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Transportation of a patient from a foreign clinic under a tourist health insurance policy

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

Transportation of a patient from a foreign clinic under a tourist health insurance policy

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

After the first examination, the insured was diagnosed with severe chronic diseases. As later stated by the attending physician, because of their exacerbation, she had a hemorrhage in the brain. The insurance policies of the company ERV include in the coverage of chronic diseases and cases of their exacerbation, and the case of the tourist, thus, was recognized as insurance.

As told in ERV, the patient was in a coma for some time, and she needed emergency surgery. The doctor made the decision to transfer the victim to hospital in Antalya as in it there was the necessary equipment for such operation.

However, even after the operation, the condition of the tourist from Astrakhan remained unstable for 10 days, which delayed her evacuation to Russia 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 the patient from a foreign clinic, such evacuation is provided by the insurance policy ERV
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 a foreign clinic will take a long time and, accordingly, will take more money than the insurance coverage of the policy, or when the patient’s condition is very serious and requires transportation to their homeland for complex and urgent operations or treatment, and the level of local medicine does not allow

At the same time, if it is possible to transport the patient to the mainland (in the case of hospitalization in the island territories, etc.), such evacuation is also provided for by the insurance policy ERV.
Permission for the patient’s flight and the method of its transportation depend 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 the insurance company, which was purchased insurance policy traveling abroad. A tourist without insurance abroad can expect to pay for an emergency medical evacuation to Russia only at his own expense (funds of relatives), as in the case of treatment.

“Depending on the condition of the patient who needs transportation to Russia, we can provide several options for such a flight. In any case, the very permission for the flight is given only by the attending physician of the foreign clinic. He also gives recommendations on how such transportation should be carried out,” says the Executive Director of the insurance company ERV Yulia Alcheeva.

The insurance company on a regular flight either buys the patient 2 or 3 adjacent seats in the cabin or a place in the 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 (as a rule, injuries with fixed limbs), the insurance company buys him under the responsibility of the policy two or three standing next to the chair in the cabin or a place in the business class, which is decomposed (for those who need a reclining position). As a rule, these places are always bought on regular flights, explains Ms. Alcheeva.

The insurance company buys the patient a place on the policy in business class
The second option, the expert continues, is transportation with the support of medical staff (usually a paramedic). In this case, more places can be purchased – for the patient, for the paramedic and medical equipment (if 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 lying down position, a state of rest and medical procedures during the flight (ventilator, droppers, 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 flies for patients from Russia, as it requires preparation (for the installation of a stretcher unit requires removal in the cabin from 6 to 9 seats – there is a reclining place for the patient, space for accompanying personnel and medical equipment). Together with the patient on this flight (always regular) fly and ordinary passengers.

To install the stretcher unit requires removal in the cabin from 6 to 9 seats
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 can cost more.

It is clear that for relatives of the tourist without insurance to order services for emergency evacuation of the patient will be prohibitively expensive, and technically almost impossible.

Transportation by air ambulance is used in severe cases, when the pressure drops inherent in conventional Airliners can be critical to health or threaten the life of the patient: with severe traumatic brain injuries, strokes, other vascular diseases, injuries and lung lesions
Finally (and it was in this way that the 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) aircraft – “special boats”.

These are specially equipped boards, which exclude pressure drops during take-off, EN-route and landing.

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

“Sanitary aviation is used in severe cases, when the pressure drops inherent in conventional Airliners can be critical to health or threaten the life of the patient. If such a threat is absent, transporting try to make on Board civil aircraft,” – says Yulia Alcheev of 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 be enough for it
Specially equipped air ambulance planes are at the disposal of EMERCOM of Russia and the Center of 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 economically advantageous if the evacuation is required at least for a group of people with accompanying personnel.

“As a rule, if the insurance company sees that there are not enough funds for dolechivanie in a foreign clinic, and evacuation is possible only by a special Board, we are trying together with the Ministry of health and the Ministry of emergency situations to evacuate people in the so-called “therapeutic window”, that is, at a time when such transportation will be safer and when it will still be enough insurance policy amount,” – says the Executive Director of ERV.

The air ambulance at the disposal of the Ministry of emergency situations of Russia
A good example is the evacuation of 4 Russian citizens from Turkey by one special ship 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.

The evacuation of a group of Russians was carried out with the involvement of extra-budgetary (at the expense of insurance funds) aviation EMERCOM of Russia – Superjet aircraft with installed medical modules and specialists of “Protection”. Then the cost of insurance cases amounted to about 3.8 million rubles, of which about 2.5 million rubles was spent on medical transportation.

The exorbitant cost of the flight by the special Board of the Ministry of emergency situations and the Ministry of health of the Russian Federation forces to attract foreign specialized companies – private planes of sanitary aviation to transport the patient
As already mentioned, for the transportation of single sick tourists special Board of the Ministry of emergency situations and the Ministry of health, departing for the sick from Russia, is rarely used because of the prohibitive cost of such a flight.

Therefore, in the practice of insurance companies, and ERV in particular, is used to attract such transportation of foreign specialized companies – private operators of air ambulances.

Private aviation aircraft
It happened in the case of evacuation at the end of August 2018 tourists to an insurance policy, the ERV, which was needed urgently to move to Russia for treatment. The flight on the route Antalya – Astrakhan was made by a Turkish carrier, which had the appropriate Board.

The cost of transportation of the tourist Board commercial sanaviation was 20500 us dollars. Evacuation took place without complications, the woman was hospitalized in city hospital in a residence, report in ERV.

Foreign specialized private air ambulance company
“It is worth noting that ERV always pays for transportation not to the nearest international airport, but to the necessary clinic for the patient, even if it is hundreds of kilometers from the nearest airport,” Yulia Alcheeva emphasizes.

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