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When we embark on the adventure of a lifetime, the last thing that we ever really want to think about is the worst-case-scenario. What are the chances of something really bad happening to me anyway? Do I even really need travel insurance? My expat job is covering everything, right?

I’ll admit, I’ve been there. I forgot to purchase insurance a few times, and I’ve spent more than my fair share of time in Chinese hospitals. But aside from tonsillitis, blood poisoning from stepping on a sea urchin, and a horrible bout of food poisoning, nothing that bad has ever happened to me abroad.

But I recently had a huge wakeup call. One of my friends in China experienced a brain issue and was stuck in a Chinese hospital for a month before she could finally be flown back to Denmark. I still don’t know exactly what happened since she texts me in Danish and I translate, but I do know that it was extremely serious and she’s still recovering months later.

This whole experience got me thinking… What if that was me?

True Medical Emergencies Abroad

For your basic medical emergency, most travel insurance policies will take care of you, or even pay to fly you home. For example, when Dave of Planet D broke his back by slipping down some metal steps in the Amazon (it really is that easy!), his insurance paid to airlift him and fly him by medical ambulance back to Canada.

But what if you’re an expat abroad with local insurance? What if your insurance is happy to pay for local treatment, but won’t fly you home because it’s not enough of an emergency? What happens if you forgot to buy insurance in the first place??!

Lena runs a Youtube channel about China!

Staying in a Chinese Hospital For a Month

My friend Lena from Lena Around had a true medical emergency abroad. She had an issue with a portion of her brain, which needed to be removed… in China.

While I haven’t gotten the whole story, since she is mainly speaking and writing in Danish, (You can watch her story here, just click “CC” for subtitles) I know that she needed to stay in a Chinese hospital for a full month, before she could fly on a regular plane back to Denmark, accompanied by a doctor.

While Chinese medical care is fine, the idea of staying in a Chinese hospital for a month with no privacy, and doctors that don’t speak my native language, is so scary!

While travel insurance might have medically evacuated her to Denmark, they could’ve easily said that her surgery and treatment could be completed in China, refusing to pay for a medical repatriation home. Now if you’re an expat like I was, your local Chinese insurance sure as hell isn’t paying to fly you back home either!

In this case, most people would fly their family out to see them, but there is another option.

No one wants to be in a foreign hospital for weeks on end

Medical Repatriation

If you’re really sick or injured abroad, and can’t take a normal flight home, you may want to consider medical repatriation.

Medical repatriation is a fancy term that means returning home for medical treatment. This could mean anything from hopping on a commercial flight home to returning home in a private air ambulance.

In the case of Lena, she may have had the initial brain surgery done in China, but then she could’ve flown home as soon as she was stable enough to board the medical aircraft, rather than waiting for a month to board a normal commercial plane accompanied by a doctor.

No one wants to be in an unfamiliar country when they’re really sick, and medical repatriation is one way that you can make this “worst-case-scenario” a little more bearable.

Fly home with a qualified doctor

The Different Types of Medical Transport

Worst case scenario, a seriously injured patient will be transported home in an air ambulance. These small jets are fitted with an intensive care unit, monitors, a defibrillator, and a satellite telephone. Specialized doctors will accompany the patient on the Medivac and care for them the entire flight until they’re fully transported to a hospital at home.

However, if the patient is stable and doesn’t need intensive care equipment, there are a few other options which are a bit more economical.

Firstly, there is doctor transport, which is what Lena did for her flight home to Denmark. This means you would sit in a normal seat while accompanied home by a doctor. Typically the patient and doctor would fly business class for a bit more room, but economy class is also possible for some.

However, if your condition is a bit more serious and you need to be transported lying down, there is a stretcher transport option as well. This stretcher would be installed on a commercial flight and is separated from the rest of the passengers by a screen. You’d be accompanied by a doctor, and any family members or friends would be seated nearby and have access to you.

I’m Having an Emergency Now: What Do I Do?

If you or a loved one is stuck in a foreign hospital and cannot take a normal, unsupervised commercial flight home, you have a few options.

Firstly, having someone fly out to be with the person who is sick or injured is always a good idea. No one wants to be alone in a foreign hospital for weeks or months on end!

If you do have the means, you should also definitely look into medical repatriation. First, check if it can be covered by any insurance. If you or your loved one has travel insurance, repatriation may be covered. If insurance isn’t an option, I would contact a medical repatriation service and ask for pricing.

If you feel uncomfortable having yourself or a loved one stuck in a hospital abroad, please consider your options. You don’t have to have a major surgery done in Cambodia if you don’t want to. You don’t need to stay in a Chinese hospital for months on end if you really want to go home.

Chris slipped off the roof of this dive boat

Flying Home Might Be Cheaper

Finally, if you have insurance or free medical care in your home country it might actually be more affordable to fly home. This is especially true if you don’t have insurance abroad.

My fiance Chris was extremely lucky in this regard. He forgot to buy travel insurance for our trip to Sumatra, Indonesia and ended up breaking his arm by slipping off the roof of a dive boat on our last day. Since there was no X-ray on the island, we decided to take our scheduled flights back to China.

The surgery in China would’ve cost him around $4,000 USD, and he was required to stay four days in the hospital. Chris didn’t have any sort of expat insurance in China either (even though I’d been bugging him about it for months), and we thought we were going to be out a few grand.

Thankfully, Chris has free medical care in Australia and was able to buy a last-minute flight home for a pretty reasonable price. He ended up paying around $700 for his round-trip ticket and was able to get his arm surgery in Australia for free! He just flew home with a temporary cast and sling and was allowed on the flight, no problem.

Definitely, don’t rule out paying for a flight home instead of getting surgeries done abroad. Depending on your situation, even paying for a doctor to fly home with you could actually end up being cheaper than getting everything done abroad.

Get travel insurance!

How to Protect Yourself From the Worst Case Scenario

S*** happens. You can get in a car accident, have a brain tumor, or slip down some steps and break your back anywhere.

But if you are living or traveling abroad, you need to take a few extra steps to make sure that you’re covered in case of an emergency.

1. BUY TRAVEL INSURANCE

Please, please, please buy travel insurance! Travel insurance will cover your medication, doctors visits, hospital stays, surgeries and even medical repatriation if necessary. Travel insurance really isn’t that expensive, and it’s much better to be safe than sorry.

Personally, I recommend World Nomads. It’s the insurance I use, and they’ve always been there for me when I needed them.

Get a Quote!

Yes, that is my blood all over everything

2. Check Your Home Insurance

Some insurance policies cover you when you travel. For example, my expat insurance in China covered me everywhere in the world except the USA. (Because the US is ridiculously expensive, of course). Once or twice I was tempted to forgo travel insurance and just use my expat insurance. However, I have no idea if my expat insurance fully covers all my travel activities!

Will my expat insurance cover scuba diving? Probably not. What about medical repatriation? No idea!

Besides, travel insurance covers more than just medical procedures. World Nomads covered me when my phone was stolen in Thailand. It also covers lost luggage, flight issues, or missing a trip due to illness or a death in the family.

3. Remember: You’re Not Stuck

If you do run into the worst-case scenario, there are options. You don’t have to stay for months in a foreign hospital. You’re not stuck abroad with no insurance. There are ways you can get home, even if it does mean spending a bit of money.

Just in case you’re ever not in a good position to care for yourself, make sure a family member or friend back home knows what medical repatriation is. It’s important they know all of the options just in case they’re ever in a situation where they will need to make medical decisions for you.

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Let’s Hear From You!

Do you have any questions about medical repatriation, travel insurance, or medical treatment abroad? Do you have a crazy medical story you want to share? Be sure to leave a comment below!

I’m always checking back for new questions and comments. So no matter how old the post is, I’ll be sure to get back to you ASAP!

While Lena isn’t currently accepting donations for her surgery and recovery, you can support her on Patreon to help her get back to doing what she does best: creating awesome videos about China!

If a small donation isn’t an option for you, feel free to support Lena by watching her China Youtube Videos. She has a ton of great advice about life and travel in China. 

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