Travel insurance and medical repatriation: what is usually covered
Falling ill or being injured abroad raises two questions at once: who organises the journey home, and who pays for it? This guide explains how insurance and assistance cover work, what they often include and exclude, and what to do first.
Medical review: [name and qualification of the referring doctor]
Insurance and assistance: two different roles
People often talk about “travel insurance” as a single product, but two roles are involved. The insurer covers the cost, within the limits of the contract. The assistance company organises the help: it runs the emergency line, follows the case and, when needed, arranges the medical repatriation.
The assistance company is often mandated by an insurer, a bank card provider or a travel agency, so its number may appear on a card or in your booking documents rather than under the insurer’s name.
Its medical team decides whether a repatriation is medically justified, when and by what means, after talking to the doctor treating the patient locally. The family can express its wishes, but the medical decision rests with these doctors. A transfer requested for comfort alone is generally not covered, and the first step is sometimes a move to a better-equipped hospital nearby rather than a flight home.
What assistance contracts often cover
Depending on your contract, the assistance may include:
Medical repatriation
Transport home or to a suitable hospital when the assistance company’s doctors judge it medically justified, with a medical escort if the patient’s condition requires one.
A relative’s travel
A return ticket for a family member to join a patient in hospital, often only after a minimum stay set by the contract.
Extra accommodation
Hotel costs when the patient or the person with them has to stay longer than planned, usually capped per night and in number of nights.
Repatriation of remains
Transport of the body to the country of residence if the insured person dies abroad, sometimes with a separate limit for funeral costs.
Some contracts also advance hospital fees abroad. Limits and conditions vary widely, so check the table of benefits in your policy.
What is often excluded or limited
Read your own policy wording before you travel. Common exclusions and limits include:
- Undeclared medical conditions. A pre-existing condition not declared when the policy was taken out can invalidate the cover.
- Travel against advice. Travelling against a doctor’s advice, or to a country or region your foreign ministry advises against.
- Sports and activities. Winter sports and some adventure activities are often excluded unless added to the policy.
- Alcohol and drugs. Most policies do not cover incidents linked to excessive drinking or recreational drugs.
- Planned treatment abroad. Standard travel insurance is not designed for people who travel to have surgery.
- Ceilings. Once the limit for medical costs or transport is reached, the balance is yours to pay.
- Type of hospital. Some policies only cover treatment in public hospitals.
The EHIC does not cover repatriation
The European Health Insurance Card (EHIC) gives access to medically necessary public-sector care during a temporary stay in another EU country, or in a few other European countries, on the same terms as local patients.
The European Commission is clear on the key point: the card covers neither rescue and repatriation nor private healthcare, as its Your Europe page on temporary stays explains. A flight home after a serious illness or accident needs separate cover.
UK residents are in the same position with the Global Health Insurance Card (GHIC) or a valid UK EHIC: the UK government’s travel insurance guidance states that neither replaces travel insurance. Outside Europe, including in Africa, these cards do not apply at all; see our guide to medical repatriation from Africa.
Cover through a bank card
Some bank cards, mainly premium ones, include assistance and medical repatriation cover for the cardholder and sometimes their family. This cover is usually designed for short trips, and the length of trip covered, the people covered and the ceilings vary from one card to another.
Before you leave, read the card’s information notice or ask your bank, and save the assistance number linked to the card. For a long stay abroad, a dedicated contract is often more suitable.
What to do first if you fall ill or are injured abroad
- Call the emergency services if life is at risk. In the European Union, the number is 112. Care comes first; call the assistance company as soon as possible.
- Call the assistance number before organising anything yourself. It appears on your policy, your card or your travel documents. A relative can call on your behalf.
- Write down the case number. The assistance company opens a file and gives you a reference. Quote it in every call and email.
- Give the treating doctor’s contact details. The assistance company’s medical team will speak to the doctor directly to assess the situation.
- Keep every document. Medical reports, receipts and invoices will be needed for any claim. You may have to pay some costs upfront, even when insured.
Many contracts state that costs incurred without the assistance company’s prior agreement will not be reimbursed. Booking a flight or an air ambulance on your own and sending the bill afterwards carries a real risk of paying it yourself. UK government advice for people in hospital abroad likewise says the insurer should arrange the repatriation; without cover, you arrange and pay for it yourself.
No insurance, or cover refused?
If you have no cover, if the contract does not apply, or if the assistance company declines the repatriation, a private repatriation paid by the patient or the family remains possible. Embassies and consulates generally do not pay for medical treatment or for the journey home.
We can study the request and send a quote based on the patient’s condition, the route and the type of transport the treating doctor considers appropriate. To understand what drives the price, see the cost of a medical repatriation. If the assistance company has refused, ask for the reason in writing so you can discuss it with the insurer. Families will find practical help on our page for patients and families.
For insurers and assistance companies
We answer requests from insurers and assistance companies that need to organise a medical repatriation for a policyholder or beneficiary. We can work on the basis of a guarantee of payment and provide the medical reports and itemised invoices your case handlers need.
Our payment terms for insurers: [payment terms for insurers]. To send a case, see our page for insurers and assistance companies.
Important information
This guide gives general information only. It does not replace the advice of the treating doctor, nor the terms of your own contract, which alone determine what is covered. Whether and how a patient can travel is a medical decision taken by the treating doctor with the medical team of the assistance company, the airline or the transport operator. In an emergency, call the local emergency number (112 in the European Union).
Frequently asked questions
Does my EHIC cover medical repatriation?
No. The European Health Insurance Card gives access to necessary public-sector care during a temporary stay, but it does not cover rescue or repatriation. For that, you need travel insurance or an assistance contract.
Can I organise the repatriation myself and claim the cost back later?
It is risky. Many contracts only reimburse costs that the assistance company has agreed in advance. Call the assistance number first and let its medical team decide on the transport.
Who decides whether a medical repatriation is needed?
When an assistance contract applies, its medical team decides after talking to the treating doctor, and chooses the means: a seat with a medical escort, a stretcher on a scheduled flight or an air ambulance.
Does my bank card include repatriation cover?
Some cards do, mainly premium ones, but the conditions differ from card to card. Read the card’s information notice or ask your bank before you travel.
Is a pre-existing condition covered?
It depends on your contract and on whether the condition was declared and accepted. An undeclared condition can lead the insurer to refuse the claim.
Related guides
Repatriation from Africa
The steps to follow for a medical repatriation from an African country.
Air ambulance or stretcher
How to choose between an air ambulance and a stretcher on a scheduled flight.
Need to organise a medical repatriation?
Tell us where the patient is, where they need to go and, in a few words, their situation.