General Information

Develop a Contingency Plan for Serious Illness

Last Updated:

Eliot C. Heher, MD

Under rare but critical circumstances of accident, injury or sudden illness, an expatriate may require evacuation to the United States or to a third country. To help ensure the best possible medical outcome, it’s very important that expatriates plan for this possibility in advance. As one HTH physician explained:

“[Expatriates] should know how to get out of [their host] country as rapidly as possible in case better medical facility is needed.” HTH Orthopedic Surgeon, Sydney, Australia.
Expatriate families should have an evacuation plan and should share the plan with friends, family and colleagues both at home and in their host country. Key questions the plan should answer:
What is the preferred hospital in the U.S. for transfer and how can a transfer be arranged to that hospital?

What regional facility is preferred in the event that transport to the US is unsafe or impossible for medical or other reasons?

What are the names of creditable air ambulance companies that service the area?

Does the expatriate have a medical evacuation benefit?

Does the expatriate have an assistance benefit, and if so how can the assistance provider be reached?

Experienced emergency assistance providers such as Medex (Timonium, Maryland) and Worldwide Assistance (Washington, DC, a subsidiary of EuropAssistance, Paris, France) can be extremely helpful in arranging evacuations. Their extensive experience with air ambulance companies can help the expatriate with the following problems:
Local authorities sometimes have financial ties to local air ambulance companies and therefore their recommendations are biased.

Air ambulance companies are usually most experienced with evacuations in certain parts of the world. A company that is skilled at evacuations from Sub-Saharan Africa might not be the best choice for an evacuation from China.

Generally expatriates who are enrolled in an assistance program can contact the assistance provider 24 hours a day, 7 days a week, by collect or toll free call (avoid assistance programs that aren’t available around-the-clock). Expatriates who are not enrolled in a group assistance program should consider joining an individual plan.