Hello Luc: Thought you might have an answer to a quick question about who pays for a helicopter evacuation.

This is a common point of concern and confusion for backcountry travelers. I always refer to my notes from Start & End at Home (my wilderness risk management and trip planning course) when fielding this question, so I am sharing those notes here.

The information below is based on my experience in Alaska. Your options will vary depending on your location. The prices listed below are likely to change.

Who is going to respond?

An understanding of who is going to respond will influence your decision to purchase evacuation insurance. But the answer is … you don’t know, and you don’t get to choose.

If you want control over who comes, the best option is to arrange for your own flight (without medical services). We did this in the Chugach Mountains after Kate broke her leg. It helped that we had an M.D. on the team and we knew that it wasn’t a life- or limb-threatening injury. Hiring a helicopter from Valdez was considerably cheaper and faster than hitting the SOS button. This option requires doing your homework ahead of time by creating a list of local contacts and/or flight services.

If you can’t initiate your own extraction, it is time to call for help.

Who to call (in the USa):

• By cell phone: 911 (managed by the State)
• By satellite phone: 911 (managed by the State of Texas?!?) or your regional Rescue Coordination Center (in Alaska: 1-800-420-7230)
• With a satellite messenger: SOS button or ask your in-town contact to call 911. Note that Zoleo users who hit the SOS button will be assisted by Global Rescue, which offers evacuation insurance.

That said, folks have shared experiences where 911 hasn’t worked from a satellite phone, etc. I carry several numbers with me, including the regional RCC, nearest State Troopers (Alaska), and nearest private charter companies.

Information to provide:

• Location (lat/lon decimal degree)
• Number of people involved
• Nature of the emergency and medical stability. Emphasize threat to life, limb, or eyesight.
• Available resources
• Special equipment required for access/transport such as a helicopter and/or hoist

The response

Your call will be managed by the nearest Rescue Coordination Center (RCC). The RCC will coordinate with multiple agencies to make a plan. I don’t understand all of the agency relationships, but here is the gist of it:

Incidents in National Parks are managed by the NPS (no fee).

Incidents on State lands are managed by the State Troopers, who might respond themselves (no fee) or authorize:

• Private assets such as LifeMed or AirMedCare (significant fee: typically $10,000 – $25,000). These agencies provide top medical care but might be unable to land in complex terrain or perform a technical extraction.
• Local Search and Rescue teams (no fee).

If other agencies can’t access the patient, Federal assets (military) such as the ANG Pararescuemen or Coast Guard might respond (no fee). These teams are capable of the most technical rescues.

Here are some examples from my own experience:

• John broke his femur when his ice skate snagged in a crack at Nancy Lakes. He was in significant pain … a few miles from the road and about 30 miles from the nearest hospital. A 911 call resulted in a LifeMed flight and medication. The LifeMed bill was $29,000, but his health insurance covered the cost. Phew!
• A skier in the Brooks Range inadvertently triggered an SOS call from an inReach by sitting on it in her backpack (a known flaw with the original DeLorme-built inReach devices). A helicopter was deployed by the North Slope Borough Search and Rescue (borough funded, no fee).
• A search that started with private efforts (local pilots) was handed over to RCC and ultimately involved local pilots, NPS Search and Rescue volunteers, and the ANG 212th Rescue Squadron (Pararescuemen).

The cost will not be my primary concern in a remote medical emergency, but given how much time I spend outside, it makes sense to have some form of evacuation insurance.

Evacuation Insurance

An urgent evacuation and medical treatment might end up costing tens or hundreds of thousands of dollars. Evacuation insurance can cover some or all of that expense.

All of the professionals involved in rescue are there because they want to help you. I don’t think anyone is trying to profit unjustly. But, there is still a bottom line. From a FB exchange about a rescue in Denali National Park:

J: I hope you[r] helicopter rescue bill doesn’t break the bank.

H: it didn’t cost a dime!! These guys were so amazing!!

J: you got super lucky!!

H: legit, the way it all worked out, it really was God.

And also the Federal Government and our tax dollars.

Health Insurance and Credit Card Coverage

Some of the better health plans (and maybe even credit cards?) will cover “necessary ambulance services” including medical flight services. It is worth asking your insurer.

Garmin’s Search and Rescue Insurance

If you own a Garmin satellite messenger (e.g., inReach), you can purchase insurance for $39.95/person/yr. You can purchase insurance for friends/family who might use the device for the same price.

You need to use the Garmin device to initiate the rescue (as opposed to calling 911), but you are covered (up to $100k) regardless of who makes the flight.

There are different plans for high altitude and higher-risk activities, and a list of exclusions in the fine print: inadequate training, travel advisory warnings, professional sports, etc.

Regional Insurance

Private companies provide emergency transport and medical care. In Alaska, a LifeMed membership is $49/month or $149/year. AirMedCare Network (Guardian Flight) is $99/year and includes nationwide coverage. Airlift Northwest (Juneau), is $60/year.

Here’s the catch: Membership only includes that company. If you are insured with LifeMed but the Troopers send Guardian, your insurance does not apply. I think you can request which company responds, but you might not have the final say, or might not want to wait for your carrier if the other company can respond sooner. In regions that are serviced by multiple providers, the safest bet is to purchase insurance with all of them.

• I’m hearing mixed reports about some companies allowing you to sign up on the flight. A friend did this outside of Anchorage. But I’ve also heard that it is no longer allowed.
• You can call your air medical transport company directly. This only seems practical in a non-urgent situation … but, it has been done.

Global Insurance

America Alpine Club rescue: The American Alpine Club insures transport from any outdoor activity emergency (not just climbing). The accident must occur away from your primary residence (and not above the Arctic Circle).

• $65-100 for $7,500 in transport fees and $5,000 in medical expenses regardless of who does the rescue. You can apply for transport fee reimbursement if the evacuation wasn’t coordinated by the AAC provider, Redpoint. This is confusing, more detail below.
• $250 for $300,000 in transport fees and $5,000 in medical expenses.

Here’s the catch: The rescue needs to be coordinated by Redpoint Travel Protection. If you have an emergency, the number to call is 1 628-251-1510, not 911.

If the nature of your emergency “prevented” you from going through Redpoint, you can retroactively apply for reimbursement up to $7,500. Redpoint will then “assess eligibility” and how much it would have cost them to respond and “may” reimburse that amount.

I sure like the simplicity of dialing 911, having a friend do it for me, or hitting the SOS button.

Global Rescue: Global Rescue has the largest network of international assets. Global Rescue can perform evacuation, transport, and offers other travel insurance services. It is the most expensive option:

• $120/$200 indiv/family coverage for 1 week
• $230/$390 indiv/family coverage for 1 month
• $330/$580 indiv/family coverage for 1 year
• 5% discount with AAC membership

Similar to the AAC option, the rescue needs to be initiated by calling Global Rescue, not 911. “We do not pay for any medical transport we have not arranged.”

Folks using the Zoleo satellite messengers are automatically routed through Global Rescue. This will streamline any evacuation effort and financial assistance if you have a GR membership.

A Few Options That Are New to Me

I haven’t had a chance to look into these, but readers pointed them out to me:

DAN Boater. Looks like $60/year ($100/family) for coverage that includes up to $25,000 for SAR.

SPOT coverage via Blister+ (this is not the same as SPOT Satellite Messengers). $395 a year for $25,000 in medical benefits (not evacuation).

In Conclusion …

I recommend thinking through your most likely evacuation scenarios to determine your best insurance option. My most likely evacuations are in remote Alaska by small plane or helicopter, initiated with our inReach device. The Garmin insurance is clearly my best option, and I’ve been a subscriber since I first researched this topic.

This information is based on my own experience and what I’ve gleaned from conversations and research. I welcome corrections and other options and perspectives.

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If you want to get better at preparing for emergencies, check out Start & End at Home, my online wilderness risk management and trip planning course. We meet throughout February and I’ll guide you through a suite of hard and soft tools to best prepare for what goes wrong in the mountains.