Questions about medical evacuation during a pandemic

I travel a lot, but I've never bought travel insurance. I have no medical conditions, and I know that my credit cards will reimburse me if I charge the entire trip on them, and need to cancel before departure if I get sick, or someone close to me becomes ill or injured — the primary reason why people make a travel insurance claim (check if yours does; not all credit cards offer cancellation reimbursement).

But I do buy an annual emergency evacuation membership, in the belief that if I'm severely injured or hospitalized far from home, I'd prefer treatment in a city or hospital of my choice. Since I'm now on Medicare, which doesn't cover me when I travel abroad, I'd want to get back to the U.S. as quickly as possible before the bills pile up in a foreign hospital.

But not until the current coronavirus pandemic did I realize that these medevac plans can't guarantee service if a country is on lockdown, as Italy now is, or if governments decree a complete cessation of air traffic between a country and the United States, as is the current case for China, or if I'm stuck under quarantine.

Several firms offer medevac coverage — it's not insurance, per se, the issuing companies are obliged to explain, but a "membership" — offering a wide range of plans: single trip, short term, annual, etc. Among them: MedJet (medjetassist.com), Global Rescue (globalrescue.com), International SOS (internationalsos.com), Global Guardian Air Ambulance Card (airambulancecard.com) and AirMed (airmed.com). It's also included in some standard travel insurance policies, such as those offered by Allianz Travel and AIG Travel Guard, although I prefer to buy directly from the membership plan. You can also compare some plans at sites such as travelinsurance.com.

You'll want to know how much this protection costs, but also what the fine print says.

Is the medevac plan sold by a broker or directly by the company providing the airlift?

Will your airlift be on a commercial airliner, or on a dedicated air ambulance with whatever medical staff is required?

• Is there an age limit?

• Are pre-existing conditions covered?

• Is there a dollar limit to coverage?

• Which countries are covered?

• How far from home or your preferred medical facility must you be before coverage is valid?

• And perhaps most important, can you choose where to be treated once you're evacuated? (Some plans, such as one that comes as a free benefit of the American Express Platinum Card, will only deliver you to the nearest appropriate medical facility.) This is especially important for people in an HMO or with other managed medical insurance that requires the use of specific hospitals.

But as MedJet spokesperson Geoffrey Weill points out, even the best plan may not help if air traffic, whether commercial airline or air ambulance, has ceased by government decree, or if you're under quarantine either on land or, as in the case of passengers on at least two Princess Cruise Line ships, at sea.

And it stands to reason that in a pandemic it might be difficult for the medevac industry to transport everyone at once. There are only so many aircraft and health care professionals.

Bottom line: An emergency medical evacuation can cost over $100,000. It can bankrupt you. And although it doesn't work in all situations, as I've now discovered, it can be a lifesaver.