Medevac: medical evacuation when staying put is not an option

A medevac is justified when the gap between the care available and the care needed is large enough to affect the outcome. Common situations:

• The local hospital cannot provide the specialism the condition requires, such as neurosurgery, cardiac surgery or a burns unit
• Diagnostics are unavailable, so treatment is being guessed at rather than directed
• The patient is in a remote location: an island, an offshore installation, an expedition or a rural region hours from any hospital
• Political instability, a natural disaster or an outbreak makes staying unsafe
• The patient needs continuity of care with their own specialist at home for a chronic or complex condition

A medevac is priced on distance, aircraft and crew. Each fuel stop on a long route adds landing fees, handling and a permit, so the total steps up rather than rising smoothly with distance. We quote a fixed total for your specific case once we know the route and the clinical picture.

Payment usually comes from one of four places: a travel or health insurer, an employer for business travel or expatriate staff, a membership or assistance programme, or the family privately. If it is the last of these, tell us at the start. For a stable patient an escorted flight often achieves the same result at a quarter of the cost, and that conversation is worth having before an aircraft is quoted.

Payment for a medevac comes from one of four places, and each fails in its own characteristic way.

Travel or health insurance

The most common source and the most common source of trouble. Nearly every policy requires prior authorisation. Arranging the transport first and claiming afterwards is the single biggest reason cover is refused, and it is entirely avoidable.

Employer or expatriate cover

Usually straightforward, because there is a named contact and a standing arrangement. Check whether the cover extends to family members travelling with the employee.

Membership or assistance programmes

These often specify a particular provider or a maximum sum. Read what happens if the transfer exceeds the ceiling: some schemes pay the ceiling and leave the balance, others decline entirely.

Privately

Around one in six of the people who contact us. If this is you, say so on the first call. It changes which options we put forward and lets us look at routing and timing that bring the total down, rather than quoting an aircraft you cannot use.

The traveller in a hospital that cannot treat them

Most common by a wide margin. Someone falls ill or is injured on holiday, the local hospital stabilises them but lacks the specialism, the diagnostics or the intensive-care capacity the condition needs. The decision hinges on whether the gap between available care and required care is large enough to justify moving a sick person. That is a clinical judgement, made with the treating physician, not a preference.

The worker on a remote site

Mining, energy, construction, shipping, expeditions. Here the constraint is rarely the aircraft but the distance to a runway, and the answer is usually a chain: road or helicopter to a field, aircraft to a hospital city, ambulance to the door. Employers with staff in these places generally have standing cover, which removes the payment question and saves hours.

The patient who needs their own specialist

Chronic and complex conditions where continuity matters: a transplant recipient, a patient on an unusual regimen, a child under a named consultant. Here the case for moving is not that local care is poor but that fragmented care is risky. These transfers are often less urgent, which means a scheduled flight with an escort is frequently the right answer.