Air Ambulance Insurance

[CALSinCM]

I currently live in Thailand and have Thai Health insurance. If I should ever develop a terminal disease, I'd want to repatriate to my own State within the US.

I know that most Air Carriers will not let you fly if they think you are sick.

So next option:

Does anyone know of companies that offer Global Air Ambulance insurance so that you at least can get back home if your sick or injured. I have no desire to die in Thailand where palliative care and hospice facilities are none existent.

So under no circumstances do I want to remain in Thailand if severely sick or injured, at least to the point where a commercial air carrier will refuse to take me home.

[FBN]

There are other options than a dedicated air ambulance; cost for this to the US will be extremely high.

Depending on the medical condition at the time, transfer on a commercial airliner by stretcher and medical escorts may be possible.

Try searching the International SOS website for more info; they have an office here in BKK.

[CALSinCM]

There are other options than a dedicated air ambulance; cost for this to the US will be extremely high.

Depending on the medical condition at the time, transfer on a commercial airliner by stretcher and medical escorts may be possible.

Try searching the International SOS website for more info; they have an office here in BKK.

I'll take a look. Thanks. It's a bit difficult to understand the services they are offering and to whom.

So, I'm still looking for Air Ambulance insurance though. I found a company last year, but for some reason I can longer find the link. The price was about 350/year US for insurance.

Edited August 18, 2015 by CALSinCM

[Sheryl]

There is no such thing as an "air ambulance" policy. But there are medical evacuation policies which will pay to bring you back to your country of residence or nationality by whatever means is needed under the circumstances. Some examples:

1. http://www.cignaglobal.com/health-insurance-plans/international-emergency-evacuation-insurance

2. https://medjetassist.com/personal-air-medical-transport/rules-regulations (This may be the one you were thinking of, but not that they while they can arrange specially equipped aircraft they will usually make use of commercial aircraft as is usually possibly with escort and appropriate equipment etc. Note also that this plan has to be enrolled in before you leave your country of residence.

There are others as well - suggest you contact an insurance broker.

Another option would be to drop your Thai insurance in favor of an internationally issued plan that includes medical evacuation to your home country. This will cover you both for care in Thailand (i.e. could then drop your Thai policy) and once back home. Need to be sure it is worldwide inc. US.

If sick enough to require medical evacuation you are likely to run up some significant costs first in Thailand. Many Thai based policies have very low caps on coverage so double check yours if you opt to keep it and just add on a medical evacuation policy.

[CALSinCM]

There is no such thing as an "air ambulance" policy. But there are medical evacuation policies which will pay to bring you back to your country of residence or nationality by whatever means is needed under the circumstances. Some examples:

1. http://www.cignaglobal.com/health-insurance-plans/international-emergency-evacuation-insurance

2. https://medjetassist.com/personal-air-medical-transport/rules-regulations (This may be the one you were thinking of, but not that they while they can arrange specially equipped aircraft they will usually make use of commercial aircraft as is usually possibly with escort and appropriate equipment etc. Note also that this plan has to be enrolled in before you leave your country of residence.

There are others as well - suggest you contact an insurance broker.

Another option would be to drop your Thai insurance in favor of an internationally issued plan that includes medical evacuation to your home country. This will cover you both for care in Thailand (i.e. could then drop your Thai policy) and once back home. Need to be sure it is worldwide inc. US.

If sick enough to require medical evacuation you are likely to run up some significant costs first in Thailand. Many Thai based policies have very low caps on coverage so double check yours if you opt to keep it and just add on a medical evacuation policy.

At my age I've done a lot of thinking about this. Not that I'm unhealthy, but I'm getting older and things happen.

After reading the information regarding the woman who died in Chiang Mai of cancer, which does nothing but reinforce my premise that Thailand is a barbaric, dreadful place to die of such a dreaded disease simply due to the fact that they will never give you palliative care that is adequate, well, unless you're rich and connected of which I'm neither.

So if I develop a disease that becomes terminal, I want to go back to Washinton State where I'll access to four things: Medical Majauana, opiates in sufficient quantify to keep me out of pain near terminal death, and should my funds run out - I have the option of legally requesting an 'end of life' prescription so that I can die in dignity and on my own terms, and I have a close extended family and friends. Here in Thailand, I have none of that.

Regarding insurance policies that include the US: They are so far out of my price range as to be literally ridiculous.

At a reasonable cost I can obtain a $500K medical policy that will cover me anywhere - except the US. Health Care in the US is totally messed up beyond repair, and lets say I sign up for ACA, what good does it do me here in Thailand? Just about a good as my Thai policy does me in the US. Or for that matter, considering my age, what will Medicare do for me here in Thailand once I turn 65. Again. Nothing. The one outfit that I did find for "medical evacuation policies" was https://globalrescue.com/signup/signup.xhtml Global+Rescue. I'm looking for options like that, and considering I live here in Thialand, I have no plans to make a trip back to the US just to sign up a medical evacuation policy. (That's one I don't undertand).

Bottom line. I don't want to die of some wasting, painful disease in Thailand where doctors have less compassion than The Marquis de Sade. I want to find an option to JUST get myself home and I'm willing to pay for insurance to get me there. But I don't want to be forced to buy a multi-level health insurance package that has 'medical evacuation' as a rider to a policy that I simply cannot afford because the US is the most expensive place in the world for insurance. Most of these types of policies would financially break me even here in Thailand. I can't afford a policy for $600 to $1000 / month. I wouldn't have enough money to live on. It might be a moot point. At 65 I might just move back to the US. The longer I stay here, the less I like it.

[Sheryl]

I fully share your concerns re palliative care here and hope it improves before it comes my time as I would much prefer to die in my home here. There is movement in that direction but pace is slow.

I would not however attribute the problems to a lack of compassion on the part of doctors. Rather it is the medico-legal environment combined with ignorance. The situation here is identical to what it was in the US prior to the 1970's.

Both links given were for medical evacuation only policies, though the second one does have to be applied for before taking up foreign residence. The Cigna one does not AFAIK. I did not price it, but suggest you do as a point of comparison with global rescue.

Also still recommend the use of an insurance broker. There may be more options than google search readily discloses, and a broker can also give some feedback on performance.

Given that your concern is the quality of palliative care it will be essential that any policy you get allows evacuation on demand by the patient and not subject to the insurer or treating doctors assessment of need. Otherwise when the time comes there is every risk that the insurer will decide that treatment of what you have can be done in Thailand (and likely it can, just not the way you want it to be).

[al007]

I expect to die in Thailand, It may also happen quicker than I wish , and if you had my prognosis you should be on your way home

I have given all this much thought, in Thailand I have no insurance, I could go to the Uk and get free medical, and free hospice but have no family left there

In this world we have many choices and if you are amongst those who do not wish to die here maybe (very understandable) you should return home sooner rather than later, maybe you want to have your cake and eat it, unrealistic, YOU HAVE CHOICES

I have been out of the Uk for over 20 yrs and the love and care in the hospitals here is very difficult to find elsewhere, my understanding however is pain medication maybe in short supply, so might need plan to to close things on ones own choice, with asking the wife to shoot me like the lame horse

I also have a plan to maybe even die at home, I know the love I get here both from my wife and the nursing community is second to none

[al007]

I can't afford a policy for $600 to $1000 / month. I wouldn't have enough money to live on. It might be a moot point. At 65 I might just move back to the US. The longer I stay here, the less I like it.

We all I believe need to be where we are happy and contented, from what you have written, I would suggest while you are young enough, you return and live in the USA, and if after being there for a while you feel you have made a mistake, you are young enough to try somewhere else

Be careful the grass is always greener on the other side

[canman]

There are other options than a dedicated air ambulance; cost for this to the US will be extremely high.

Depending on the medical condition at the time, transfer on a commercial airliner by stretcher and medical escorts may be possible.

Try searching the International SOS website for more info; they have an office here in BKK.

SOS will not insure you. If you pay for a membership they will provide care and transport at a cost. An air ambulance from Thailand to the states would be huge dollars.

[al007]

I currently live in Thailand and have Thai Health insurance. If I should ever develop a terminal disease, I'd want to repatriate to my own State within the US.

I know that most Air Carriers will not let you fly if they think you are sick.

Some observations, I write a lot at the moment as I have my own problems

One seldom is diagnosed with a terminal disease and immediately confined to hospital

In most case you would be able to fly without the airline knowing anything

If you are planning on returning to the USA why waste money paying Thai health insurance, premiums well worth saving, may even enabl you to eventually fly home first class

Just observations !

[Sheryl]

I expect to die in Thailand, It may also happen quicker than I wish , and if you had my prognosis you should be on your way home

I have given all this much thought, in Thailand I have no insurance, I could go to the Uk and get free medical, and free hospice but have no family left there

In this world we have many choices and if you are amongst those who do not wish to die here maybe (very understandable) you should return home sooner rather than later, maybe you want to have your cake and eat it, unrealistic, YOU HAVE CHOICES

I have been out of the Uk for over 20 yrs and the love and care in the hospitals here is very difficult to find elsewhere, my understanding however is pain medication maybe in short supply, so might need plan to to close things on ones own choice, with asking the wife to shoot me like the lame horse

I also have a plan to maybe even die at home, I know the love I get here both from my wife and the nursing community is second to none

There is no shortage of pain medication. But there is reluctance to provide large amounts of narcotic for outpatient use, even in terminal cases, and such meds as are prescribed will only be oral which is a problem for people near death as often unable to swallow. Home hospice care such as in the west, complete with iv morphine at home etc, is not available here.

As a result one has to choose between dying at home (indeed an option provided family members and treating physician are on board and advance directive made out) or dying pain free but in a hospital.

[Sheryl]

I know that most Air Carriers will not let you fly if they think you are sick...

This is not quite the case and sick people travel all the time for medical care.

Airlines will not let you on if they suspect you have an infectious disease that could endanger other passengers and crew. And if you appear so ill as to require medical care inflight (or at risk of worsening so that you do) they will allow you to fly only with a medical escort. In any doubt doctor certificate of fitness to fly will be requested.

I have assisted arrangements for people on respirators and/or in coma to fly on commercial aircraft and most international hospitals have staff who can help with this. It is not cheap as have to pay for whole row of seats to be removed if patient is unable to sit up, rental of equipment, oxygen etc and nurse to accompany...but still much less than a chartered flight.

For someone who is ambulatory and requires no special care in flight, even if due to weakness they need a wheelchair in the airport, it is no issue to fly unaccompanied. But to be on safe side anyone whose appearance might alarm airline staff should get a medical certificate stating they are fit to fly.

[chubby]

maybe you can make up some documents, stating your wishes, help you to relax.

maybe put in there, no antibiotics, then you may die without any pain of pneumonia.... though of course morphine drip for pain is a back door to lessen the time it takes, i wonder if thai hospitals are not giving morphine while an inpatient in these cases.

http://www.usatoday.com/story/news/nation/2014/03/05/how-we-die-sherwin-nuland/6070247/

Edited August 23, 2015 by chubby

[CALSinCM]

I fully share your concerns re palliative care here and hope it improves before it comes my time as I would much prefer to die in my home here. There is movement in that direction but pace is slow.

I would not however attribute the problems to a lack of compassion on the part of doctors. Rather it is the medico-legal environment combined with ignorance. The situation here is identical to what it was in the US prior to the 1970's.

Both links given were for medical evacuation only policies, though the second one does have to be applied for before taking up foreign residence. The Cigna one does not AFAIK. I did not price it, but suggest you do as a point of comparison with global rescue.

Also still recommend the use of an insurance broker. There may be more options than google search readily discloses, and a broker can also give some feedback on performance.

Given that your concern is the quality of palliative care it will be essential that any policy you get allows evacuation on demand by the patient and not subject to the insurer or treating doctors assessment of need. Otherwise when the time comes there is every risk that the insurer will decide that treatment of what you have can be done in Thailand (and likely it can, just not the way you want it to be).

Given that your concern is the quality of palliative care it will be essential that any policy you get allows evacuation on demand by the patient and not subject to the insurer or treating doctors assessment of need. Otherwise when the time comes there is every risk that the insurer will decide that treatment of what you have can be done in Thailand (and likely it can, just not the way you want it to be).

Good point and one that I had not thought of. Thanks for bringing that to my attention.

[CALSinCM]

I expect to die in Thailand, It may also happen quicker than I wish , and if you had my prognosis you should be on your way home

I have given all this much thought, in Thailand I have no insurance, I could go to the Uk and get free medical, and free hospice but have no family left there

In this world we have many choices and if you are amongst those who do not wish to die here maybe (very understandable) you should return home sooner rather than later, maybe you want to have your cake and eat it, unrealistic, YOU HAVE CHOICES

I have been out of the Uk for over 20 yrs and the love and care in the hospitals here is very difficult to find elsewhere, my understanding however is pain medication maybe in short supply, so might need plan to to close things on ones own choice, with asking the wife to shoot me like the lame horse

I also have a plan to maybe even die at home, I know the love I get here both from my wife and the nursing community is second to none

There is no shortage of pain medication. But there is reluctance to provide large amounts of narcotic for outpatient use, even in terminal cases, and such meds as are prescribed will only be oral which is a problem for people near death as often unable to swallow. Home hospice care such as in the west, complete with iv morphine at home etc, is not available here.

As a result one has to choose between dying at home (indeed an option provided family members and treating physician are on board and advance directive made out) or dying pain free but in a hospital.

Just curious, but in your advanced directive, can you state that you wish to be placed in a medical induced coma if the pain become too much to bear?

[cooked]

Thai health insurance (http://www.thaihealth.co.th/product_simply_eng.php) also does a repatriation deal. I believe that you have to be under the age of 65 to apply. I have a Swiss repat. insurance so I haven't gone into it.