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Transportation of a patient from a foreign clinic under a tourist’s medical insurance policy

Together with the experts of the insurance company ERV, we found out in what cases and in what ways the evacuation of sick tourists from abroad is carried out and how much it can cost…

ERV insurance policies include chronic diseases and cases of their aggravation
On August 17, 2018, a resident of Astrakhan, who was vacationing at a Turkish resort in the Antalya region, was admitted by ambulance to the nearest clinic to the hotel. The tourist had an ERV insurance policy.

After the first examination, the insured was diagnosed with severe chronic diseases. As the attending doctor later stated, due to their aggravation, she suffered a brain hemorrhage. ERV’s insurance policies include chronic diseases and cases of their aggravation, and the case of the tourist was thus recognized as an insurance case.

According to the ERV, the patient was in a coma for some time, and she needed emergency surgery. The doctor decided to transfer the victim to a hospital in Antalya, as it was the right equipment for such an operation.

However, even after the operation, the condition of the tourist from Astrakhan remained unstable for 10 days, which caused her evacuation to Russia to be postponed several times. Finally, on August 28, the attending neurosurgeon issued a flight permit. How the Russian tourist was taken to Russia, read on.
If it is possible to transport a patient from a foreign clinic, this evacuation is provided by the ERV insurance policy
As explained by the Executive Director of the insurance company ERV Julia Alcheeva, evacuation of sick tourists is required, as a rule, in 2 main cases.

This happens either when the insurance company and relatives understand that the treatment in foreign clinics need a lot of time and, accordingly, leave more money than provides insurance policy coverage, or when the patient’s condition is very heavy and requires transportation home for complex and urgent operations or treatment, and the level of local medicine are not allows to do it.

At the same time, if it is possible to transport the patient to the mainland (in case of hospitalization on island territories, etc.), such evacuation is also provided by the ERV insurance policy.
The permission to fly the patient and the method of transportation depends only on the recommendations of the attending physician of the foreign clinic
Transportation of sick tourists to Russia almost always falls on the shoulders of an insurance company that has purchased an insurance policy for those traveling abroad. A tourist who finds himself without insurance abroad can only rely on his own funds (relatives ‘ funds) to pay for emergency medical evacuation to Russia, as in the case of treatment.

“Depending on the condition of the patient who needs to be transported to Russia, we can provide several options for such a flight. In any case, the flight permit itself is given only by the attending physician of a foreign clinic. It also gives recommendations on how such transportation should be made, ” says Yulia Alcheeva, Executive Director of the insurance company ERV.
The insurance company on a regular flight either buys the patient 2 or 3 adjacent seats in the cabin or a seat in business class, or pays for the removal of the insured patient on an airplane with a stretcher unit installed
So, if the patient’s condition is not severe, but he is limited in his movements (usually injuries with fixed limbs), the insurance company buys him two or three adjacent seats in the cabin or a seat in business class, which is laid out (for those who need a lying position). As a rule, these seats are always purchased on regular flights, explains Ms. Alcheeva.

The insurance company buys the patient a place in business class under the policy
The second option, the expert continues, is transportation accompanied by medical staff (usually a paramedic). In this case, more places can be purchased – for the patient, for the paramedic and medical equipment (if it is required).

The cost of these types of transportation of sick tourists can be in different directions from 5 to 8 thousand US dollars or euros.

For more severe cases, when the patient requires a strictly supine position, a state of rest and medical procedures during the flight (artificial lung ventilation apparatus, droppers, and other equipment required to maintain and monitor his condition), the insurance company pays for the removal of the insured patient on an airplane with a stretcher unit installed.

This aircraft always takes off for a patient from Russia, as it requires preparation (for the installation of the stretcher block, it requires the removal of 6 to 9 seats in the cabin – there is a lying place for the patient, places for accompanying personnel and medical equipment). Along with the patient on this flight (always regular), ordinary passengers also fly.

To install the stretcher block, you need to remove 6 to 9 seats in the cabin
The cost of such transportation, depending on the direction, ranges from 9 to 13 thousand US dollars or euros, in the case of long-haul destinations, this service may cost more.

It is clear that for relatives of tourists without insurance to order emergency evacuation services for the patient will be prohibitively expensive, and technically almost impossible.
Transportation by air ambulance is used in severe cases, when the pressure drops characteristic of conventional Airliners can be critical for the health condition or threaten the life of the patient: in severe traumatic brain injuries, strokes, other vascular diseases, injuries and lung lesions
Finally (and this is the way a sick tourist from Astrakhan was evacuated to Russia at the end of August 2018), in some cases it is necessary to attract special (sanitary, medical) aviation – “special boards”.

This is a specially appointed Board, which excludes changes in pressure during take-off, EN route and landing.

As a rule, transportation by air ambulance is used in the case of severe traumatic brain injuries, strokes, other vascular diseases, injuries and lung lesions, etc.

“Air ambulance is used in severe cases, when pressure drops typical of conventional Airliners can be critical to the health status or threaten the life of the patient. If there is no such threat, they try to carry out transportation on the boards of civil aviation, ” explains Yulia Alcheeva from ERV.
Evacuation of the patient is possible by a special Board together with the Ministry of health and the Ministry of emergency situations, when such transportation will be safer for the patient, and the insurance amount of the policy will still be enough for it
Specially equipped air ambulance planes are at the disposal of the Russian emergencies Ministry and the center for disaster medicine of the Ministry of health of the Russian Federation. However, their use for the evacuation of single patients from abroad is extremely rare: these are large Airliners, the use of which is cost-effective if the evacuation is required by at least a group of people with accompanying personnel.

“As a rule, if the insurance company sees that funds for follow-up care in a foreign clinic is not enough, and the evacuation is only possible by a special flight, we are trying, together with the health Ministry and the emergencies Ministry to evacuate people in the so-called “therapeutic window”, i.e. in the period when such transportation will be more safe and when it still will lack insurance amount of the policy,” says the Executive Director of the ERV.

Air ambulance aircraft at the disposal of the Ministry of emergency situations of Russia
An illustrative example is the evacuation of 4 Russian citizens from Turkey by one special aircraft at once, which took place in may 2017. All patients were clients of ERV and were hospitalized in intensive care units of clinics in Antalya and Alanya with various pathologies in serious condition.

Evacuation of a group of Russians involved on an extrabudgetary basis (due to insurance funds) aviation of EMERCOM of Russia aircraft Superjet with established health modules and experts vtsmk “Protection”. Then the expenses for insurance cases amounted to about 3.8 million rubles, of which about 2.5 million rubles were spent on medical transportation.

 

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