How much does an air ambulance transfer cost?

There is no simple price tag for an air ambulance transfer. The cost depends on where the patient is, where they need to go, their medical condition, the aircraft and medical equipment required, the number and type of medical crew, and whether specialist care is needed during the journey.

In practical terms, the cost can range from support on a commercial flight to hundreds of thousands of pounds for a dedicated specialist mission. The determining factors are the patient’s clinical needs, the required medical team and equipment, the route, and the complexity of coordinating a safe transfer.

For straightforward cases, a traveller may be able to return home on a normal commercial flight with wheelchair assistance or a medical escort. At the other end of the scale, a critically ill patient may require a dedicated air ambulance, intensive-care equipment, and a specialist medical team.

The following international medical assistance case shows how a patient’s clinical condition and required level of care can transform the cost and complexity of repatriation.

One repatriation cost almost £300,000 in air ambulance fees

A patient travelling in the Caribbean developed acute cholangitis, septic shock, and multi-organ failure.

The situation was particularly complex because the local medical facilities did not have the specialist hepatology capability required to manage the patient's condition.

Because local facilities could not provide the specialist hepatology the patient required, the patient was transferred with intensive care to a specialist facility in Florida. The case became more complex when the patient required extracorporeal membrane oxygenation, or ECMO, support.

ECMO, or extracorporeal membrane oxygenation, is an advanced form of life support that temporarily performs some of the work of the heart or lungs when they cannot maintain adequate circulation or oxygen levels on their own.

After specialist treatment in the USA, a highly specialised ECMO air ambulance mission was arranged to return the patient to the UK.

The costs illustrate why air ambulance repatriation can become extremely expensive:

• £46,000 - air ambulance from Barbados to the USA
• £239,000 - ECMO air ambulance from the USA to the UK

The two air ambulance transfers therefore cost £285,000 in total: £46,000 for the transfer from Barbados to the USA and £239,000 for the specialist ECMO mission from the USA to the UK.

This was not simply a matter of transporting a patient by air. The aircraft, equipment and medical team had to sustain intensive care throughout an international transfer and meet the specialist clinical requirements of ECMO support.

Once the patient was stabilised, they were safely transferred to the UK and admitted to a specialist intensive care unit.

What happens before an air ambulance is approved?

Before arranging an air ambulance transfer, an emergency assistance team must determine whether it is medically appropriate, where the patient should receive care and what support is required for a safe journey.

An emergency assistance team will usually need to establish:

1. Where the patient is located.
2. What has happened.
3. What treatment has already been provided.
4. Whether the patient is medically stable.
5. What facilities are available locally.
6. Whether the patient can continue treatment where they are.
7. Whether they are fit to fly.
8. What type of aircraft and medical support would be required.
9. Which receiving hospital can provide the appropriate care.

Depending on the assessment, the safest option may be continued treatment at the current facility, transfer to another local hospital, a supported commercial flight, or a dedicated air ambulance.

Commercial flights can sometimes be used for medical repatriation.

A commercial aircraft can be suitable for some patients once they are stable enough to travel.

Depending on the circumstances, assistance may include:

• Airline medical clearance
• Wheelchair assistance
• Airport transfers
• Extra seating
• Oxygen
• A doctor escort
• A nurse escort
• Ground ambulance transport

Air ambulance costs are driven primarily by the patient’s medical complexity and the planning required to reach an appropriate level of care safely - not simply by the distance travelled.

Cases of this scale also show why travellers with existing medical conditions should declare them accurately and understand the medical and repatriation cover available under their policy.

Total Travel Protection travel insurance has no upper age limit and can provide cover for declared pre-existing medical conditions. Total Travel Protection takes a different approach to medical screening, which may result in a better price.