Even though this article specifically discusses the example of a visitor to the U.S. from India, this is applicable in general to any traveler who is traveling from anywhere to anywhere.
We have received a question few times from the customers whether the insurance company would evacuate their parent to India (who is visiting them to the U.S. from India) if they were to get seriously sick such as heart attack or stroke and they already know that it is a pre-existing condition and the insurance company is not going to cover it (or only partially cover it) and they can not afford the treatment in the U.S. Some of the potential customers have also reported that some agents are claiming that they have got some of their customers evacuated to various parts of India. Therefore, I would like to explain the basics of the emergency medical evacuation in the simplest possible terms using the most likely scenarios.
Please note that the emergency medical evacuation means the transportation to the nearest place where the adequate care can be given. It is based on the medical necessity and not based on financial necessity of the customer. It must be medically appropriate to do so.
For example, a visiting parent gets a heart attack. The patient must be treated in the nearby hospital where adequate facility is available. However, if the insured is traveling to a remote location or gets into an accident on a highway, away from major places, the person must first be taken to any nearby medical facility. While there, the insured and the attending physician will need to call the emergency assistance department of the insurance company and discuss the medical situation. The insurance company, in association with the attending physician, will determine the medical necessity to medically transport the patient to the nearest medical facility where adequate care can be given. That is how medical evacuation basically works, no matter how different companies word it or how you are explained.
Please note that there are only a handful of insurance companies that provide visitors insurance for visitors to the U.S. They operate on a very similar set of rules and regulations. Most importantly, it is very important to understand that, at least for the medical evacuation purposes, the insurance company can not be making different rules for different agents. That is quite obvious.
Therefore, no matter what you are told about this matter, make sure to carefully read the brochure and policy wording and you will see that any visitors insurance you find will have very similar wording according to what I described above.
Please note that, just because you can't afford the medical treatment for your parent in the U.S., and the insurance company is not going to cover it, they are not going to evacuate to the person to India as that itself may cost them $100,000 or more. No insurance company can afford to work like that.
Moreover, apart from the financial, it is medically not practical for the patient to be evacuated to India while he is in the ICU in the U.S. The person is simply not medically fit to be able to travel that long distance.
Even where someone claims that the patient would be evacuated to India, their insurance brochure says under the Evacuation benefits '...evacuation is recommended and approved by the attending physician.... at the Insurer's discretion'. That is no different from any other visitors insurance plan. E.g., if you are admitted into the hospital in Atlanta, Georgia, you are already in good place. Therefore, no physician is going to recommend or approve that the patient be transported to India, just because you can't afford the treatment there. Additionally, it says that the evacuation is at the discretion of the Insurer, that is the insurance company. Why should insurance company spend money evacuating you halfway around the world when you are already being treated properly where you are?
When can the person actually be evacuated to India? Two most likely scenarios:
The person is traveling to Sri Lanka or Nepal, for example, and the nearest medical facility where adequate care can be given naturally occurs to be India.
The person is in the U.S. hospital, gets treated and is medically fit to be able to travel long distances (whether it be in business class, first class or even with some medical equipment or some special arrangements), then based on the appropriateness of the situation, the person may be repatriated to India. However, that is not really an emergency medical evacuation technically.
Does it mean the medical evacuation benefit is practically useless for visitors traveling to the U.S.? No, that is not true. You would still get the coverage as per scenario #2 described above.
Additionally, even within the U.S., you may not always be near the place where adequate care can be given. For example, we had a case of one customer who lived in San Diego, CA who invited his parents to visit him from India. He took them in car to Sequoia National Park which is in Central California. Unfortunately, they ran into an auto accident. Everyone was hurt up to some degree. They were taken to the nearby clinic in the park. They were being treated in different rooms. The doctor over there determined that visiting father needed an MRI urgently. However, they had no facility for doing MRI. Therefore, it was decided to fly him to Fresno, CA by helicopter. That helicopter ride cost was $22,000. Unfortunately, the customer had purchased a policy that explicitly excluded emergency medical evacuation (and was only about $10 cheaper, for the whole duration, than the other one that included it, but he bought that anyway.) Had he purchased a policy that included emergency medical evacuation, they would have covered that amount, provided appropriate procedures were followed such as arranging it through the insurance company and their approval etc. Again, please note that most customers call us when they have some problem and therefore, we get to know mostly about the problematic cases only.
Therefore, it would be in the best advantage of the customers to set their expectations correctly regarding what the emergency medical evacuation is and how it works.