For most people considering a move to Mexico, healthcare issues generally are low on their list of priorities, unless they currently have health problems. Plans for catastrophic illnesses or injuries are seldom considered. But medical emergencies can happen to expats in Mexico at any time, so you should know about the air evacuation option for emergency care in Mexico.
As most of you probably know, U.S. Medicare does not cover medical costs incurred in Mexico by expats. Some Medicare supplemental plans may have very limited coverage for travelers, but you need to read the fine print to determine if you qualify. If you have a medical emergency, the solution would obviously be to fly back to your home country for care.
However, the assumption that you can easily fly home needs to be examined carefully.
Consider first that if you are seriously ill you will not be hopping on a commercial flight. Even if you were able to obtain a boarding pass, airline personnel are trained to screen out passengers who are seriously ill and you may not be permitted to board the plane. Even if you were able to board, your illness might be detected in flight (and if you are contagious, you certainly aren’t going to want to share your infection). The stresses of travel could easily make your condition worse. You may cause a forced landing or create a situation where you are in dire need of medical attention while on the flight. And of course, in the case of serious injuries, commercial air travel is not even a possibility.
Air evacuation by a private jet with a service provider is always an option if you are wealthy. Depending on where you are to be picked up, what on-board medical attention is required and where you are going, the cost could easily be over US$50,000. That does not include the cost of any hospitalization required in Mexico until a patient is sufficiently stabilized to allow transport by ambulance to an airport. But for most of us, this cost is prohibitive. However, there is an option that many find affordable: Air evacuation insurance. The price is more typically in the hundreds of dollars, and while you pay for it annually, you hope to never use it.
Even with air evacuation insurance, things are not always as simple as they seem to be. You can’t just call them up and expect a jet to arrive because you have a stomach ache. One of the things you need to inquire about is what are the terms of service? In other words, how sick do you have to be to be evacuated? How is that determined and who decides?
For example, if they say they will only come and get you if you have been admitted to the hospital, are they going to help you if you broke your leg in a bike race across the desert in the middle of nowhere and there is no ambulance or hospital nearby? Normally, air evacuation companies send staff to a hospital for pickup and use an ambulance to take a patient from bed-to-bed, but you should confirm this, especially if you are involved in off-road activities like marathons, bike races or hiking or camping in remote places.
Often your own doctor in Mexico is going to be involved in making the call about whether you can be released from the hospital for safe transport to the U.S. or Canada or another country. But believe it or not, patients with credit cards are sometimes viewed as “cash cows” that keep hospitals operating, and they may not be too happy to see “Mr. Creditcard with a heart condition” leave their hospital. And your doctor could even be a shareholder in the business!
Remember, you must be in stable condition before you can be officially released. It is also a good idea not to release your credit card to a hospital without informing the bank that you personally must approve payment, but that is a topic for another article. Complications like this can and do happen, occasionally.
It certainly helps if the air evacuation company that provides the service for the insurance provider has staff that speaks both Spanish and English and has experience in Mexico. They are sometimes instrumental in getting a patient released from the hospital just by showing up.
You may notice that I suggest that in some instances the insurer and the air evacuation service provider may not be the same. Before signing on the dotted line, you will want to know something about the business model you are paying for. Is this an air evacuation company that sells insurance for their own account? Or is it an insurance company that subcontracts to a company that provides the medical flights for them? Who is performing the air service, where are they stationed? In other words, how far must they fly to get to you? Do they own or rent the planes they use? How many planes are in their fleet? Do they have their own pilots and medical personnel on staff? Are they using freelancers on standby? What are their arrangements?
It is standard that planes used for air evacuation have been modified to allow a patient to travel on a stretcher like those used in ambulances. The plane should also be equipped with basic paramedic-type supplies and equipment. However, if the provider does not own planes, how are these modifications made? And what medical personnel will be with you on the flight? Can you bring a friend or family member with you on the flight?
Occasionally an air evacuation does not involve a private jet, but rather a commercial flight. Sometimes what is needed is a nurse to assist with a wheelchair and on-flight seating (sometimes a commercial plane can be modified to accommodate a stretcher). Your attending nurse can also help with medications, oxygen and eating. This may be acceptable when the patient is not dealing with a contagious infection or life-threatening condition.
Like many international flights, there are various complications involving border crossings, passports, visas and declarations. Fortunately, you are likely to be assisted with all of that by your provider, but you should ask them how that is done.
Communication during the preparation and transport process is vitally important. Who will be responsible for that? Is someone available 24/7 to communicate with you, your doctor or family members? Who?
Another topic you will want to cover with a potential air evacuation provider is where they will take you? Ideally you are transported by plane and ambulance from bed-to- bed in the city and hospital of your choosing. But, this is not always the case, so you need to discover what the terms of their plan specify.
Arrangements with the arriving hospital and ambulance service are typically made by the air evacuation company. It is important that your arrival is expected, the handover of both you and your medical records, etc. is done flawlessly, and without unexpected glitches, such as no bed is available, they do not accept Medicare patients or their cardiac surgeon is on vacation.
If you rely on U.S. Medicare or government healthcare programs in other countries, air evacuation services can be a good solution for emergency situations, but be prepared to ask lots of questions of any service provider before you sign on the dotted line.