CMSA Communities

A couple of weeks ago we wrote about whether or not insurance covers air ambulance service.  With health insurance companies, the discussion typically boils down to one factor: medical necessity.  But medical necessity can be a matter of opinion.  In some cases, for example, insurance companies have said that transporting a patient to be with family members for convalescent care is not medically necessary but rather “at the convenience of the family.”  We’d like to challenge that notion.

Many medical professionals agree with us.  In a number of reports on traumatic brain injury, spinal cord injury, and even chronic illness, medical researchers have found that being in a “normal” environment with family members and friends leads to a speedier recovery than being in an unfamiliar environment with unfamiliar people.

• “It has been well demonstrated through ‘The Coping and Adaptation Theory’ that when a patient has experienced a traumatic series of events being away from a ‘normal environment’ the efficacy of their care, treatment, and rehabilitation produce far inferior results than the counterpart.”  (Stacey Hoffman Barone)
• “Patients with chronic illness can benefit when their family members support them in managing their care.”  (California Health Care Foundation)
• “You [the family member] and the person with brain injury are important members of the health care team. Active participation in treatment and rehabilitation is essential to recovery. The involvement of other family members, caregivers, friends and co-workers also can help the person with brain injury successfully return home and to the community.”  (Mayo Clinic)

Many of the air ambulance medical flights that we provide are to reunite family members with their loved ones.  In one case an older woman had been spending the winter in Arizona when she suffered a debilitating stroke; we arranged a medical flight for her back to the East Coast.  In another case a man had been in Nebraska when his chronic breathing condition severely worsened; we arranged a commercial air medical escort back to Bulgaria.

Being with family members in a “normal” environment (rather than in a facility with no familiar faces) matters on a number of levels.  In part, it takes away the anxiety we all feel when we’re alone and lets the patient concentrate on recovery.  Being with family can also give patients a boost of strength and determination – both key factors in recovery.

So from our perspective, at least, being with loved ones when recovering from a traumatic injury or illness is not a matter of convenience; it’s a matter of necessity.

MedFlight911 specializes in finding the right medical flight provider (and the right form of transport) at the lowest possible cost. We can do that in part because we have a large, worldwide network of the top medical transport providers.

But even then, the fact is that medical transport – by air ambulance, commercial air medical escort, or ground medical escort – is expensive.

Sometimes a patient’s health insurance provider will help pick up the tab (though not always). Next week I want to go into that discussion (“How can I find out if my health insurance policy covers air medical transport?”) in detail. Today, though, I want to talk about another kind of insurance that might cover medical air transport: travel insurance.

A few weeks ago Dr. Tim Stevenson, Aviation Medical Examiner at Virgin Atlantic, set out 8 tips for safe and healthy summer travel. #1: Take out travel insurance. “Many people don’t realise the real cost of medical emergencies abroad. For example, an air ambulance on the USA’s East Coast can cost up to £45,000. Travellers should ensure they take out adequate travel insurance. . .”

Stevenson, of course, was speaking from the perspective of a Brit travelling to the U.S. But the same principle holds true for Americans travelling internationally: if you have a medical emergency in some other country, how are you going to get home? And how are you going to pay for it?

What is travel insurance? Travel insurance covers medical expenses (including emergency medical flight evacuation), financial default of travel suppliers, and other losses incurred while traveling domestically or internationally. Temporary travel insurance can usually be arranged to cover exactly the duration of your trip; or a "multi-trip" policy can cover an unlimited number of trips within a set time frame.

Some notes on travel insurance coverage of air ambulance services:

• Policies don’t typically cover “pre-existing conditions” (or, put another way, the illness or injury that necessitates your medical flight back to the U.S. must have been “unforeseen”). If you’re ill before you leave, your travel insurance carrier may deny coverage. Similarly, if you’re travelling to receive medical care somewhere else (often called “medical tourism”) travel insurance probably won’t pay for emergency medical air transport back home.
• Typically, the insurance case manager and the receiving physician must agree that air medical transport is “medically necessary.”
• Buy just the coverage you need. As it is with any insurance policy, it’s hard to say exactly how much coverage is “just right” (not too little, not too much). Your best bet is to work with the travel insurance provider to determine how much coverage is right for your unique situation, given factors such as your destination, your age, and your general state of health.

The cost of travel insurance varies, but is often relatively reasonable (especially given the range of coverage it provides – even beyond medical air transport). Most travel agencies and travel reservation websites (Orbitz or Expedia, for example) offer travel insurance options when you book.

Another alternative is to buy a membership plan with a company like Medjet Assist (who we’ve worked with before). It’s not a travel insurance plan, but rather a “medical evacuation membership program” which covers medical transport services at zero cost to the member. (And with far fewer of the exclusions you’ll find with typical insurance policies.) Membership fees start at $95 for coverage over a short, specified time frame; annual family coverage worldwide starts at $385.