How to choose a medical repatriation company
A medical repatriation places a patient in the hands of people you have often never met. Before you agree, check who flies the aircraft, who makes up the medical team, what the quote covers and which warning signs should make you pause.
Medical review: [name and qualification of the referring doctor]
Why the choice of provider matters
A patient who travels by air ambulance or with a medical escort is often at a fragile moment, after an accident, an operation or a stay in intensive care. Three things are at stake: patient safety, which depends on the aircraft, the crew and the medical team; continuity of care, from one hospital bed to the other; and cost transparency, because whoever pays needs to know exactly what is included.
This guide is for patients and families, and also for insurance and assistance case managers comparing several offers for the same file.
Organiser or air operator: who actually flies the patient?
Many medical repatriation companies coordinate the mission without owning the aircraft, which is fine as long as everyone knows who does what. The organiser plans the transfer, the medical team and the logistics. The air operator flies the aircraft and is responsible for flight safety.
In the European Union, an air operator needs an air operator certificate (AOC). The European Union Aviation Safety Agency (EASA) describes it as the certificate that allows an operator to carry out specific commercial air transport operations. It is normally issued by the civil aviation authority of the operator’s home country, and other countries issue equivalent certificates.
Ask for the name of the operating carrier. For passenger air journeys that begin in the EU, European rules already require the seller to name the airline actually operating each flight from the time of booking, so asking is a normal request. You can also check that the operator is not on the EU Air Safety List of airlines banned or restricted in the EU for safety reasons. On a scheduled flight, the operator is simply the airline: our guide on air ambulance or stretcher on a scheduled flight compares the two options.
Independent medical accreditation
An AOC covers flight operations, not the quality of medical care on board. Some providers also choose an independent medical audit. Accreditation is voluntary: a provider without it is not necessarily unsafe, but one that holds it has accepted an external audit against published standards.
EURAMI
The European Aero-Medical Institute (EURAMI) is a European association that accredits aeromedical providers in three areas: fixed-wing air ambulance, rotary-wing air ambulance and medical escort on commercial airlines. Accreditation is valid for three years and renewed through a new audit. EURAMI publishes a list of accredited providers.
CAMTS
The Commission on Accreditation of Medical Transport Systems (CAMTS) is a non-profit peer-review organisation. Its voluntary programme covers fixed-wing and rotor-wing services, ground critical care transport and medical escort, with site visits. Full accreditation lasts three years, and visits outside North America go through its global programme.
Whatever logo a website shows, check it on the accreditation body’s own list and ask which services are covered.
Our accreditations: [accreditations and authorisations held by the company, with reference numbers]
The medical team and the medical plan
Ask who will be on board, by role and not only by number. For a patient who needs close monitoring, look for doctors and nurses with solid experience in intensive care, anaesthesia or emergency medicine, and with specific training in aeromedical transport.
The medical plan is a shared decision. The treating doctor provides an up-to-date medical report and discusses the case with the transport team’s doctor, who then proposes the type of transport, the level of care and the equipment. On a scheduled flight, the airline’s medical service gives its own clearance, usually based on a MEDIF form: see our guide to medical repatriation documents. A careful provider names a medical contact and does not commit to a date before the medical information has been reviewed.
Equipment adapted to the patient
The equipment on board should follow the patient’s needs, not a standard package. Depending on the condition, it may include monitoring, oxygen, infusion pumps, ventilation or devices suited to children. Ask what is planned for this particular patient, and whether the oxygen and battery capacity cover the whole journey, including possible waiting time on the ground.
One coordinator, 24/7, from bed to bed
A medical repatriation involves two hospitals, often two airports, ground ambulances, the family and frequently an insurer. Ask for a single coordinator, reachable 24/7, who keeps everyone informed of the timetable and of any change.
Clarify the scope from the start. In a bed-to-bed transfer, the provider takes charge of the patient from one hospital bed to the other, including the ground ambulances at both ends. If only the flight is included, find out who books the ambulances, who confirms the bed and who hands the patient over to the receiving team. Our page on how a medical repatriation works describes each stage.
What a written, itemised quote should show
Ask for a written quote, broken down by item, before you commit. It lets you compare offers line by line.
| Item | What to check |
|---|---|
| Medical team | Number and roles of the doctors and nurses, fees for the whole mission |
| Aircraft or airline seats | Air ambulance flight, or seats and stretcher on a scheduled flight, with the operator’s name |
| Ground ambulances | Transfers at departure and arrival |
| Permits and airport fees | Landing and overflight permits, handling and airport charges |
| Escort’s return | Return journey of the medical team after the handover |
Some costs may be billed separately, such as waiting time if the departure is postponed, extra nights for the team or a relative travelling with the patient. A clear quote says so in writing. Our page on the cost of a medical repatriation explains the main price factors.
When an insurer or an assistance company covers the transfer, the provider can work on the basis of its guarantee of payment, so the family does not have to advance the cost. See our guide to travel insurance and repatriation and our page for insurers and assistance companies.
Warning signs
- No written quote, or a price given only over the phone.
- A price far below other offers, with no breakdown of what it includes.
- A refusal, or vague answers, when you ask for the name of the air operator.
- Pressure to pay the full amount immediately, before any document is sent.
- No named doctor or nurse to talk to about the medical plan.
An emergency calls for speed, but it never prevents a provider from sending a written quote.
Questions to ask before you agree
- Who is the air operator, and does it hold a valid AOC?
- Which accreditations do you hold, and for which services?
- Who will be on board, and with what qualifications?
- Has your doctor discussed the case with the treating doctor?
- What equipment and how much oxygen are planned for this patient?
- Who is our coordinator, and how can we reach them at any time?
- Are the ground ambulances at both ends included?
- What exactly does the quote include, and what could be extra?
- Can you work with our insurer on a guarantee of payment?
Important information
This guide provides general information only. It does not replace the advice of the treating doctor, who decides with the medical team of the airline or the operator whether and how a patient can travel. In an emergency, call the local emergency number (112 in the European Union).
Frequently asked questions
Is a company that does not own its aircraft less reliable?
Not necessarily. Many organisers work with certified air operators. What matters is transparency: the operator’s name, its certificate and a clear split of responsibilities.
Is EURAMI or CAMTS accreditation compulsory?
No, both are voluntary. They show that a provider has accepted an external audit. Check the accreditation on the body’s own list.
Who decides whether the patient can fly?
Not the provider alone. The treating doctor and the transport team’s doctor assess the case together. For a scheduled flight, the airline’s medical service must also accept the passenger.
Can the insurer pay the provider directly?
It depends on the policy. If the repatriation is covered, the insurer or its assistance company may issue a guarantee of payment. Call the assistance number on the policy as early as possible.
Related guides
Ask us these questions directly
Tell us where the patient is and where they need to go: we reply with a written, itemised quote and answer all these questions.