The truth about emergency medical evacuations

You think it’s never going to happen to you, until it does.

You get seriously ill on a cruise or at a resort, or you get injured on a ski trip or a once-in-a-lifetime adventure, and you need to be evacuated to get proper medical care — at the cost of tens or even hundreds of thousands of dollars.

It happened last week to 86-year-old former astronaut Buzz Aldrin, the second man to walk on the moon. He suffered altitude sickness at the South Pole, 9,000 feet above sea level, and he needed to be evacuated to Christchurch, New Zealand.


Aldrin had been cleared by his doctors for the expedition, according to a statement from the outfitter White Desert Antarctica.

“People don’t realize when they travel overseas that medical care won’t always be comparable to the United States, whether in Mexico, parts of Europe, Africa or Asia,” said Dr. William Brady, professor of emergency medicine at the University of Virginia and medical director at Allianz, an international travel insurance provider.

Age is not necessarily a factor in travel-related illnesses like altitude sickness, and people don’t get ill or injured only in remote locations, added Dr. Jan Stepanek, chairman of the Mayo Clinic’s Division of Preventive Occupational & Aerospace Medicine and the High Altitude and Harsh Environments Medical Clinic in Arizona.

He noted that people are often evacuated from the Grand Canyon due to excessive heat or dehydration.

Think you're prepared? Travelers should always:

--Know what  insurance will cover in an emergency. Is the coverage sufficient for the location? Are pre-existing conditions covered? Travelers should always factor in that a medical emergency may occur away from home.

--Educate themselves to symptoms they may experience wherever they are going. “You won’t know you are in danger if you don’t recognize the symptoms,” says  Dr. Jan Stepanek, chairman of the Mayo Clinic’s Division of Preventive Occupational & Aerospace Medicine and the High Altitude and Harsh Environments Medical Clinic in Arizona.

Dr. William Brady, professor of emergency medicine at the University of Virginia and medical director at Allianz, agrees. “If you feel it is an emergency or don’t know if it is, seek medical care immediately. Absolutely don’t tough it out because you are on vacation.”

--Carry a recent medical record and list of medications on a flash drive or in a PDF on your phone, in case doctors need the information.

--Bring extra medication in case you have to stay longer than planned.

--Take a medical kit for less extreme cases. It should include bandages, antiseptic ointment or cream and over-the-counter medications for pain (acetaminophen, ibuprofen or naproxen), stomach upset (like Pepto-Bismol) and an antihistamine (like Benadryl.) Based on your health and where you are going, ask your physician or travel clinic what else you need.

Travelers of all ages have had to be evacuated from vacation spots because of pneumonia, motor vehicle and scooter accidents, snake bites and even a barracuda attack, Brady said.

Bob Mattson, a retired U.S. Navy chief petty officer who lives in Florida, had a heart attack in St. Maarten during a Caribbean cruise and had to be evacuated to Miami. At the urging of their travel agent, he and his wife, Diana, purchased travel insurance. It cost them $142 and it turned out to be “the best deal on the planet,” Diana Mattson said.

Medical evacuation can cost $20,000 from a Caribbean cruise, and it can easily go into six figures from locations farther from the United States, said Daniel Durazo, a spokesman for Allianz, which insures 21 million customers and handles roughly 400 medical evacuations a year.

Insurance covers the evacuation, coordination of care, transfers and other unforeseen expenses, such as when foreign hospitals ask patients to pay up front. Travel insurers guarantee payment, so travelers don’t have to pay out of pocket.

“If we had not had the insurance, I do not know what we would have done,” said Diana Mattson. “Who would we have called while we were sitting on that island? I would not have known which hospital to call to get a room and a doctor. I can’t imagine the crushing cost if we had not had insurance.”

Travel insurance generally costs 5-10 percent of the cost of a non-refundable trip. (Travelers can compare plans at   Durazo said Allianz’s most popular plan is the Classic, which provides $500,000 in emergency medical transportation coverage, enough to get you back from anywhere in the world.

“I wouldn't have wanted to cover the five-figure cost of the medical evacuation from Panama,” said travAlliancemedia executive editor Brian Major, who suffered a collapsed lung just as he arrived there last year. He was rushed to the emergency room straight from the airport and ultimately was evacuated, accompanied by medical personnel, on a Lear Jet to Miami, where he underwent surgery. Though he has traveled widely for his job for 30 years, including 10 times overseas each year, Major had purchased a travel insurance policy for the first time just before that trip.

“I tell anyone who is traveling out of the country on any sort of leisure (or business) trip to purchase travel insurance,” Major said.

“I was really convinced by the EMS folks who transported me from Panama to Florida. After talking with them and realizing how often they evacuated folks out of unexpected situations, I realized it was pretty foolish to travel all these years without travel insurance.”

Travelers who are elderly or have chronic conditions should factor in the medical care that will be available when they choose a vacation, Brady said.

But people who are heading to Antarctica — more than 43,000 are expected to visit this year, more than a third of them from the U.S., according to the International Association of Antarctica Tour Operators — should note that Aldrin’s situation was highly unusual.


The South Pole is 9,000 feet above sea level and feels even higher, because the atmosphere is thinner at the Earth’s poles, Stepanek said.

Most people visit Antarctica by ship, so they remain at sea level. Abercrombie & Kent, which is known for its polar expeditions, has had only one situation in the last 15 years when the ship’s onboard doctor required assistance, said company spokeswoman Pamela Lassers. That was for acute appendicitis.

Aldrin, meanwhile, is recuperating and says he doesn’t plan to let this slow him down. “I’m looking forward to getting home soon to spend Christmas with my family,” he said in a statement from his hospital bed.  “You ain’t seen nothing yet!”