A client of ours, an employee at a multinational company, recently underwent back surgery in Thailand to address three damaged vertebrae. The procedure was fully covered by his April insurance plan. Following the surgery, he returned to Vietnam for recovery and rehabilitation. Unfortunately, he developed a severe infection at the surgical site that caused his condition to worsen over a two-week period.
He wanted to return to the hospital in Thailand where he had the initial surgery, feeling he could get better care there. However, his condition was not fit for commercial air travel, and the hospital would not issue a fit-to-fly certificate. The patient had also lost trust in the local doctors’ advice. Furthermore, the specialized hardware used in his back surgery was not available in Vietnam, meaning the local hospital couldn’t even remove it if necessary.
The client’s case highlights the complexities and misconceptions surrounding medical evacuation. While many believe it’s an easy benefit to use, it’s not. As an insurance broker, we know that evacuation coverage is extremely difficult to qualify for because it is so expensive. All providers have a minimum qualifying criteria:
Although the client’s worsening infection was a life-threatening situation and the specialized equipment wasn’t available in Vietnam, the insurance claim for an evacuation was ultimately denied. This was because April’s doctors, along with the original surgeon in Thailand, did not recommend removing the hardware. They believed the infection could be treated anywhere without the need for additional surgery.
Evacuation is also not a fast-moving process. It can take several business days to get a medical team to evaluate a situation, coordinate documentation, and make a decision. In this case, the Vietnamese hospital was slow and unhelpful, and the client’s medical records were difficult to obtain. Our team at Tenzing Pacific Services was deeply involved from the start, coordinating with April’s 24/7 emergency assistance team on a daily basis, and even making a personal visit to the hospital to support the client.
Despite the denial, the client’s employer decided to pay for the medical evacuation out of pocket. Because the client was not medically cleared for a commercial flight, he needed to be transported by a specialized private jet with a stretcher—a service that cost around $21,000. The Tenzing team worked tirelessly to coordinate this process, including securing a quote from the emergency services provider and assisting with the mountain of administrative paperwork and contracts required for the transfer.
The client’s total medical bills are estimated to reach $120,000. While his April insurance policy has covered most of this, the client and his employer are still out of pocket for the $20,000 evacuation. This case underscores the necessity of having a robust insurance plan with high coverage limits, as local policies with limits of $50,000 or less would not be sufficient.
Evacuation is not guaranteed: It is extremely difficult to qualify for. Even if a patient believes they need to be evacuated, an insurance company will not approve it unless it meets their strict criteria.
The process is not fast: Even in an emergency, evacuation requires extensive paperwork and coordination, which can take several days.
Insurance coverage matters: A comprehensive plan with a minimum of $250,000 in coverage is recommended. In a serious situation, medical bills can quickly exceed lower limits, leaving the patient to cover the rest.
Inpatient policies are not enough: Even with a plan that covers your care, what happens if you can’t travel home? Without evacuation coverage, you may find yourself stuck and unable to get the care you need.
A strong partner is essential: This case highlights the value of having a proactive insurer like April and a broker like Tenzing Pacific Services who can help navigate the complex and stressful process. Our involvement went far beyond selling a policy; we were on the front lines, helping to coordinate with both the local hospital and the emergency assistance team, securing necessary documents, and providing hands-on support to the client. This level of service proved to be invaluable and, in the client’s and employer’s words, made a significant difference in a very difficult situation.
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