What does medical repatriation on travel insurance actually cover?
It covers getting you home, or to appropriate treatment, when you cannot travel normally — and it is the single most expensive thing travel insurance does, which is why the rest of the policy exists around it.
What it involves. Not a rebooked flight. Depending on your condition it can mean an air ambulance, a commercial flight with multiple seats removed for a stretcher, a medical escort — a doctor or nurse travelling with you — ground ambulance transfers at both ends, oxygen and equipment, and coordination between hospitals.
Why the cost is so high. Repatriation from a long-haul destination by air ambulance can run to tens of thousands of pounds, and from remote locations considerably more. This is the scenario travel insurance genuinely protects against — treatment abroad may also be very expensive, but repatriation is the cost that has no ceiling in people's imagination and frequently exceeds it.
What is usually included alongside it: emergency medical treatment abroad; hospital costs; extended accommodation if you must stay longer; travel and accommodation for a family member to be with you; and repatriation of remains, which is a grim but important part of the cover.
The conditions that determine whether it pays:
The insurer's medical team decides, not you. Repatriation happens when and how the assistance company judges appropriate. Arranging your own flight home and claiming afterwards will very likely fail.
You must contact the emergency assistance line before incurring significant costs. This is a condition in almost every policy and is the most common reason claims are reduced or refused.
Pre-existing conditions must have been declared. An undeclared condition that contributes to the emergency can invalidate the whole claim, including the repatriation.
Activity exclusions matter — many policies exclude or require an extension for skiing, motorcycling, diving and similar.
Alcohol and drugs exclusions are applied in practice.
What a GHIC does not do. The UK Global Health Insurance Card gives access to state healthcare in participating countries on the same terms as locals. It does not cover repatriation at all, and is not a substitute for insurance.
General information, not advice.