Flight companions for elderly travellers

Reviewed by the AirAmbulance.org editorial team · Updated 13 November 2026 · Editorial policy

When an older relative can't manage a flight alone, there are five levels of help, from free airline assistance to a nurse escort or air ambulance. The right one depends on their health, not just their age.

The five options

• Airline and airport assistance (free in the US and EU): wheelchair, boarding and connection help. See airport assistance.
• A family member or friend travelling with them.
• A non-medical travel companion: someone paid to accompany them door to door, help with bags, meals and the airport, but not to give medical care.
• A nurse or medical escort on a commercial flight, for travellers who need medication, oxygen or monitoring. See medical escort.
• An air ambulance, for travellers who need to lie down, intensive monitoring or can't fly commercially. See air ambulance cost.

What a companion or escort costs

• You normally pay for the companion's or nurse's time, their seat (and return flight), and any hotel nights.
• A stretcher on a commercial flight takes the space of several seats, so it costs more than a seated escort.
• An air ambulance is usually the most expensive option because you pay for the whole aircraft and medical crew.

How to decide

• Ask the treating doctor whether the traveller can sit upright for the whole journey, needs oxygen or medication on board, or could become confused.
• If the answer to any of these is yes, a medical escort or air ambulance is safer than a non-medical companion.
• Check travel insurance: medical repatriation cover may pay for an escort or air ambulance if a doctor says it's needed.

Sources

• US DOT: Passengers with disabilities
• EU Regulation (EC) No 1107/2006

General information only, not medical, legal or insurance advice. Rules, coverage and prices change; confirm with your provider and insurer.