Emergency Evacuation And Repatriation


A baggage delay is a nuisance -- you buy another toothbrush or pair of socks to hold you until your bags show up. A trip cancellation would hurt more but losing a few thousand dollars, while painful, is not the end of the world. But a $100,000 emergency evacuation or repatriation can ruin your retirement. That's why many travelers, even if they decide not to get any other benefits, often insist on having emergency evacuation/repatriation coverage.

What can an evacuation or repatriation cost? A source at CSA has said that the average cost is $25,000 which probably means there are lots of evacuations that cost much less averaged in with a few that can be $100,000 or more.

What is an emergency evacuation? If you need immediate transport from wherever you're at to emergency medical care that's an evacuation. It can include anything from ground transportation up to an air ambulance with doctors and nurses in attendance. A cruiser's worst fear is having to be taken off the ship by helicopter -- while it's rare, it does happen.

What's a repatriation (sometimes called a "non-emergency medical evacuation")? Once you're stable enough to travel but still need medical care the insurer will arrange for you to be brought home or to a hospital near your home. It can also refer to the return of your mortal remains to your home.

Where to get this coverage? The coverage is probably included in whatever package travel insurance plan you're considering. It's become a fairly standard feature of most plans although the coverage amount can vary widely -- anywhere from $25,000 up to $2,000,000. Stand-alone plans from companies such as MedJet are also available on an annual or per trip basis.

Here's a sample from the TravelSafe Classic plan:

When You suffer a loss of life for any reason or incur a Sickness or Injury during the course of a Trip, the following benefits are payable, up to the Maximum Benefit Amount. [with this plan $1,000,000]

1.  Emergency Medical Evacuation : If the local attending Legally Qualified Physician and the Program Medical Advisor determine that transportation to a Hospital or medical facility is Medically Necessary to treat an unforeseen Sickness or Injury which is acute or life threatening and adequate Medical Treatment is not available in the immediate area, the Transportation Expense incurred will be paid for the Usual and Customary Charges for transportation to the closest Hospital or medical facility capable of providing that treatment.
If You are in the Hospital for more than 7 consecutive days and Your dependent children who are under 18 years of age and accompanying You on the Trip are left unattended, Economy Transportation will be paid to return the dependents to their home (with an attendant, if considered necessary by the Program Medical Advisor).
If You are traveling alone and will be hospitalized for more than 7 consecutive days and Emergency Evacuation is not imminent, benefits will be paid to transport one person, chosen by You, by Economy Transportation, for a single visit to and from Your bedside.

2.  Non-Emergency Medical Evacuation : If the local attending Legally Qualified Physician and the Program Medical Advisor determine that it is Medically Necessary for You to return to Your place of permanent residence because of an unforeseen Sickness or Injury which is acute or life-threatening, the Transportation Expense incurred will be paid for Your return to Your permanent residence or to a Hospital or medical facility closest to Your permanent place of residence capable of providing that treatment via one of the following methods of transportation, as approved, in writing, by the Program Medical Advisor: i) one-way Economy Transportation; ii) commercial air upgrade (to Business or First Class), based on Your condition as recommended by the local attending Legally Qualified Physician and verified in writing; or iii) other covered land or air transportation including, but not limited to, commercial stretcher, medical escort, or the Usual and Customary Charges for air ambulance, provided such transportation has been pre-approved and arranged by the Program Medical Advisor. Transportation must be via the most direct and economical route.

3.  Return of Remains : In the event of Your death, the expense incurred will be paid for minimally necessary casket or air tray, preparation and transportation of Your remains to Your place of residence or to the place of burial.


But, as always, you can't stop there. If you poke around the plan document you'll also find the following additional information:
 

"*For Persons Age 80 and older, the Benefit limits are subject to a maximum of $25,000 for Accident & Sickness Medical Expense and $50,000 for Emergency Medical Evacuation/ Repatriation of Remains." 

and in the plan's list of general exclusions you'll find this:

"14. due to a Pre-Existing Condition, as defined in the Policy. The Pre-Existing Condition Limitation does not apply to the Emergency Medical Evacuation or Return of Remains coverage; or "


That second part is huge -- no matter what your situation with pre-existing conditions you're covered. Many insurers will apply their normal pre-existing condition exclusion to this benefit also so iff that's the case with the plan you're choosing be sure to get the waiver of the pre-existing condition exclusion if possible. And be sure to check your state exceptions for any other changes that might apply to you.

What does the following portion of that above coverage description mean?

1.  Emergency Medical Evacuation : If the local attending Legally Qualified Physician and the Program Medical Advisor determine that transportation to a Hospital or medical facility is Medically Necessary to treat an unforeseen Sickness or Injury which is acute or life threatening and adequate Medical Treatment is not available in the immediate area, the Transportation Expense incurred will be paid for the Usual and Customary Charges for transportation to the closest Hospital or medical facility capable of providing that treatment.


What this is telling you is that the decision as to where you will be taken and by what means is not going to be yours. This is standard with all of the package plans and is the major difference between these plans and some (but not all) of the stand-alone evacuation plans such as MedJet. How big of a deal is this? In all honesty, if you are in serious enough shape to need an evacuation your decision will probably be the same as what the insurer would decide -- get me to the nearest hospital ASAP that can handle this. The big difference probably comes in when you have been stabilized. At that point there may be a difference of opinion as to what steps to take next. With the plan shown above if the insurer wants you to remain where you are for a while longer you have two choices -- stay where you are or arrange your own transport at your own expense. With a service such as MedJet the decision is yours.

There's obviously a difference in cost. With the package plans the emergency evacuation portion of your premium is minimal -- just a few bucks depending on your age. MedJet, if purchased on a per-trip or annual basis, will cost quite a bit more. For those that want complete control over their medical decisions while on a trip that additional cost may be well worth it.

One other thing to keep in mind is that the insurers want to make all of the arrangements for your evacuation, even taking care of pre-paying the service provider. This is a great feature because you may not be able to afford to pre-pay a $100,000 air transport. But be aware that not following this procedure may void your coverage and you might not be reimbursed. From that same policy:
 

All medical transportation services must be authorized and arranged by One Call. In the event of an unauthorized Medical Evacuation, reimbursement may be limited or coverage may be invalidated. 

 

Some insurers have recently come out with a "hospital of choice" benefit. Here's one example that comes at no additional expense:

Hospital of Choice

Subject to the terms and conditions of this item #2, You may choose a Medical Evacuation to a Hospital in a city within the USA other than Your home city, but the maximum amount payable is limited to the cost of a Medical Evacuation to Your home city.


Obviously, there no additional premium because you're picking up the tab for any additional expense. Other insurers will cover this additional expense if you pay an additional premium for this coverage at the time the plan is purchased such as with some Travel Guard plans and their optional medical upgrade.

TravelSafe has recently come out with a new benefit which might be of value to you depending on your type of trip and your destination. It's called "Non-Medical Emergency Evacuation" (not to be confused with the same plan's "Non-Emergency Medical Evacuation."

Non-Medical Emergency Evacuation Benefits

All reasonable expenses incurred for Your transportation to the nearest place of safety, or to Your home, are covered, up to a maximum of $25,000, if You must leave Your Trip for a Covered Reason.

Evacuation must occur within 10 days of any covered event. Arrangements will be by the most appropriate and economical means available and consistent with Your health and safety. Benefits are only payable for arrangements made by One Call Worldwide Travel Services Network, Inc.

Covered Reasons : We will pay for the Non-Medical Emergency Evacuation Benefits listed above if, while on Your Trip, a formal recommendation from the appropriate local authorities, or the U.S. State Department, is issued for You to leave a country You are visiting on Your Trip due to: 1) a natural disaster; 2) civil, military or political unrest; or 3) Your being expelled or declared a persona non-grata by a country You are visiting on Your Trip.

Non-Medical Evacuation Exclusions :

We do not cover: 1) loss or expense recoverable under any other insurance or through an employer; 2) loss or expense arising from or attributable to: (a) dishonest or criminal acts committed or attempted by You; (b) alleged violation of the laws of the country You are visiting, unless We determine such allegations to be fraudulent, or (c) failure to maintain required documents or visas; 3) loss or expense arising from or attributable to: (a) debt, insolvency, business or commercial failure; (b) the repossession of any property; or (c) Your non-compliance with a contract, license or permit; 4) loss or expense arising from or due to liability assumed by You under any contract.


This coverage is included at no additional cost and can be invaluable when you're in a tough situation far from home.


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