Medical evacuation insurance: costs, limits and how it works
Few people picture needing an air ambulance when they book a vacation. It is also one of the few travel problems that could wipe out your savings, which is why this benefit deserves careful attention.
By the StarHolidays Editorial Team Updated 4 min read
Key takeaways
- The CDC says an evacuation could cost more than $100,000, and the State Department cites $20,000 to $200,000 for an air ambulance back to the US.
- Evacuation cover pays for transport, not the treatment itself, so you need both.
- The insurer's doctors usually decide if, how and where you're moved.
- Don't arrange your own evacuation without speaking to the assistance team first.
On this page
What it covers
Medical evacuation cover pays to move you to a hospital that can treat you, when local care isn't adequate. Depending on the policy, it may also include:
- Repatriation: getting you home once you're stable, possibly with a medical escort
- Repatriation of remains: returning a person's body home if they die abroad
- Family travel: getting a relative to your side, or children home
- Search and rescue: usually a separate and often more limited benefit, if it's included at all
It doesn't pay for your hospital treatment. One comparison guide puts this plainly: evacuation cover pays to transport you, not for your medical care. You'll want travel medical insurance too.
What does an evacuation really cost?
Official figures are broad, and commercial estimates vary, so be wary of any single number.
| Source | Figure | Context |
|---|---|---|
| CDC | More than $100,000 | "Could cost" for medical evacuation |
| US State Department | $20,000 to $200,000 | Air ambulance back to the US, depending on location and condition |
| State Department advisory | Often above $100,000 | Evacuations from the Marshall Islands |
| Commercial air ambulance sites | About $120,000 to $250,000 | Europe to the US, as quoted by providers |
Most of the commercial figures come from companies selling these services, so treat them as rough estimates. Even so, the message is consistent: this is a very large bill.
How much cover do you need?
Published evacuation limits vary from about $50,000 to $1 million. Think about the worst case for your own itinerary, rather than a general rule.
| Trip | Consider |
|---|---|
| Short trip near home, with major hospitals nearby | A moderate limit may be fine |
| Long-haul trip to another continent | A high limit, because of distance |
| Remote areas such as safaris, islands and treks | A high limit, plus search and rescue |
| Cruises | A high limit, as ship-to-shore transfers add complexity |
| Older travelers | A high limit, as a medical escort is more likely |
Commentators differ on the right figure. Some suggest $250,000 is enough for complex evacuations and others want $1 million for remote travel. When quotes for higher limits differ by only a small amount, we'd generally take the higher one.
Who decides?
Most people assume they can choose to fly home. Generally, they can't. Policies typically require evacuation to be medically necessary, and they typically let the insurer's medical team decide whether you're moved, by what means and where.
So check these points:
- Destination. Does the policy take you to the nearest suitable hospital or to your home country? Those are very different promises. The Canadian government specifically recommends looking for evacuation to Canada or the nearest location with appropriate care.
- Approval. Most policies require the assistance team to arrange it.
- Physician access. The CDC suggests checking that the plan includes a 24-hour physician support center.
- Infectious diseases. The CDC also suggests checking whether it will evacuate people with certain infectious diseases.
Some membership programs promise transport to a hospital of your choice. They work differently from insurance, so read their terms and how they coordinate with your medical cover.
Who needs it most?
The CDC recommends it especially for travelers going to remote places or where care is unlikely to meet the standard they'd have at home. We'd add:
- People on cruises, where a ship's medical facilities are limited
- Older travelers, and those with existing conditions
- People doing adventure activities away from major hospitals
If you've got Medicare, note that it generally doesn't cover care abroad, let alone transport home. See our US residents guide.
What to do in an emergency
- Get urgent care first. Make the local medical team aware of your insurance.
- Call the assistance line as soon as possible. Family can do it for you, so make sure someone has the number.
- Let the medical team and insurer talk to each other. They'll need your records.
- Don't book your own air ambulance without approval, or you might end up paying for it.
Save this now: add your insurer's 24-hour number to your phone, with your policy number, under a name that someone else would recognize, such as "Travel Insurance Emergency". Then send it to someone at home.
Frequently asked questions
Is medical evacuation included in travel insurance?
Often in comprehensive plans, but not always, and limits vary widely. Some medical-only plans include it and others treat it as a separate benefit, so look for it specifically.
Does evacuation insurance fly me home?
Not necessarily. Many policies take you to the nearest suitable hospital, and home only when medically appropriate. Read the definition in your policy.
Does Medicare or my health plan pay for evacuation?
Usually not. The US State Department says most health plans will not cover that transport. Ask your own plan, and consider a separate benefit if it won't.
Is search and rescue the same as evacuation?
No. Rescue covers finding and reaching you, and evacuation covers medical transport afterward. Rescue is often limited, and it may be excluded altogether, so check it if you are going somewhere remote.