International medical repatriation: how to bring a patient home

Reviewed by the AirAmbulance.org editorial team · Updated 6 November 2026 · Editorial policy

Medical repatriation brings an ill or injured person home from abroad, by air ambulance or with a medical escort on a commercial flight. Here is how it works and what to prepare.

The steps

• Get a current medical report from the treating doctor, and ask whether the patient is fit to fly.
• Call the travel insurer or assistance company first: many arrange and pay for repatriation directly.
• Decide the transport: air ambulance for stretcher or critical-care patients, medical escort for stable patients.
• Line up a receiving hospital or care at home, with a doctor who accepts the patient.
• Prepare documents: passports, visas if needed, insurance details and medical records.
• Confirm ground ambulances at both ends and who travels with the patient.

Questions to ask a provider

• Is the quote bed to bed, including both ground ambulances?
• What medical crew and equipment will be on board?
• How long does it take to arrange, and what could delay it?
• What payment is needed upfront, and what if the insurer pays later?

Costs that catch families out

• Hospitals abroad often ask for payment, or an insurer's guarantee, before they discharge a patient.
• Ground ambulances at both ends, and positioning the aircraft, may or may not be included in a quote.
• With a medical escort, you usually also pay for the escort's return journey and any extra seats.
• Companions' flights, hotels while waiting, and medical records translation can add up.

If you're a US citizen abroad

• The nearest US embassy or consulate can help find local doctors and hospitals and contact family, but it generally can't pay medical bills or the cost of getting home.
• Travel insurance with evacuation or repatriation cover, or a membership, is usually what pays for the flight.
• Keep copies of passports, insurance details and medical reports in one place you can share quickly.

Who decides if a patient can fly

• The treating doctor gives a fit-to-fly opinion; the flight provider's medical team, or the airline's medical department for commercial flights, makes the final call.
• Some conditions need waiting time or special measures before flying, so the date is set by the patient's recovery, not just by availability.

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