How much does a medical repatriation cost?

What is a medical repatriation?

It is the transport of a patient under medical supervision to a facility able to treat them, usually in their country of residence. Three operations carry similar names and are regularly confused. They share neither the same trigger, nor the same route, nor the same cost — and our own general conditions, edition 2025.03, separate them article by article.

• Primary transport — the ambulance that takes the casualty to the first emergency room. It belongs to the rescue services of the country you are in. The policy only steps in where those primary emergency services do not exist (art. 6.2.1).
• Medical evacuation — emergency transport to the nearest hospital with appropriate medical facilities (art. 6.2.1). It aims for reachable equipment, not for home: often a short flight, sometimes a road transfer.
• Medical repatriation — the journey back to the most suitable hospital, to a hospital near home in the country of residence or the assigned country, or to the home itself (art. 6.2.2). It is the longest leg, and the heaviest item on the invoice.

All three can follow one another in a single case: local ambulance, then evacuation to an equipped hospital, then repatriation once the patient's condition allows it. The bill discussed on this page is the third one, sometimes the second.

Who decides on a repatriation, and on what grounds?

Not the patient, not the family, not the employer. The policy hands that decision to one body only, and it says so in plain terms.

• The insurer's doctors call the treating doctors on the ground and take the decisions best suited to the patient's condition “based on the information obtained and medical requirements only” (art. 6.2.2). Neither the distance nor the price of the aircraft enters that reasoning.
• The last word is theirs. “The final choice of the place of hospitalisation, the date, the need for the insured to be accompanied and the means used are a matter solely for the insurer's medical team” (art. 6.2.2). An evacuation follows the same logic: it is subject to that team's prior approval of the means and the place (art. 6.2.1).
• They still need to read the file. The insured expressly authorises the insurer's doctors to request test results and reports from the practitioner treating them locally (art. 6.4). Without those documents there is no decision, only a wait.
• Where the case cannot be judged remotely, the insurer may send a doctor out, to judge on site what should be done and to set it up (art. 6.3).
• Where the condition rules out the journey and local hospitalisation exceeds five consecutive days, two close relatives travel instead, ticket and accommodation paid for — but only where no adult family member is already on site (art. 6.7).

The costliest mistake: arranging it yourself

The special terms of the policy (no. 20 00 479, edition 01.26) leave no room at all. Two duties are set there: reach the insurer at once, and appoint nobody else without its go-ahead. The sanction sits in the same sentence — benefits cut, or withheld. In other words, an air ambulance chartered in panic by the family can stay at the family's expense. The useful reflex is one number, answered day and night: the contract's single emergency number (+41 22 ••• •• •• — in full on the insured card and in the client area).

What sets the price of a repatriation?

Four variables account for most of the gap between €14,000 and €260,000.

• Distance. An intercontinental flight means technical stopovers, sometimes a second crew. You pay for flying hours, not for a ticket.
• The patient's condition. A stable casualty travels seated. A patient who is intubated, ventilated or infectious requires a doctor, a nurse and equipment on board.
• The means used. A dedicated air ambulance flies for a single patient, out and back: it is the most expensive option. A stretcher on a scheduled flight costs less but takes up several seats on a commercial aircraft; a medical escort in a standard seat is the cheapest of the three.
• Access to the patient. A usable airport, overflight permissions, ground ambulances before and after the flight, an unstable area: each of these adds days and costs.

None of those four variables is chosen over a counter: they all follow from the medical decision described above. That is why one and the same country shows a lower and an upper bound separated by a factor of two — China — up to fourteen — Mexico.

What does a repatriation cost, country by country?

Ranges in euros. Every line carries its source and the year it was recorded: that is the right-hand column. The country name leads to its country page: dated alert level, comparison of the clauses, medical network, repatriation cost.

Three families of sources feed this table, and we allow ourselves no others: air ambulance operators, specialist brokers, official pages or documented guides. By name, in the order of the table: Diversified Quotes, Le Ciel Africain, SkyCare, Staysure — an insurer that publishes its own claims —, Travel Care Air, CostGuide India, Realting, Japanode, Air Traveler Club and Mexperience. Nineteen countries appear here; our own base prices forty-one, and every page on the alert map shows its own.

Our method, stated plainly

We hold no claims statistics of our own. These ranges come from published specialist sources, named line by line. They are wide, and we own that: a quotation depends on the day, on the aircraft available and on the patient's condition. They are orders of magnitude to help you decide, not quotations.

Three rules govern this table, and they explain its gaps. A country with no real source does not appear: we do not invent a range to complete a list. We do not transpose the figure of a neighbouring country. And we date the record itself rather than the update of the page — a 2025 guide is still shown as 2025, even when re-read today. A fourth observation explains the repetitions: where one single record covers several countries, the lines look alike because the source is the same. That is the case for the four Sahel countries in the table, backed by one scale, and for the Sudan–Somalia–DR Congo trio, backed by one broker.

Who pays for the repatriation, in practice?

The insurer, if the cover applies on the day

We have read four market contract documents. Three expressly set aside areas formally advised against; the fourth sets aside the consequences of war and political instability. Out of a destination formally advised against, the three express exclusions target the trip itself — at American Express, general exclusion no. 11 applies to every travel guarantee, repatriation included. The stated ceiling then becomes irrelevant.

• Amex Platinum, general exclusion no. 11 of the French terms applicable as at 01/01/2025 (p. 11) — territorial, express.
• World Elite Mastercard, article 5.5 of the Fortuneo notice, in force as at 01/01/2026 (p. 11) — territorial, express.
• Standard travel insurance, chapter 1.D of the Évasio temporaire terms issued by Europ Assistance (EA5117/2, 03/2021) — territorial, express.
• Visa Infinite, common exclusions (p. 12) of the BNP Paribas notice for policy PT7, edition 04/2025 — conditional, assessed on the facts.

The wording of each clause, quoted word for word with its full source, is gathered on our file on countries formally advised against. The product-by-product comparison — ceilings, excesses, durations — lives on our file on bank card cover, and it is your own bank's edition that binds you. For this page, one comparison matters: the medical ceilings of those four documents run from €150,000 to €2,000,000, while the upper bound of our table — €260,000 out of the United States — covers transport alone. The case is dissected on our Visa Infinite file.

The employer

On a business trip, the bill falls on the company when the employee's cover does not respond. Our own policy also provides for the aftermath, which few documents do: if the repatriation entails more than five days of hospitalisation or more than thirty days off work, the insurer pays for a return ticket to send a replacement colleague to the assigned country, provided the request is made within eight days of the medical decision (art. 11.1). And once the insured is able to resume work, the return to the interrupted assignment is organised and paid for (art. 11.2). A repatriation is therefore not necessarily a one-way trip. The full sequence on the company side is set out in our file on an employee hospitalised abroad; the tooling, on the Duty of Care OS and the corporate pack.

The family

Failing that, the family fronts the money. That is what direct settlement prevents on the hospital side, a mechanism set out in the file devoted to it. On the transport side the question arises differently: the aircraft is not invoiced to the patient, it is chartered by the insurer — which is why the prior agreement mentioned above decides everything.

What does the Pack VIP cover?

Three lines, the ones that concern this page.

• Medical evacuation and medical repatriation: unlimited, worldwide — table of benefits, special terms 01.26 of policy no. 20 00 479.
• The transport decision belongs to the insurer's medical team, on medical requirements alone (art. 6.2.2): it is that team which chooses between air ambulance, stretcher and escorted seat.
• One number triggers it, before any other step: the contract's single emergency number (+41 22 ••• •• •• — in full on the insured card and in the client area), answered day and night.

The rest of the table of benefits — medical expenses, cancellation, private liability, death and disability — does not belong here: it is compared product by product on our file on bank card cover, and the documents themselves are freely available on the Documents page.

“Unlimited” against a stated ceiling: what the word covers

“Unlimited” does not mean “everything is unlimited”. The table of benefits sorts line by line, and that sorting is what you have to read before comparing with a capped amount.

• No ceiling, worldwide. Medical transport — evacuation and repatriation —, sending a doctor out, the early return of the companion whom the repatriation forces to cut the trip short (art. 6.6), and death assistance: repatriation of the body or the ashes, local formalities, cost of the coffin (art. 6.5).
• Capped, right next to it. Search and rescue stops at CHF 50,000, and that particular cover responds neither if the insured is kidnapped nor more than 200 km offshore (art. 6.1). The visit of two close relatives stops at CHF 5,000, and it requires three things at once: that the condition rules out repatriation, that local hospitalisation exceeds five consecutive days, and that no family member of legal age is already on site (art. 6.7). It cannot be combined with the companion's return.
• A collective ceiling exists, but elsewhere. The maximum cumulative sum insured is capped at CHF 3,000,000 per event, across every insured of one and the same policyholder. It bears on medical expenses and on death, accident or disability benefits — not on medical transport, which stays outside any ceiling.
• The cover is subsidiary. It always comes on top of other public or private social insurance benefits: the insurer answers only for the differences and for what the local insurer does not cover.

The consequence is easy to state. A medical ceiling is a ceiling on care: the American Express terms, for one, list medical cover and repatriation as two distinct travel guarantees. Transport is therefore added to the bill, and on its own it can exceed €200,000. A transport with no ceiling, by contrast, does not shrink as hospitalisation eats into the sum insured.

Before you leave

Cost is read alongside the country's alert level: it is the level that determines whether many contracts apply at all. Our map records the official U.S. State Department level for 207 countries every morning. See the map of 207 countries and the log of changes. The table of benefits can be downloaded without signing up; the full Corporate Mobility general conditions are available in your member area.