Harvard Health Letter | March 2007 (excerpt)

More Americans than ever before are traveling to Africa, Asia, and South America. These adventurers now include many older people with the time, money, and able bodies necessary for such long, awe-inspiring trips.

But even if you’re in good overall health, there’s no getting around the fact that age makes you more vulnerable to medical setbacks. A serious one at home may become calamitous when it happens overseas, particularly in a remote place. Some commercial airlines reserve space for a stretcher and medical personnel in the back of the cabin, so you could always get home that way. But many airlines are no longer providing that service.

The demand for air ambulance service is growing fast, although statistics are hard to come by. Patients are flown on medically configured jets with medical personnel onboard. The expense is enormous. Companies usually charge a base fee, a separate fee for the medical personnel, and mileage. Flying a patient from Florida to Boston will cost at least $10,000. The bill for “medical evacuation” from Africa to the United States at least $50,000; from India, it could exceed $100,000. Moreover, most companies require customers to pay up front. Most health insurers do not cover the cost of a medical evacuation/transport.

You can buy travel insurance that will cover air evacuation services, either as part of medical coverage or as a separate policy. In many cases, though, the policies are written so that the coverage is limited to transportation to the “nearest appropriate facility.” That wording doesn’t rule out a flight home, but more often it means transportation to a nearby major hospital. “ An alternative to conventional travel insurers are membership companies such as MedjetAssist…..” You enroll for several hundred dollars a year. One of the main selling points for this company is that they will transport you to the “hospital of your choice”.

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