How to evacuate when a medical emergency strikes overseas

Insurers usually cover the cost of transporting the insured party to the nearest medical facility for suitable treatment. PHOTO: ADOBE STOCK

SINGAPORE – When Grace Tay’s mother went into cardiac arrest in Spain in 2025, Tay had to arrange for her parent to be medically evacuated and repatriated to Singapore. 

A 63-year-old woman was on holiday in Barcelona, Spain, when she went into cardiac arrest in her hotel room. ST GRAPHICS: NG WENG CHI

First responders took her to the hospital. Her husband and children called the medical evacuation hotline number that came with their insurance. ST GRAPHICS: NG WENG CHI

None of the family spoke Spanish, so it was hard to coordinate with local doctors and the medical evacuation team to discuss the patient’s condition, and how evacuation could be arranged. ST GRAPHICS: NG WENG CHI

To the financial adviser’s surprise, it took more than a week for the insurer’s appointed emergency medical evacuation team to arrange a suitable aircraft to reach her mother’s location and get the necessary flight permits. 

The patient needed an air ambulance fitted to manage a person needing intensive care. It took four days for this to arrive. During this time, she remained in hospital. ST GRAPHICS: NG WENG CHI

A commercial flight between Barcelona and Singapore takes from 13½ hours non-stop to at least 16 hours with a single layover. The aircraft used by Tay’s 63-year-old mother took close to three days to reach Singapore as it required refuelling and maintenance to deal with a technical fault.

During the evacuation, the 34-year-old and her family were added to a WhatsApp chat group with the medical evacuation team and the doctors in Singapore. 

The air ambulance had to make several refuelling stops and needed maintenance, so the journey back to Singapore took longer than a commercial fight. ST GRAPHICS: NG WENG CHI

They received updates on her mother’s condition during refuelling stops and had a tense few hours when engineers had to troubleshoot an issue with the left engine fuel pump.

“It was a traumatic experience,” recalls Tay. She is glad her parents had insurance that covered medical expenses overseas and the cost of repatriation.

On reaching Changi Airport, the patient and her husband were taken to a local public hospital via ambulance. The medical evacuation team handed over her care at the hospital. ST GRAPHICS: NG WENG CHI

Demand for medical evacuation and repatriation to Singapore is steady, say hospitals, insurers and health and security risk services company International SOS. 

Some even say it is growing, as more seniors travel, and as more from Singapore opt for adventure travel.  Most cases of medical evacuation and repatriation are seen during the holiday season and may involve accidents during leisure activities such as skiing, diving or road trips, according to insurers and hospitals. 

Tan Tock Seng Hospital (TTSH) received over 60 queries about medical evacuation in 2025, compared with over 40 in previous years. Singapore General Hospital (SGH) saw 80 cases in 2024 and 2025, compared with 50 in 2023.

Samuel Duong, a senior manager of SGH’s patient liaison service, says cases come in via ferry from Batam, land transport from West Malaysia or via flights. Foreign patients are also medically evacuated to SGH for complex conditions such as burns, he adds.

A spokesperson for International SOS says it is seeing more complex cases, with growing need for a level of care similar to a hospital’s intensive-care unit. Patients may need to be on ventilators or extracorporeal membrane oxygenation for people with heart and lung failure.

This can increase the costs of medical evacuation and repatriation. Older travellers, especially, should read the fine print in their insurance coverage. 

“Many travellers are unaware that policies often exclude pre-existing conditions or have reduced coverage for older individuals,” the spokesperson says.

Here is what you need to know about medical evacuation and repatriation before your next overseas holiday.

Check travel insurance carefully

Does your travel insurance cover overseas medical expenses, medical evacuation and repatriation, and for how much?

A spokesperson for insurer MSIG Singapore says a recent case of medical evacuation from South Korea cost more than $100,000. This was fully paid by the insurer.

“Medical evacuation is inherently costly, especially from remote locations or certain countries when complex medical arrangements are needed,” adds the spokesperson.

MSIG Singapore and Great Eastern offer travel insurance plans with medical evacuation and repatriation coverage of up to $1 million for medical evacuation. 

FWD Singapore says its plans cover “necessary and reasonable costs of arranging the evacuation, such as medical transport and related logistics, rather than up to a fixed dollar limit”.