I hold both US and French passports. I live in Dubai. I had a stroke. I wanted to be evacuated to Paris (better healthcare, free for me). My insurance insisted on flying me to the USA because I used my American passport to buy the policy. I was terrified of the US medical bills.
Key Takeaways
- The “Primary Residence” Rule: Evacuation is almost always to your Country of Primary Residence, not necessarily your country of citizenship. If you listed “Dubai” as your home, they fly you to Dubai.
- The Passport Trap: If you buy the policy with your US passport number, the insurer views the US as your “Home Country.” They might force repatriation there, even if you prefer France.
- Dual-Nationality logic: Insurers will not pay for “Medical Tourism.” They won’t fly you to France just because you like the doctors there. They fly you to where you legally reside.
- Medjet’s Flexibility: Memberships like Medjet allow you to send them both passports on enrollment, but they typically repatriate to the “Point of Origin” listed on your application.
The “Why” (The Trap)
The trap is “Repatriation Definitions.”
Repatriation isn’t a free ticket to your favorite country. It is a risk-mitigation tool for the insurer. They want to dump you in the healthcare system where you have coverage.
- The Crisis: If you have no insurance in the US but the insurer flies you there, you face bankruptcy. You must ensure the insurer knows your “Home” is the country where you have health coverage.
The Investigation: I Called Them
- Cigna Global: “We evacuate you to the nearest Center of Excellence. Repatriation to a specific home country is only done if medically necessary treatment is unavailable locally. We look at your ‘Principal Country of Residence’ on the file.”
- Medjet: “You declare your residence when you sign up. If you list New York, we fly you to New York. If you list Paris, we fly you to Paris. You can’t change it mid-crisis.”
- Seven Corners: “Repatriation is to the country of which the Insured is a citizen and resident.” If you are a citizen of both, they usually default to the address on the policy.
Comparison Table: Evac Destinations
| Feature | Standard Travel Insurance | Medjet Membership | Expat Health (Cigna) |
| Destination | Country of Residence | Hospital of Choice (Home) | Nearest Center of Excellence |
| Dual Citizen Choice | No (Defaults to Policy Address) | Pre-Selected | No (Medical Necessity) |
| Cost to Change | Self-Pay | N/A | N/A |
[IMAGE: Graphic of two passports (Blue and Red) with flight paths diverging to different continents]
Step-by-Step Action Plan
- List the Correct Address: When buying insurance, use the address in the country where you want to end up.
- Verify “Home Country” Definition: Read the definitions section. Does it say “Country of Citizenship” or “Principal Residence”?
- Use Medjet for Choice: If you want the option to pick (e.g., “Take me to Paris, not Dubai”), buy Medjet and list Paris as your residence (if you have an address there).
- Carry Both Passports: If evacuated, you need the passport for the destination country to enter without visa issues.
FAQ
Can they evacuate me to a third country?
Only if the medical care you need doesn’t exist locally or at home.
What if I gave up my residency in both?
You are a “digital nomad.” They will likely repatriate you to your passport country, regardless of whether you have a home there.
Does my family get flown with me?
Usually one escort. They need the correct visa for the destination country too.