Little-known sources of emergency medical evacuation coverage

By Wayne Wirtanen
This item appears on page 52 of the November 2003 issue.
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Among the choices to be made regarding travel insurance, emergency medical evacuation coverage continues to be what I recommend most.

I believe that emergency medical evacuation coverage is a must for overseas travelers (and especially for seniors). This coverage is so rarely used that it can be relatively inexpensive to purchase, and it is often available at no or very little extra cost through a variety of “clubs” or affinity groups.

Although emergency medical evacuation coverage is almost always a part of a travel insurance package, those of us who choose not to buy a comprehensive travel insurance policy should at least try to find some “evac” coverage.

This evac service is generally not included in the health insurance that you have at home. There are some exceptions: I know that Kaiser provided this coverage on a “case by case” basis in the past. Inquire of your regular health insurance company if they do the same.

So here’s what to do

1. Before your trip, check with your health insurance provider as to what services and assistance they provide in the event of overseas medical problems.

2. Inexpensive and comprehensive “stand alone” emergency medical evacuation coverage is available from Divers Alert Network, or DAN (phone 800/446-2671 or visit www.diversalertnetwork.org). DAN coverage is unlimited and has no preexisting-condition clause. (It would pay to inquire of any evac-coverage provider as to whether or not there is a preexisting-condition clause.)

3. Inquire if an affinity group that you belong to provides evac coverage as part of their membership package or includes it with their “plus” membership extra features.

4. Be aware of three very important travel insurance rules:

a) If you have evac coverage and you have an emergency, you must contact the provider before initiating any expensive evacuation services. Of course, if the problem is life-threatening, go ahead and get urgently needed medical assitance and then continue to try contacting the provider. They will not pay for evacuation services that you arrange without their assistance.

b) Emergency medical evacuation providers do not pay for medical expenses, only for transportation, and the fine print generally says that transportation will be provided only “to the nearest appropriate medical facility.” Full transportation home is provided only on a doctor’s recommendation.

c) Even if you have a standard travel insurance package that provides for payment of medical expenses, you will have to pay up front for medical expenses overseas, bring English-language receipts and descriptions of services home and then present them to the travel insurance company for reimbursement.

Auto club “plus” programs

I’ve found quite a number of organizations that provide evac coverage. One of the most prominent is the auto club.

What we know as the “Auto Club” is actually some 77 different organizations across the U.S. and Canada. These individual clubs have differing packages of services.

An example is the Northern California Auto Club that provides coverage in Northern California, Nevada and Utah. They have an AAA Plus program, at an extra cost, which offers expanded auto emergency services and a $25,000 emergency medical evacuation service. I’ve been told that a similar “plus” program is available from the New York State Automobile Club. If you are an auto club member, inquire at your local office to see if a similar program is available in your area.

Other affinity groups which provide evac coverage

MEDEX (800/732-5309 or www.medexassist.com), an evac provider, has supplied me with a list of the following associations/affinity groups that provide evac coverage as part of their benefits package: Family Motor Coach Association, Good Sam, National Rifle Association, Habitat for Humanity, DiveSafe, Coast to Coast, Camping World, Golf Card International, American Legion, United States Marine Corps Association, Little League Baseball and Special Olympics.

If you are a member of one of these groups, inquire about their evac coverage. If not, consider joining one of them if they are an affinity group of your interest. If you don’t have a contact number available, look up the group on the Internet or, as a last resort, contact me at the address given near the end of this article.

How much evac coverage is enough?

The few affinity groups that I have contacted have maximum coverage amounts of $25,000. For the most popular destinations in Europe and the Caribbean, this upper limit on coverage generally will be adequate.

The usual image of an emergency medical evacuation is of a flight home from an exotic destination in a private jet, accompanied by medical personnel. This is an extremely rare occurrence (and truly very expensive). Evac policies guarantee transfer to the “nearest appropriate medical facility” and service beyond that only if clearly necessary and recommended by appropriate medical personnel.

Jim Grace, president of Insure My Trip (800/487-4722 or www.insuremytrip.com), gave me some figures relating to evac costs and updates on very recent changes in this type of coverage.

Price said that approximately 80% of calls for medical evacuation result in simply transporting the patient to the nearest appropriate medical facility.

As to costs of the more expensive evac services, he said, “Most commonly, evacuations from Europe and the Caribbean run between $10,000 and $30,000. Costs from more remote destinations can, and do, run up to $50,000 to $100,000. Evac costs vary greatly depending on the severity of the medical problem and the destination involved.

“Within the last three months, due to customer requests, most travel insurance policies have had their evacuation limits raised to $250,000 or $300,000, and medical limits have been raised from the $10,000 range to as much as $50,000.

“As many as half of travel insurance policies will pay (reimburse for) overseas medical expenses incurred — up to the policy limit. Only if your medical expenses exceed the travel policy limits will your at-home medical policy be responsible for the balance.

“MEDEX is the only evac provider that will guarantee to fly you home after a serious medical emergency oveseas. Others will fly you home only if the problem is serious enough for a doctor’s recommendation.”

Access to 43 different travel insurance policies from 13 different companies (including Medex) is available from Insure My Trip. Tell them what your requirements and priorities are and they can recommend appropriate coverage. 

Specific evac examples

Carol Mueller, Communications Manager of Travel Guard International (800/826-7791 or www.travelguard.com) provided the following examples of evacuations required due to medical emergencies overseas.

Case 1. A policyholder traveling in BRAZIL suffered a broken hip and needed immediate medical attention. Travel Guard arranged a ground ambulance evacuation to Rio de Janeiro, where he had surgery. Once he was capable of returning home, Travel Guard arranged a commercial stretcher flight with an R.N. escort to Denver. Cost: $29,000.

Case 2. A woman traveling in Omsk, RUSSIA, suffered a broken femur and was taken to a local hospital for surgery. Afterward, she and her husband were flown back to the U.S. with a medical escort. Cost: $10,000.

Case 3. A woman traveling in Sandton, SOUTH AFRICA, called Travel Guard after a cut on her leg became infected, resulting in the removal of a portion of her leg. Her husband was also admitted into a local hospital with pneumonia. Travel Guard monitored their conditions until both were stable enough to travel, then arranged a commercial flight back to the U.S. and vehicle transportation to a hospital. Total cost: $5,000.

More evac information

For more information, see the article The Ins and Outs of Emergency Medical Evacuation Coveragein the December 1999 issue of ITN (from that stack in the garage) or send $2 for a reprint to me, Wayne Wirtanen, c/o ITN. 

My continuing advice regarding emergency medical evacuation coverage for overseas travel is “Don’t leave home without it.”

Thanks to Leif Heilberg of San Francisco, CA, for reminding me of the auto club “plus” program.

Happy trails.    

Please login or subscribe to ITN to read the entire post.

Among the choices to be made regarding travel insurance, emergency medical evacuation coverage continues to be what I recommend most.

I believe that emergency medical evacuation coverage is a must for overseas travelers (and especially for seniors). This coverage is so rarely used that it can be relatively inexpensive to purchase, and it is often available at no or very little extra cost through a variety of “clubs” or affinity groups.

Although emergency medical evacuation coverage is almost always a part of a travel insurance package, those of us who choose not to buy a comprehensive travel insurance policy should at least try to find some “evac” coverage.

This evac service is generally not included in the health insurance that you have at home. There are some exceptions: I know that Kaiser provided this coverage on a “case by case” basis in the past. Inquire of your regular health insurance company if they do the same.

So here’s what to do

1. Before your trip, check with your health insurance provider as to what services and assistance they provide in the event of overseas medical problems.

2. Inexpensive and comprehensive “stand alone” emergency medical evacuation coverage is available from Divers Alert Network, or DAN (phone 800/446-2671 or visit www.diversalertnetwork.org). DAN coverage is unlimited and has no preexisting-condition clause. (It would pay to inquire of any evac-coverage provider as to whether or not there is a preexisting-condition clause.)

3. Inquire if an affinity group that you belong to provides evac coverage as part of their membership package or includes it with their “plus” membership extra features.

4. Be aware of three very important travel insurance rules:

a) If you have evac coverage and you have an emergency, you must contact the provider before initiating any expensive evacuation services. Of course, if the problem is life-threatening, go ahead and get urgently needed medical assitance and then continue to try contacting the provider. They will not pay for evacuation services that you arrange without their assistance.

b) Emergency medical evacuation providers do not pay for medical expenses, only for transportation, and the fine print generally says that transportation will be provided only “to the nearest appropriate medical facility.” Full transportation home is provided only on a doctor’s recommendation.

c) Even if you have a standard travel insurance package that provides for payment of medical expenses, you will have to pay up front for medical expenses overseas, bring English-language receipts and descriptions of services home and then present them to the travel insurance company for reimbursement.

Auto club “plus” programs

I’ve found quite a number of organizations that provide evac coverage. One of the most prominent is the auto club.

What we know as the “Auto Club” is actually some 77 different organizations across the U.S. and Canada. These individual clubs have differing packages of services.

An example is the Northern California Auto Club that provides coverage in Northern California, Nevada and Utah. They have an AAA Plus program, at an extra cost, which offers expanded auto emergency services and a $25,000 emergency medical evacuation service. I’ve been told that a similar “plus” program is available from the New York State Automobile Club. If you are an auto club member, inquire at your local office to see if a similar program is available in your area.

Other affinity groups which provide evac coverage

MEDEX (800/732-5309 or www.medexassist.com), an evac provider, has supplied me with a list of the following associations/affinity groups that provide evac coverage as part of their benefits package: Family Motor Coach Association, Good Sam, National Rifle Association, Habitat for Humanity, DiveSafe, Coast to Coast, Camping World, Golf Card International, American Legion, United States Marine Corps Association, Little League Baseball and Special Olympics.

If you are a member of one of these groups, inquire about their evac coverage. If not, consider joining one of them if they are an affinity group of your interest. If you don’t have a contact number available, look up the group on the Internet or, as a last resort, contact me at the address given near the end of this article.

How much evac coverage is enough?

The few affinity groups that I have contacted have maximum coverage amounts of $25,000. For the most popular destinations in Europe and the Caribbean, this upper limit on coverage generally will be adequate.

The usual image of an emergency medical evacuation is of a flight home from an exotic destination in a private jet, accompanied by medical personnel. This is an extremely rare occurrence (and truly very expensive). Evac policies guarantee transfer to the “nearest appropriate medical facility” and service beyond that only if clearly necessary and recommended by appropriate medical personnel.

Jim Grace, president of Insure My Trip (800/487-4722 or www.insuremytrip.com), gave me some figures relating to evac costs and updates on very recent changes in this type of coverage.

Price said that approximately 80% of calls for medical evacuation result in simply transporting the patient to the nearest appropriate medical facility.

As to costs of the more expensive evac services, he said, “Most commonly, evacuations from Europe and the Caribbean run between $10,000 and $30,000. Costs from more remote destinations can, and do, run up to $50,000 to $100,000. Evac costs vary greatly depending on the severity of the medical problem and the destination involved.

“Within the last three months, due to customer requests, most travel insurance policies have had their evacuation limits raised to $250,000 or $300,000, and medical limits have been raised from the $10,000 range to as much as $50,000.

“As many as half of travel insurance policies will pay (reimburse for) overseas medical expenses incurred — up to the policy limit. Only if your medical expenses exceed the travel policy limits will your at-home medical policy be responsible for the balance.

“MEDEX is the only evac provider that will guarantee to fly you home after a serious medical emergency oveseas. Others will fly you home only if the problem is serious enough for a doctor’s recommendation.”

Access to 43 different travel insurance policies from 13 different companies (including Medex) is available from Insure My Trip. Tell them what your requirements and priorities are and they can recommend appropriate coverage. 

Specific evac examples

Carol Mueller, Communications Manager of Travel Guard International (800/826-7791 or www.travelguard.com) provided the following examples of evacuations required due to medical emergencies overseas.

Case 1. A policyholder traveling in BRAZIL suffered a broken hip and needed immediate medical attention. Travel Guard arranged a ground ambulance evacuation to Rio de Janeiro, where he had surgery. Once he was capable of returning home, Travel Guard arranged a commercial stretcher flight with an R.N. escort to Denver. Cost: $29,000.

Case 2. A woman traveling in Omsk, RUSSIA, suffered a broken femur and was taken to a local hospital for surgery. Afterward, she and her husband were flown back to the U.S. with a medical escort. Cost: $10,000.

Case 3. A woman traveling in Sandton, SOUTH AFRICA, called Travel Guard after a cut on her leg became infected, resulting in the removal of a portion of her leg. Her husband was also admitted into a local hospital with pneumonia. Travel Guard monitored their conditions until both were stable enough to travel, then arranged a commercial flight back to the U.S. and vehicle transportation to a hospital. Total cost: $5,000.

More evac information

For more information, see the article The Ins and Outs of Emergency Medical Evacuation Coveragein the December 1999 issue of ITN (from that stack in the garage) or send $2 for a reprint to me, Wayne Wirtanen, c/o ITN. 

My continuing advice regarding emergency medical evacuation coverage for overseas travel is “Don’t leave home without it.”

Thanks to Leif Heilberg of San Francisco, CA, for reminding me of the auto club “plus” program.

Happy trails.