Care navigation or medical transport, and which you need

The difference between navigation and medical transport

Navigation and medical transport solve different problems. Navigation is for a person who can travel, or is already where they need to be, and needs the right specialist, the right tests and a plan. Medical transport is for a person too unwell to travel in the ordinary way, who needs to reach a hospital that can treat them, or to go home while still receiving care.

The FCDO describes two kinds of transport. Medical repatriation brings you home while you are still receiving care, and medical evacuation moves you because the specialist care you need is not available where you are [1].

What care navigation does

Navigation takes a health problem off your desk. A named liaison finds the right specialist for the problem, arranges the first appointment, has tests and imaging done so the results are ready for it, and brings the letter back into your record [2].

A first appointment is offered within 48 hours when the problem is urgent and within 5 working days when it is routine, and you approve every booking [2]. The consultant and any tests or scans are billed by those who provide them, with each fee told to you before you agree [2].

What medical transport involves

Medical transport moves a patient with medical care on the way, and it is costly. The CDC gives the cost of an evacuation as ranging from USD 25,000 within North America to more than USD 250,000 for distant and remote places, rising when the patient is critically ill [3].

Under evacuation insurance the decision to evacuate rests with the insurer, and the CDC notes that it is usually made when the traveller is in hospital and expected to need several more days there, or needs treatment not available to a comparable standard locally [3].

A return on a scheduled flight needs planning too. The airline may ask for advance confirmation from your treating doctors that you are fit to fly [1], and its own medical department makes the final decision, treating a doctor’s letter as advice [4].

Who arranges and pays for medical transport

Your insurer should arrange medical repatriation or evacuation, and if your policy does not cover it you will have to arrange and pay for it yourself [1]. A British embassy or consulate cannot arrange or pay for medical repatriation, and cannot pay medical bills [1].

Check your cover before you travel. The FCDO advises a policy that covers existing conditions you have declared, emergency transport and getting home after treatment, and gives examples of uninsured costs of £25,000 or more for a broken leg in Spain and £150,000 or more for hospital treatment of an infection in the USA [5]. The CDC suggests looking for an insurer that arranges direct payment to hospitals, has a 24-hour support line staffed with physicians, and covers transport home [3].

Which you need

Most situations fall into one of these, and the first always comes first.

• Seriously unwell anywhere, call the local emergency number, or 999 in the UK, before anything else [2]
• In hospital abroad and needing to come home, call your insurer’s emergency line, which arranges repatriation or evacuation [1]
• Home or in London with a diagnosis and no clear next step, navigation finds the specialist and arranges the tests
• Facing a major decision about treatment, a second opinion arranged through navigation gives you another expert view
• Well enough to travel and wanting care in another city, navigation can arrange the appointments before you fly

How the two work together

After a transfer home, navigation picks up where transport stops. Once you are back, the next specialist appointment and any scans still need arranging, and a liaison working with your doctor keeps every letter in one record [2].

Members who need to be seen in person abroad have a trusted local doctor or clinic found for them and their record sent ahead, and on Platinum the physician also speaks to any hospital that admits them [6].

How The Wellness can help

Navigation is £295 for one case, or included in membership, and it is not an emergency service [2]. Medical transport is arranged by your insurer or a medical repatriation company [1], and your record, which a doctor anywhere can read, goes with you [7].

Every doctor is GMC registered, regulated services are delivered through registered partner clinics and accredited laboratories, and our London clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia. Beyond London, appointments can be arranged with partners in 12 more cities.