Cathy Lizak
Contributing writer
last updated 11/11/2019

Medical Repatriation: Safely and Quickly Bring Your Patient Home

What is medical repatriation and what are medical evacuation procedures?

InsuranceAir Ambulance

When your loved one is injured or stricken ill in another country, you may need medical repatriation. Medical repatriation is used to rapidly and safely return your patient to their country of origin to receive immediate medical care.

Every year, people traveling abroad are confronted with serious illnesses or injuries that require them to be returned to their home country for medical treatment. This blog will document reasons for medical repatriation, how to get your loved one home safely and fast, several medical flight options available to you, as well as potential costs to repatriate a patient, and the steps involved.

Reasons for quickly returning your patient home from another country include: - Better medical treatment - Insurance coverage - Support of Doctors Who Know Patient’s Medical History - Support of loved ones

Medical Evacuation For Better Medical Treatment

All over the world, doctors worldwide are concerned for the welfare of their patients. However, in many parts of the world, medical facilities are sub par, access to medical equipment and medicines are limited, or specialty skills are non-existent. Patients are faced with the dilemma of obtaining an operation in a country with these limitations or of being evacuated to a country with higher success rates for survival and recovery.

Global Air Ambulance can typically evacuate your patient to a higher level of care within 24 hours to eliminate the risk of an unsuccessful operation or insufficient care. While some patients should be stabilized in country prior to transport, many others will reduce their risks by being transported as soon as possible to their home country. It is vital that you consult with a medical transport doctor to assess the risks of medical repatriation versus staying in country.

Insurance Coverage

While the cost of medical repatriation is substantial, repatriation costs are often much less than the cost of staying in a country where you have no medical insurance. Please check with your insurance company to determine coverage outside of your country. The cost of out-of-network medical care can be substantially higher than repatriating back to in-network providers.

In addition, ask the hospital, where your patient is located, to explain the costs of continuing to receive treatment there. Your medical repatriation company can give you free quotes of different patient transport options that are available so that you can compare costs of staying versus costs of medical repatriation.

Support Of Doctors Who Know Patient’s Medical History

Laying ill in a foreign country’s hospital is severely stressful. Similarly, a medical staff that may have communication problems attempting to diagnose a patient’s issues, without knowing the patient’s medical history, can be debilitating to the patient. Getting the patient quickly to their known medical support can be critical to their stabilization and recovery.

Support Of Loved Ones

When a person is injured or takes ill, being in a foreign hospital, where caregivers may not speak their language, or where facilities are inadequate, is stressful. Often, doctors speak some English, for example, but nurses and other hospital staff do not. The lack of communication between staff and patient becomes a detriment to getting proper treatment. The stress can exacerbate the patient’s condition for months. Studies prove that a patient’s condition improves significantly when surrounded by family. Studies also show that a patient receives better care when the family witnesses the hospital staff.

The best care often occurs in a patient’s hometown surrounded by family. Global Air Ambulance will speak to the foreign medical facility staff in their language to fully understand the patient’s needs so that we can provide you the best options for safely and quickly transporting your patient and family back to their home country anywhere in the world.

If the cost of medical repatriation is too great, please consider temporarily setting up base near the patient to reduce their stress as much as possible. Hopefully, there are several options for medical repatriation that families can afford so that more family members can provide support and loving attention.

Medical Repatriation Options

  • Options for medical repatriation depend on several factors including:
  • How quickly the patient needs to be repatriated
  • The severity of the patient’s medical condition
  • Specific limiting medical conditions of the patient
  • The patient’s location and destination
  • How many passengers want to accompany the patient
  • What the family can afford, including insurance and private pay
  • How Quickly Does The Patient Need To Be Repatriated?

In some instances while travelling, a person’s life may be threatened by illness or injury where medical facilities may be inadequate to save them. In these cases, time is of essence and air ambulance may be the only option. Air ambulance can pick up a patient anywhere in the world within hours. When distances are great and same day travel is required, Global Air Ambulance can partner with other international air ambulances to conduct wing-to-wing transfers to expedite travel.

In most cases, air ambulance can be completed within 24 hours. In other instances, where immediate evacuation is not required, other, less expensive options may be available. Medical escorts can be completed in 72-96 hours. Ground transportation can be performed in 24-96 hours. Airline medical stretcher transports can be 50% less costly compared to air ambulance and, in many cases, can provide a similar level of care. However, stretcher transports are complicated to set up and may take 10-14 days preparation time.

The medical repatriation medical director can advise you on all medically appropriate repatriation options. Sometimes, it is best to wait to stabilize the patient. For instance, for 24 hours after a heart attack, it is best for a patient to rest in a darkened room and to avoid the stress of transport. Another best-to-wait transport is immediately after a patient is intubated. In this case, the patient may need to stabilize on the vent for at least 24 hours prior to transport.

How Severe Is The Patient’s Medical Condition?

For unstable patients, the only option, if at all, is to transport them via air ambulance. Most stable patients, even critically ill ones, can be transported by stretcher on a commercial airline. For basic patients that can sit and that do not have conditions where they act out, airline medical escorts may be a less expensive, viable option. Finally, for shorter distances, some patients can be transported by ground ambulance across national borders. In these instances, we may need to coordinate between two or more ground ambulance companies and border authorities to conduct the trip.

Patient Medical Conditions May Limit Options

Patients requiring more than 2-3 liters per minute of oxygen may need to be transported by air ambulance. In addition, patients on ventilators should be transported by air ambulance. Patients that cannot sit for at least three hours cannot travel by airline medical escort. Unfortunately, expecting mothers in labor cannot be transported internationally.

Patient’s Location And Destination

No matter where on earth the patient is, they can be transported by air ambulance, as long as the pick up and drop off locations are not at war. However, in some locations that might endanger the crew, the aircraft will land in country shortly before patient pickup and depart as soon as possible.

International airline stretcher and medical escort transports are best when the pick up and drop off locations are within an hour or two from a major airport. Stretcher transport can be non-stop flights but they do not have to be. Global Air Ambulance will recommend shortest flights available that also meet pickup and drop-off time limitations of medical facilities.

Ground transports can be conducted between neighboring countries, in many cases. Ground transports should be no more than 24 hours in length for the safety of the patient and crew. Some country borders do not allow for handoff of patients. Your medical repatriation company can advise you on any restrictions.

How Many Passengers Want To Accompany The Patient?

Most transport options allow family members to accompany the patient during a medical repatriation. Some options, like air ambulance, are limited to two passengers in addition to the patient. Some air ambulances, while more costly, provide conveniences like standing room and full restrooms on board. Airline escorts and stretcher transports simply require additional tickets to be purchased for family members.

What Can The Family Afford, Including Insurance And Private Pay

Unfortunately, medical repatriation can be very costly and air ambulance is the most costly of all the options. If money were no object, Global Air Ambulance would recommend all patients be transported by air ambulance, as it is the safest, fastest, least stressful of all the options for the patients. However, we offer more options so that most families can afford to safely transport their patient. Global Air Ambulance will ensure that you understand every option available.

The Cost Of Medical Repatriation

Your medical repatriation company can provide you free written quotes of all options available for your patient. Here are some example ranges for Medical Repatriation Using the United States as the Destination:

Europe:

  • Air Ambulance: $50,000 to $100,000
  • Stretcher: $40,000 to $70,000
  • Escort: $15,000 to $30,000

Asia:

  • Air Ambulance: $90,000 to $200,000
  • Stretcher: $50,000 to $90,000
  • Escort: $20,000 to $35,000

Central America:

  • Air Ambulance: $10,000 to $40,000
  • Stretcher: Not Available
  • Escort: $7,000 to $15,000

Steps To Perform Medical Repatriation

The following are steps needed for a family to repatriate a loved one:

  • Medical consultation
  • Contract and payment
  • Develop itinerary
  • Doctor evaluation
  • Create a flight/immigration clearance plan
  • Get immigration clearance
  • Perform trip
  • Medical Consultation

When you call a medical repatriation company such as Global Air Ambulance, you will immediately be paired with a consultant who will give you all the information you need to understand which medical repatriation options are best for your patient. We will ask you about the patient’s condition and what you are trying to accomplish. We will advise you on all the available options and provide you written quotes for those options. We will answer all of your questions and put you at ease about the risks involved with transporting your loved one safely to their destination.

Contract And Payment

Your medical repatriation provider should provide you with a written contract detailing all of the services provided, the date of the service, and an exact cost, with no additional fees, so that you know your financial responsibility. Medical repatriation may be covered by insurance and your provider should detail what insurance will cover and what the family will be responsible for out of pocket.

Medical repatriation is a service that must be financially guaranteed or paid for prior to the service. Your provider should be able to give you the option of authorizing credit cards prior to the trip so that no money is transferred until after the trip is successfully completed. Your provider should be able to accept multiple credit cards from multiple family members to help cover the entire cost of transport. If insurance will cover part of the cost, expect a 24 hour delay while insurance details are worked out between the insurance company and your provider.

Develop Itinerary

After collecting all the information regarding your patient and passengers, including medical information, pick up and destination contacts, preferred timing and passports, your medical repatriation provider will provide you a written itinerary for your review and agreement. Afterwards, your consultant will work with various repatriation departments to set up ground transportation, to work with sending and receiving facilities, doctors, nurses and case managers, to make flight arrangements, to obtain visas and landing permits, to purchase airline tickets, to work with port authorities and security personnel and to complete the full plan for the repatriation.

A critical path item for the itinerary is selecting the receiving facility. Your medical repatriation company should be able to assist you with obtaining permission to bring a patient to that facility. Some countries, such as the United States, will not allow you to bring a patient into the emergency room unannounced, so you must obtain permission prior to the medical repatriation company repositioning to the patient pickup location.

Doctor Evaluation

Prior to departing base to pick up your patient, your medical repatriation company will want to obtain all pertinent medical information regarding the patient. The company’s medical director will speak to the patient’s attending physician and will create specialized protocols as necessary for the safety of the patient’s transfer. They will also consult with the medical crew as necessary.

Flight Plan

A detailed flight plan will be developed and filed with the appropriate international authorities regarding your patient’s medical repatriation prior to the trip. All permits required for the trip will be obtained so that the trip will be seamless as far as the patient is concerned. All passengers, including the patient will be cleared for entering each stop and destination. Immigration will be scheduled to meet the aircraft upon arrival. If your patient is not a citizen of the country that they would like to enter for medical treatment, they may need to obtain a medical visa waiver prior to conducting the trip. Your medical repatriation company should be able to assist you in expediting entry into the country of your choice.

Final Thoughts

Medical emergencies, while unplanned, can be handled quickly, and as stress free as possible with the assistance of a medical repatriation company. If your need is immediate, air ambulance is always available. If your patient can recover in place, other less costly options are available. But, rest assured, you can bring your loved one home from another country to recover surrounded by family. Experts in international patient transport, like Global Air Ambulance, are there to help you. Be assured that Global Air Ambulance has 35 years experience transporting patients from every country in the world. As over 600 hospitals trust us to safely and quickly transfer their patients, you can also count on us to bring your patient home.

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