Medical repatriation through insurance or on your own
When a Canadian resident needs to be transported back home as a medical patient, there is no one-size-fits-all solution. The plan of action will depend on a long list of factors, including the time of year, available resources at the destination, the urgency of the mission, and the budget.
If a travel insurance company organizes the medical repatriation, arrangements will be made through an assistance center that works with an international medical transport company and local providers in Canada. The patient might wait a few days, but then the assistance company will come back with a clear plan from start to finish.
It gets more complicated and expensive if the insurance company declines medical repatriation. Or, what also happens is if it turns out that the patient is not insured at all for assistance outside of Canada or only insured up to an insufficient amount to cover medical repatriation expenses.
Where to turn to arrange medical repatriation to Canada?
If the patient is admitted to a hospital overseas, many hospitals will have the contact details of the local or North American medical repatriation company they’ve used before. The information might come from the attending doctor, a social worker, or an administration department tasked with the billing or discharge of patients.
Large hospitals that frequently admit international patients often have an international office with English-speaking staff that can provide a list of aeromedical companies.
Our advice is always to research the internet and compare prices, reviews and service offerings. Choosing between a few aeromedical companies that operate independently from the major hospitals gives you the best chance of finding the most cost-effective solution possible.
You’ll also find that some companies are less reliable than others, offer more or less flexibility and that multinational companies have large call centers with different case managers who are efficiency-driven. In contrast, smaller companies tend to provide a more personalized service.
How does a Canadian patient get back to Canada?
Some medical patients can only be safely transported by Medevac. In that case, the air ambulance plane can land in any suitable civilian airport in Canada designated as a port of entry by the Canadian Border Services Agency, closest to the hospital where the patient will be brought.
Air ambulances are very expensive, but once the payment has been figured out, a plane can be up immediately without waiting for the next flight to the destination.
The least expensive option is to bring the patient back on a commercial flight with a fully-equipped medical escort onboard. But the patient will have to get clearance from the airline.
If the patient can fly on a commercial flight, one of the larger commercial airports in Canada will be the port of entry. After arriving in Canada, the patient will continue on a domestic transfer to the home community.
If the patient travels on a stretcher onboard a commercial plane, the flight will land in one of only five airports: Toronto, Vancouver, Montreal, Calgary or Edmonton.
While hospital patients typically go directly to a Canadian hospital after arriving in Canada, patients who need medical repatriation are only sometimes staying in a hospital overseas when the aeromedical crew picks them up.
Occasionally, we find our patients at their hotel, in a long-term care home or at a residential address, with the help of a home care nurse. In these cases, it can be challenging to pre-arrange a hospital bed and a receiving physician in Canada. The patient will arrive in Canada and be transported home.
Remember that it is important for the Canadian doctor to know in detail what happened overseas, what medical problems were found and what treatment was given. It will pay off if you ask the hospital overseas for the medical reports well ahead of time and have any documents translated that have yet to be written in English.
Despite all the documents, the Canadian doctor will conduct a new assessment after the patient arrives in Canada, and the treatment plan will be different from overseas.
Medical repatriation to Alberta
When an Alberta-bound patient is repatriated from overseas on a commercial flight, most flights will land in Toronto, Vancouver or Montreal, with a connecting domestic flight into Edmonton or Calgary.
From there, the patient will travel by ground to one of the hospitals in the city or to one of the smaller communities in Alberta. Some patients from the USA, Europe or the Caribbean will take an international flight that lands directly in Calgary or Edmonton.
Major hospitals like Foothills, South Health Campus in Calgary, the Royal Alexandra, or the University of Alberta Hospital in Edmonton accept Alberta residents who are medically repatriated after an out-of-country emergency every week.
However, a process must be followed, and the same applies to any other Canadian province.
Alberta’s airport hubs also have an important function for patients who must be transported to Saskatchewan, the Yukon, Northwest Territories or Manitoba.
For example, a patient from Africa to Winnipeg may travel via Amsterdam and Edmonton with KLM or Frankfurt and Edmonton with Condor.
Medical repatriation to British Columbia
Most international patients repatriated with a medical escort on a commercial flight will land in Vancouver before taking a domestic flight to their community airport.
Airline stretcher passengers may also land in Seattle and get transferred to BC over the road in a Canadian ambulance. Alternatively, they may fly in on a stretcher onboard a KLM flight that lands in Edmonton or Calgary and get transferred by stretcher charter to their BC community.
Stretcher patients who need to be transported to other Western provinces as far as Manitoba or up North in the Yukon or Northwest Territories also tend to land in Vancouver, depending on where they come from.
Increasingly, BC-bound patients land in Calgary or Edmonton and take a domestic flight into smaller communities like Prince George, Kitimat, Terrace, Kelowna, Kamloops or Fort St John.
The same applies to passengers who need to end up on Vancouver Island. While flights from Asia all land in Vancouver or Seattle, a patient from the South or Europe might fly into Alberta and take a domestic flight into Victoria or Comox.
The reason is that the short hop from Vancouver to Vancouver Island is done on small turboprop aircraft or float planes. If the patient is believed to need the added comfort of flying domestic business class, flying on a Boeing 737 out of Edmonton or Calgary makes more sense.
Repatriations from Africa, the Middle East or South America tend to land in Montreal or Toronto first, followed by a cross-country domestic flight to the West.
Medical repatriation to Manitoba, the Yukon, Northwest Territories or Nunavut
A patient who needs medical repatriation to get back to Manitoba will end up hospitalized at one of Winnipeg’s hospitals unless the patient has been discharged and can be sent home.
Manitoba is a province with many small communities that are difficult to access by road. Medical repatriation to one of the Northern communities in Manitoba is generally done by turboprop commercial aircraft or air ambulance charter.
Still, even then, some patients will land on an airstrip and require a final transfer by boat, helicopter or ice road to the community, deep in the province’s interior.
Medical repatriation to the arctic provinces of Nunavut, Northwest Territories and the Yukon is flown by private charter or commercial flight with a medical escort onboard.
A few regional Canadian airlines fly to the far north out of Vancouver, Edmonton, Calgary and Toronto. Patients repatriated to these arctic communities are generally flown to the regional hospitals in Yellowknife, Whitehorse or Iqaluit first for an assessment.
The provincial health authority will organize a second repatriation to the home community if they are not hospitalized.
Medical repatriation to Ontario
Toronto Pearson International Airport is the largest airport hub and receives flights from all over the world. This airport also receives medical patients daily who are being repatriated to Canada with a medical escort or onboard an air ambulance.
Toronto is well-connected with the large cities in other provinces, and high-frequency routes like Toronto-Calgary and Toronto-Vancouver are serviced by widebody aircraft with full flat-pods in business class, allowing sicker patients to travel commercially on the domestic segment of the journey.
The greater Toronto area is also home to some of the largest hospitals in Canada, including world-class centers of expertise like the Sick Kids Hospital and Sunnybrook Health Sciences Center. Patients from different parts of the world fly into Toronto for advanced treatment.
Toronto is also the most important hub for patients who require medical repatriation to one of the Atlantic provinces: New Brunswick, Prince Edward Island, Nova Scotia and Newfoundland and Labrador. The city has multiple daily flights to Halifax, St John’s, Moncton, Charlottetown and Fredericton.
JET COMPANION is a Canadian medical repatriation company that organizes patient transfers from all over the world back to Canada.
JET COMPANION’s medical escorts are doctors, nurses and advanced paramedics who have received additional aeromedical training to escort patients onboard commercial flights and private charters.
JET COMPANION works with professional assistance partners as well as corporate clients, hospitals, and families tasked with organizing medical repatriation to Canada without the financial support of an insurance company.
JET COMPANION is familiar with the procedures of most Canadian airlines, provincial health authorities and hospitals and has a network of assistance partners in all Canadian provinces.
Conclusion
Be prepared for your medical repatriation to Canada. Jet-Companion has you covered for all your medical repatriation questions. Contact us today to get started.