Getting You Home: Medical Evacuation from On Call International
What happens when you become injured or ill when you’re traveling abroad? Ideally, you have a policy from a company like On Call International, a leading provider of customized medical, security and travel assistance for international business and leisure travelers. On Call International’s has a multi-lingual team of Assistance Coordinators and in-house Medical Directors on call 24/7. They specialize in delivering “life-determining aid during medical emergencies from any point on the globe as well as coordination of transportation home after accidents or illnesses.”
How does it work, what services can they provide and what does it cost? I caught up with Mike Kelly, On Call International’s CEO and Founder, for answers to these and other questions.
Everett Potter: How did On Call begin?
Mike Kelly: During the late 80’s, I was Director of Marketing for American Express Travelers Cheques when we decided to enhance the travelers cheques refund program to include “hand delivered refunds for travelers who lost their cheques.” To get those hand delivered refunds accomplished, we contracted with a series of medical and travel assistance companies all over the world. For the most part, these companies were being run by foreign insurance companies and executives from their home countries. At the same time, I was reading a book by Ted Turner about entrepreneurship and he recommended two things: First, run somebody else’s company; and second, use their money to learn to make all your mistakes. I left Amex to run an assistance company which was focused primarily on Fortune 500 employees. After a few years there, I found an opportunity to develop On Call, focusing on high-quality customer service and medical care. Shortly after we started, we signed Thomas Cook to service their travel insurance portfolio and Merrill Lynch for their Visa Signature Card.
EP: What is medical evacuation coverage?
MK: Our medical evacuation coverage pertains to members who are traveling more than 50 miles from home and are in need of immediate or specialized care that might not be readily available at their current medical facility, making transport to another location necessary. We also offer medical repatriation coverage, which allows the members to travel to a medical facility of their choice if they prefer not receive treatment locally, provided they are medically capable of the trip.
EP: How does it differ from travel insurance?
MK: Travel insurance policies are most often purchased for the trip cancellation coverage. Our services are a great supplement to these travel insurance benefits as we specialize in medical evacuation and travel assistance services for those concerned about their health and safety while traveling more than 50 miles from home. We are available to provide travel and medical assistance services for more than 10 million members, and in 2009 alone we handled nearly 35,000 cases – meaning that our team is very skilled and proficient in handling any type of emergency situation that may occur.
In terms of what differentiates us from the competition, we have an in-house Medical Director, who personally oversees every medical case we receive to make sure each member receives the highest possible level of care. In addition, we have one of the largest physician and hospital networks in the world, allowing us to provide more immediate referrals for doctors and hospitals than many of our counterparts. On Call also provides the flexibility for patients to choose where they are evacuated to, a luxury that is not offered through many travel insurance plans.
EP: Is it only for those who are involved in adventure travel, or adventurous foreign travel?
MK: No, although our memberships are great for these types of travelers, we have developed our programs and services for everyone from the individual traveling on business or leisure, to family or group travelers and students and faculty studying abroad. Our memberships are great for domestic or international travel.
Exposure to different environments – food, culture and activities leaves each individual in unfamiliar situations. While adventure travelers put themselves at a higher risk to health related emergencies, all types of travelers are exposed to unfortunate and unpredictable circumstances whether it is lost/stolen documents, illness or other medical emergencies that can lead to high cost and high stress. On Call helps travelers respond immediately and in the most effective way possible.
EP: What does an On Call International medical evacuation membership include?
MK: Our membership plans offer unlimited medical evacuation coverage including (if medically necessary), transportation of members to their hospital of choice, or even to their home if they need ongoing outpatient care. A medical evacuation membership includes two separate “incidents” per plan term. An “incident” is limited to one evacuation and/or repatriation.
We don’t require an airstrip to perform an evacuation, something that is required by some companies. We also have Canadian-based evacuation teams, giving us the ability to fly into places often restricted by the US, such as Cuba.
EP: Are there any exclusions we should be aware of, in terms of pre-existing conditions, or parts of the globe where the coverage is void?
MK: Some membership exclusions include intentionally self-inflicted injuries, suicide or any attempted threat, except when hospitalized as an inpatient. Any treatment or expense related to childbirth, miscarriage or pregnancy is not covered, unless the mother and/or unborn child experiences abnormalities that endangers either of their lives during the first 6 months (24 wks) of pregnancy. We do not cover the last trimester of pregnancy. There are no exclusions for pre-existing conditions and our coverage applies anywhere in the world, as long as the country is open for assistance.
EP: Who makes the decision to fly me home?
MK: The member can decide whether he or she wants to remain hospitalized locally or be transported to the hospital of choice, as long as they are medically safe enough to travel. Our medical director, Dr. Robert Wheeler, speaks with the on-site physician or medical personnel about our member’s health status, and we determine the most appropriate method of transportation for the member’s condition, as well as whether they are in need of a medical escort, travel companion or even an air ambulance in extreme circumstances.
EP: What is the actual flight like, in terms of aircraft and personnel?
MK: The actual flight by private jet requires a significant amount of pre-planning and execution to move a gravely ill patient in a timely manner. Once On Call is notified by a client or a patient that someone has been admitted to a hospital, we have our in-house medical director, Dr. Bob Wheeler, speak directly to the treating physician to understand the patient’s condition and confirm the hospital’s capabilities to treat the patient. Once we determine that the patient needs further treatment at home or care for their condition is not available at the local hospital, we begin sounding the alarm.
We determine the best method of transport for the patient, which hospital they will be transported to, make sure there is a bed available, and notify the receiving hospital. Then, we dispatch a medical team in, usually, a Lear 35 aircraft to the location to pick up the patient. Upon landing in the location, the nurse and/or physician immediately go to the hospital to examine the patient and make sure they are ready for the flight. The patient is put on stretcher and transported by ground ambulance to the airport. The patient is then carried on the stretcher into the air ambulance and the stretcher is locked into a special rack to hold them safely in place with all IVs, oxygen and monitors ready for transport. On the inside, an air ambulance looks like a traditional ambulance with a few extra seats. It is not a fancy corporate jet with a flight attendant serving cookies and milk; it’s a working ambulance with wings.
Once the patient is ready, the pilots close the door and the jet shoots down the runway. The patient is in limited space and his spouse or significant other might be there with just an overnight bag because extra weight reduces the efficiency of the aircraft.
The airplane is quite cramped. In fact, you cannot stand up in a Lear 35/air ambulance. The nurse/physician is usually kneeling when assisting the patient. While in flight, the nurse/physician are checking the patient’s vital signs and making sure they are comfortable and stable. Upon landing, they are met on the tarmac by a ground ambulance and whisked off to the hospital for admittance. Depending upon the condition of the patient, they will be admitted through the Emergency Room or some other department in the hospital. Upon reception, the nurse/physician on the flight reviews the patient’s condition with the receiving physician and the patient is turned over to them for care. This is often a very emotional moment for the patient as they are finally back in their home town and after a very difficult ordeal, and their vacation or business trip did not turn out as planned.
EP: What’s the fine print?
MK: We provide coverage to our members if they are anywhere more than 50 miles from their home. Two parents and up to eight dependents (up to the age of 24) can be included in a family plan – all for the same price. Members can enroll up to the day before they turn 77. They become ineligible to enroll on their 77th birthday. If the member enrolls while still age 76 but turns 77 while enrolled, he/she will still be covered until the coverage expires. They will not be eligible to re-enroll after the coverage has expired.
EP: And Mike, the bottom line — what does it cost?
MK: Travel assistance from On Call varies depending on the type of membership and length of time covered. Single trip membership starts from $55, Annual membership begins at $225 and Academic membership starts at $45.
For more information, visit www.oncallinternational.com.