If you get injured or sick during your trip, travel insurance can come to your rescue by reimbursing the cost of prepaid travel arrangements, like a hotel room, rental car or airfare. But it won’t necessarily cover the actual costs to get medical treatment, nor will it always cover the cost of transportation to get care.

For most people, you’ll need to rely on your existing medical insurance to cover the treatment. And while some health insurers cover you anywhere in the world, not all do, so check your policy before traveling.

Even if your plan covers treatment abroad, it may not cover transportation to get there, like an ambulance ride or perhaps even a helicopter. For that, you’ll need medical evacuation insurance.

What is medical evacuation insurance?

Medical evacuation insurance is typically included in travel insurance policies. It’s also commonly sold in tandem with travel medical expense insurance, which covers emergency medical treatment during your trip.

The exact terms of medical evacuation insurance vary by policy, but generally speaking, this type of insurance covers medical transportation, such as an ambulance ride or air evacuation services, to the nearest adequate medical facility. If you need to head back home for treatment, some plans may also cover the cost to change your flight or book new travel arrangements so you can return sooner.

What’s covered with medical evacuation insurance?

Again, exact coverage varies by policy, but it generally encompasses:

Emergency transportation to the nearest adequate treatment center: Most policies promise transportation to what’s generally referred to as an “adequate” treatment center. But “adequate” can be a relative term, and a medical facility not up to your personal standards might still be deemed adequate by your insurer. And not all policies will pay for a flight back home to visit the doctor you already know.

However, if local doctors can’t help, medical evacuation usually covers transportation home. Those doctors would have to provide documentation that your condition is either untreatable locally or severe enough that a flight home is necessary.

A medical escort or travel companion’s travel: Some policies cover not just your transportation, but also the cost of someone else to accompany you. In some cases, that might need to be a medical professional who can support you throughout the journey, such as by administering oxygen. In other cases, it might be a trusted family member or friend.

Some policies cover only economy-class airfare, while others might cover business class, but only with a doctor’s order.

Repatriation of remains: Should you die during the trip, repatriation can transport your remains home. Typically this service also covers the costs of embalming, local cremation or a casket to transport remains by air.

How much coverage should you have?

If going to the doctor for a sprained ankle at home seems expensive even if you’re insured and visiting an in-network doctor, then getting coverage for an emergency abroad might be even costlier.

Most medical evacuation insurance coverage starts at $100,000 per year, but even that might not be enough. The national average for an emergency helicopter ride is about $40,000, according to medical travel service Flying Angels. That’s just an average, so flights to remote places could easily be more expensive.

Plus, it’s unlikely your existing insurance will cover an air ambulance. About two-thirds of medical flights in 2017 for people with private insurance are still out-of-network, according to the U.S. General Accounting Office, meaning you’re on the hook for most or all of that bill, unless you have medical evacuation insurance.

Throw in the actual cost of treatment, plus last-minute flights for you, a travel companion and a medical escort, and $100,000 might not go that far. Then again, some policies cover as much as $1 million or $2 million per person.

While accidents can happen anywhere, you’re less likely to need medical insurance for a winter trip that entails building snowmen and drinking cocoa in the cabin versus going backcountry skiing on challenging runs. Understand the risk and your risk tolerance. With the former scenario, slipping on an icy sidewalk might mean a patch-up at urgent care that costs a few hundred dollars, especially if your travel companions can drive you. In contrast, a severe injury with the latter might necessitate a full rescue crew.

Read the fine print

Like any travel cost, it’s always wise to read the fine print of your specific policy. Some have additional limits, require specific paperwork or exclude certain circumstances. Though this list is far from comprehensive, here are some common things to look out for:

  • Whether you have primary or secondary coverage: If your medical evacuation coverage is considered secondary coverage, that means it kicks in after your primary health insurance plan.
  • Trip length requirements: Some policies won’t cover trips longer than a certain period (60 days is common).
  • Distance from home: Many policies exclude accidents occurring within 100 miles of your home.
  • Documentation required: You typically can’t just twist your ankle, rebook an early flight home and expect to successfully file a claim, even if your ankle is puffy and painful. Most policies require extensive documentation, like approvals from a legally licensed physician that emergency evacuation is warranted. Save every receipt and get documentation of everything.

How to get medical evacuation insurance (maybe for free)

Medical evacuation insurance coverage is sometimes included with comprehensive travel insurance policies, alongside other forms of travel insurance like lost luggage insurance. Prices vary by the length and nature of your trip, so a long weekend at a resort would likely cost far less than a multiweek camping adventure off the grid.

However, you might already have travel insurance — and not need to pay any extra for it. That’s because many premium travel credit cards include medical evacuation insurance within their trip insurance policies, which are often a benefit for trips paid for on that credit card. If you’re considering purchasing trip insurance anyway, this benefit alone can easily offset any annual fees on the credit card.