A student on a gap year in Tokyo had a severe psychotic break. She was hospitalized in a Japanese psych ward. Her parents wanted to fly her home to a US facility. The travel insurer said, “We cover the hospital stay up to $10,000, but we strictly exclude Medical Evacuation for mental health conditions.”
Key Takeaways
- The Mental Health Evac Gap: 90% of travel insurance policies cover medical evacuation for physical injuries only. They explicitly exclude evacuation for “Mental, Nervous, or Psychological disorders.”
- Safety vs. Medicine: Insurers argue that a mental health patient can be treated locally or fly commercial (with an escort) and does not require an air ambulance.
- The “Danger to Self” Clause: Even if coverage exists, if the patient is deemed a flight risk or danger to others, commercial airlines will refuse to board them. Private psych air ambulance costs $100k+.
- GeoBlue’s Exception: GeoBlue (and some student plans) is one of the few that often includes mental health evacuation if medically necessary.
The “Why” (The Trap)
The trap is “Physical Manifestation.”
Insurers require a “Bodily Injury” or “Sickness” for evacuation. They classify mental breakdown as non-physical. Unless the patient attempted suicide and has physical trauma (broken bones), the evacuation logic fails.
The Investigation: I Called Them
- GeoBlue (Student Plans): “We cover medical evacuation for mental health conditions if the local facility cannot provide adequate care.” This is the gold standard for students.
- World Nomads: “Evacuation is not covered if the primary cause is a mental health disorder.”
- Cloud 9 (Psych Air Ambulance): I asked for a quote. Tokyo to LA for a psych patient requires a sedated flight with 2 specialized nurses. Cost: $140,000. Cash upfront.
Comparison Table: Mental Health Evac
| Feature | Standard Travel Insurance | GeoBlue / Student Plans |
| Inpatient Psych Care | Limited ( 10k−10k− 20k) | Full Coverage |
| Evacuation (Psych) | Excluded | Covered (Usually) |
| Repatriation of Remains (Suicide) | Excluded | Covered (Sometimes) |
[IMAGE: Graphic of a brain icon with a ‘No Fly’ symbol overlay, versus a broken leg icon with a ‘Fly’ symbol]
Step-by-Step Action Plan
- Buy Student/Expat Insurance: If the traveler is young or has a history, buy GeoBlue or a university-sponsored plan. They have better mental health parity.
- Medical Escort is Key: If insurance denies a jet, ask for a “Psychiatric Medical Escort” on a commercial flight. This is cheaper ($15k) and might be approved or self-fundable.
- Stabilize Locally: You cannot fly a manic patient. They must be medicated and stable before any airline touches them.
- Check “Trip Interruption”: If they need to come home early due to mental illness, check if Trip Interruption covers the economy ticket home (some “Cancel For Any Reason” policies might).
FAQ
What if it’s drug-induced?
Denied. Substance abuse exclusions apply instantly.
Can I drive them home (e.g., Mexico to US)?
Yes, but get a “discharge against medical advice” if the hospital tries to keep them.
Does Medjet cover this?
Medjet excludes transport for mental health conditions unless there is a co-morbid physical injury requiring transport.