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Guide to Insurance for Medical Evacuation and Repatriation

International health insurance plans usually cover evacuation and repatriation. But what exclusions apply?
Last update:
18th April 2023
Reviewed by a licensed advisor
repatriation COVID-19
repatriation COVID-19
International health insurance plans usually cover evacuation and repatriation. But what exclusions apply?
Last update: 18th April 2023

In this article, you will be introduced to medical evacuation and repatriation, learn about the types of insurance that include an evacuation and repatriation benefit, and understand the process of evacuation and repatriation if you need emergency medical care while overseas.

What is medical evacuation and repatriation?

Medical evacuation

Medical evacuations are required in the case of a medical emergency in a country where the medical facilities available locally are inadequate and the patient needs to be sent elsewhere to be treated. Evacuations may be conducted via air (helicopter or airplane air ambulance), land (ambulance), or water (sea ambulance), depending on the patient’s location and the location of the destination medical facility.

Medical repatriation

Medically required repatriation is similar to medical evacuation, except the individual is sent back to his/her country of residence to be treated – provided that this country is within their insurance policy’s geographical area of coverage.

How much do medical evacuations and repatriations cost?

Evacuations and repatriations are very expensive and can cost a fortune, depending on the logistics involved. Examples in the hundreds of thousands of USD are not uncommon.

What does the medical evacuation and repatriation insurance benefit cover?

In health insurance and travel insurance policies, the evacuation and repatriation benefit covers transportation, medical expenses, and accommodation for the insured person. In most cases, it also covers transportation and accommodation for an accompanying friend or family member. Sometimes he insurance company will also cover the costs of sending any dependents back to their home country. After the insured person has recovered, the insurance company will cover the return airfare for the patient to their country of residence.

Insurance companies cover evacuation and repatriation provided that these are recommended by the attending doctor at the medical facility where the patient is receiving treatment and the insurer has granted approval. If the doctor believes the local healthcare facilities cannot provide a suitable level of care to you, they will recommend evacuation.

It is important to get in touch with your insurance provider as soon as possible to get their approval for the evacuation and ensure a smooth process.

Does health insurance cover medical evacuation and repatriation?

Most international medical insurance plans cover worldwide medical evacuation, repatriation and assistance, as well as repatriation of mortal remains in the case of death. Be sure to communicate with your insurer as soon as you require these services so they can grant approval and make arrangements for you.

If you have a health insurance plan, it’s a good idea to check over your policy documents to understand your coverage and any exclusions that may apply. Substance abuse, childbirth, engaging in high-risk sports, pre-existing conditions, and putting yourself in danger by entering high-risk countries are typically listed as policy exclusions. If in doubt, you can get in touch with your insurance advisor or agent, who will answer your questions about your coverage.

To give you an idea of evacuation and repatriation coverage by health insurance plans, please see the examples from Bupa and April below.

Bupa Global medical evacuation and repatriation coverage

The Bupa Global Elite health insurance plan provides cover for the following items, provided that “all arrangements are agreed and approved in advance by Bupa Global”:

  • Medical evacuation (paid in full)
  • Medical repatriation (paid in full)
  • Living allowance (up to a limit)
  • Travel cost for an accompanying person (paid in full)
  • Travel cost for the transfer of children (paid in full)
  • Compassionate visit transport costs (up to a limit)
  • Compassionate visit living allowance (up to a limit)
  • Local air ambulance (paid in full)
  • Local road ambulance (paid in full)
  • Repatriation of mortal remains (paid in full)

Note: Epidemics and pandemics are listed as exclusions under this Bupa plan, so if you require evacuation or repatriation due to COVID-19, it may not be covered by your plan. You will also not be covered if you put yourself in danger by entering a known area of conflict (for example, where there is war, terrorist acts, martial law, or military or usurped power).

April MyHealth medical evacuation and repatriation coverage

April goes above and beyond evacuation and repatriation services by providing additional medical assistance when you’re abroad. Every April MyHealth insurance plan comes with repatriation, evacuation, and assistance services provided by April Assistance, such as:

  • Emergency medical evacuation and medically required repatriation (fully covered)
  • Return of the member to the country of residence after recovery (return economy class airline ticket covered)
  • Compassionate visit (economy round trip transportation and hotel accommodation, up to a limit)
  • Supply and delivery of medication not available locally (fully covered)
  • Return of member’s family members (one-way economy class airline ticket)
  • Return of dependants (one-way economy class airline ticket)
  • Repatriation of mortal remains (fully covered)

In addition to the above, April will also provide a cash advance and other assistance in case you lose personal effects abroad, and even provide you with an advance of legal expenses in the event of an unintentional law in fraction abroad. For a comprehensive list of items covered by April Assistance, please refer to the benefits schedule on April’s website.

Note, again, that April members must get approval in advance and in writing from April Assistance for these expenses beforehand, and that terms and conditions (and exclusions) apply.

Does travel insurance cover medical evacuation and repatriation?

Travel insurance plans typically include coverage for medical expenses, emergency evacuation and repatriation, and compassionate visits. Each insurer has different coverage limits.

Note that certain exclusions apply. Generally, insurers won’t provide coverage for emergency medical assistance if you have traveled to a country flagged with a black alert (severe threat) or red alert (significant threat) by the Hong Kong Government’s Security Bureau.

What is the emergency evacuation or repatriation process?

Here is what to do if you have a medical emergency overseas:

  1. Call the local emergency phone number.
  2. You may be taken to the local medical facility where a local doctor will evaluate your case and begin treatment.
  3. If the local doctor considers it medically necessary for you to seek treatment at a more qualified facility, they will recommend evacuation or repatriation.
  4. Contact your insurance advisor or agent to make arrangements and get approval. If necessary, the insurance company may provide you assistance with getting an emergency visa for the country where you will receive treatment.
  5. Your insurer will arrange emergency evacuation and en-route medical care and supplies.
  6. Once you are in stable condition, if you are deemed unfit to continue your trip, your insurer will arrange a medically supervised repatriation on a commercial carrier (air, rail, road) as soon as your condition allows for you to travel. You might be accompanied by a doctor and/or nurse.
  7. Alternatively, after you have recovered, your insurer will arrange a return air ticket for you to return to your country of residence.


What should I do if I need emergency evacuation or repatriation?

If you need emergency evacuation or repatriation, communicate with your insurer as early as possible so they can grant approval and make arrangements for you. The insurance company has a team of specialists that will determine the most suitable course of action for you – evacuation or repatriation, based on your condition and circumstances – before arranging transport.

Be sure to take note of your insurance provider’s emergency assistance hotline and keep it on hand when you travel.

What are some examples of emergencies requiring evacuation and repatriation?

Some emergencies that may require evacuation and repatriation include:

  • Heart attack
  • Stroke
  • Fracture from a fall
  • Car accident
  • Skiing accident
  • Random acts of violence
  • Natural disasters

That said, whether or not you require evacuation or repatriation depends on many factors, such as the nature of your case, the availability of suitable medical resources where you’re seeking emergency treatment, and if the attending doctor deems it medically necessary for you to be treated at a better-equipped facility with specialist care in a different country.

Do I get to choose whether I'll be evacuated (to a different country) or repatriated (to my home country)?

Generally speaking, if a person has a medical emergency overseas and needs to be evacuated, they will be taken to the nearest suitable healthcare facility for treatment. After the patient has recovered to a condition that allows them to travel, they will be repatriated (returned to their home country) to continue their recovery.

Let’s say a patient who normally resides in Canada suffers a heart attack in Papua New Guinea, and they need to be evacuated for urgent specialist care. It wouldn’t make sense to repatriate them to Canada for treatment when Australia is much closer. They would first be evacuated to Australia for treatment, and perhaps repatriated to Canada to continue their recovery.

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This article was independently written by Alea and is not sponsored. It is informative only and not intended to be a substitute for professional advice and should never be relied upon for specific advice.