Having a serious medical emergency while travelling abroad can be a frightening experience, especially if you require emergency air transportation to receive treatment.

A common question we receive from Canadian snowbirds and other travellers is:

“Does my emergency travel medical insurance cover me for “Air Ambulance” or “Emergency Air Transportation” services if I get sick or injured while travelling and need to be transported back to Canada or to another medical facility for treatment?”

The short answer is, yes, almost all emergency travel medical insurance policies issued in Canada include these benefits. However, it’s important to understand what these benefits do and don’t cover, when they are and aren’t available and some key terms, conditions and limits that apply.

While the coverage terms for air ambulance services may vary from provider to provider, this overview provides helpful insight into what you need to be aware of when it comes to air ambulance benefits – regardless of who your travel insurance provider is.

What exactly are “Air Ambulance” or “Emergency Air Transportation” benefits?

Air Ambulance and Emergency Air Transportation are terms that are often used interchangeably and refer to medical air evacuation services for patients from their travel destination so they can be treated either:

1. Back in Canada, or
2. At a medical facility in another location - if the first medical facility is not equipped or able to provide the necessary and required care for the patient. For example, if you were injured or became ill on a Caribbean Island that wasn’t equipped to properly treat you, you may be flown to another island or to the U.S. for treatment.

These benefits can also refer to medical air transportation back to Canada after your medical emergency has ended, if required. For example, if you break your leg and are treated in your destination, but still require some form of medical accommodation to fly back home.

When am I able to use Emergency Air Transportation benefits and who decides if I am eligible?

Some travellers are under the impression that if they become sick or are injured while travelling, they have the right to demand that their insurance provider return them to Canada by air ambulance for treatment.

However, this is a misconception. Emergency Air Transport benefits are only payable if they have been pre-approved by your insurer.

Ultimately, the insurance provider – not the patient - decides if it would be appropriate to provide air ambulance or emergency air transportation services based on the recommendation of the treating physician in your destination and the insurer’s emergency medical assistance team, which includes nurses and doctors.

When making this determination, many factors are taken into consideration, including:

• The severity of the illness or injury
• The urgency of the treatment required
• Whether or not the medical facility in the destination has the expertise and equipment to provide the care and treatment the patient requires
• Whether or not the patient is “medically stable” enough to fly. If it is determined it would be unsafe or pose a risk for the patient to fly, emergency air transportation would not be an option.

In some cases, your insurer may offer you the option to be treated at your destination or return to Canada by emergency air transport for treatment.

It’s also important to be aware that the availability of air ambulance benefits is also dependent on whether or not a hospital bed is available back in Canada where you can receive treatment, which is outside the control of your insurance provider. While your insurer will make best efforts to find you a hospital bed back in Canada, if none are available, it may not be possible to fly you back home for treatment.

If your insurer approves you for air ambulance benefits, they will make all of the necessary flight and transportation arrangements, which can include:

• Travel arrangements and assistance.
• Ground transportation coordination at departure and arrival points.
• Identification of medical escort requirements and appropriate air transportation.
• Immigration clearances for the patient, and if applicable, a travelling companion.
• Admission coordination at a medical facility in Canada.

What type of aircraft and medical support will be used?

The type of aircraft, medical equipment and medical team used for medical repatriation can differ greatly depending on the type and severity of the patient’s injury or illness, as well as the medical equipment and expertise required to treat the patient while they are being transported.

In more severe cases, a dedicated air ambulance outfitted with specialized medical equipment and a medical team that includes doctors and/or nurses may be used. Typically, the patient in an air ambulance will lie on a stretcher and be accompanied by one or possibly two medical professionals and a flight crew.

The patient may be permitted to have a family member present on the flight, but the space aboard a dedicated air ambulance is quite limited and family members may be required to travel home separately.

Depending on the distance between the patient’s original pickup location and the destination they are being flown to for treatment, the air ambulance may require multiple stops due to the range of the aircraft and limits on the maximum number of continuous hours the flight crew is permitted to work on the flight.

In less severe cases, patients may be transported on a commercial flight. In these situations, the assistance provider will ensure that the flight arrangements are made taking the patient's individual medical situation into consideration, which means the patient may be provided with an Economy Class, Business Class or First Class seat and may or may not be accompanied by a medical escort - as determined by the insurer. In some cases, the patient may be given an entire row of seats on a commercial flight, or even a section of the airplane, and be accompanied by medical equipment and medical professionals - depending on their medical requirements.

The Bottom Line

While almost all emergency travel medical insurance policies in Canada include air ambulance benefits, the availability of these benefits and the type of benefits that will be provided will depend on each patient’s unique situation.

It is also important to know that the insurer – not the patient – has the discretion to determine if air ambulance services will be provided and the type of services that will be available.