy Global CEO’s LinkedIn posts. Complemented by her background in business writing, Jantra’s passion for health, insurance, and employee benefits helps her create engaging content - no matter how complex the subject is.
Growing up as a third-culture kid has given her a multicultural perspective that helps her relate to expats and their families while 8 years of working remotely have given her unique insight into hybrid work arrangements and enthusiasm for employee benefits.
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