Steps

Flowchart – Medical Evacuation Travel (MET) Process

Responsible Party

Template/Guideline

Explanatory Notes

Steps

Request approval for MET to Head of Office and advise HR Administrator 

Responsible Party

Staff member

Template/Guideline

Explanatory Notes

Request for MET must be accompanied by a medical report from the attending physician that justifies medical necessity.

Steps

Verify eligibility of patient for MET

Responsible Party

Template/Guideline

Explanatory Notes

International and national staff members with an appointment governed by the UN Staff Regulations and Staff Rules.

Steps

Consult with UN Examining Physician/UN Dispensary Physician on the need for MET

Responsible Party

Head of Office

Template/Guideline

Explanatory Notes

Head of Office (RR/Officer-in-Charge) 

MET should be approved on the recommendation of the local Medical Officer of the Regional Commission/UN Examining Physician/UN Dispensary Physician.

Steps

Evaluate and recommend MET

Responsible Party

Physician

Template/Guideline

Explanatory Notes

The local Medical Officer of the Regional Commission or 
the UN Dispensary Physician or 
local UN Examining Physician 
Guidelines for physicians on MET should be followed (Annex C); the recommendation for MET should be forwarded to the Head of Office for approval.

Steps

Approve MET to a recognized regional medical centre within the region

Responsible Party

Head of Office

Template/Guideline

Explanatory Notes

If MET is not authorized, the HR Administrator should inform the staff member. 

MET to any other place will require the prior approval of the UN Medical Director.

Steps

Evaluate request for MET outside the region and approve MET to any other place other than the recognized medical centre within the region

Responsible Party

UN Medical Director

Template/Guideline

Explanatory Notes

The Head of Office should forward a request to the UN Medical Director with the following information: 
- staff member’s name, agency, duty station and index number; 
- indication of whether the patient is the staff member or an eligible family member; if eligible family member, relationship to staff member; 
- proposed place and date of evacuation; 
- patient’s current clinical condition; 
- tentative diagnosis by the treating physician; 
- laboratory test; 
- treatment initiated; 
- specific purpose of the evacuation; and 
- recommendation of the local Medical Officer of the Regional Commission, the UN Dispensary Physician or the local UN Examining Physician. 

It is essential that correct and complete information be communicated to the UN Medical Director to avoid unnecessary delays. Each request for MET will be reviewed individually, taking into consideration the recommendation of the Medical Officer of the Regional Economic Commission, the UN Dispensary Physician or the local UN Examining Physician, and any other medical information at hand. 

If MET is not authorized outside the region, the RR would be advised to inform the staff member.

Steps

Arrange MET: 
- Communicate approval to staff 
- Inform Cigna or GMCS of MET 
- If patient is unable to, forward completed and signed Cost Estimate form to Medical Insurance on behalf of patient 
- Organize MET of the patient and accompanying escort, if applicable 
- Organize purchase of tickets, confirmation of flights and DSA 
- Process salary advance for the staff member, if requested 
- Ensure that any required entry visas are obtained 
- Forward itinerary and MET approval to Finance for payment of DSA and terminal expenses 
- If the MET destination is in security level I or above, request security clearance for the patient and/or family member/ medical escort 
- Forward the travel details to the HR Administrator of the receiving office and request logistical arrangements for the patient: hospital appointment, hotel accommodation and transportation

Responsible Party

Template/Guideline

Explanatory Notes

In non-emergency cases, appointments with the hospital should be confirmed before the staff member or dependent leaves on MET; Cost estimate forms should be completed at least 10 days before hospitalization or no later than three days after hospitalization in cases of emergency 

All logistical arrangements should be put in place before departure and confirmed with the receiving UNDP office at the place of MET 

The following information should be forwarded to the receiving office: 
- patient’s name, date of birth and relationship to the staff member; 
- if applicable, name of accompanying family member and/or medical escort; 
- date of arrival, name of airline, flight number and estimated time of arrival for patient and, if applicable, accompanying family member and/or medical escort; 
- estimated date of departure, name of airline, flight number and estimated time of departure for patient and, if applicable, accompanying family member and/or medical escort; 
- whether hotel accommodation arrangements are required for the patient and, if applicable, accompanying family member and/or medical escort; 
- whether transportation arrangements to and from the airport are required for the patient and, if applicable, accompanying family member and/or medical escort; and 
- whether patient is covered under Cigna, MIP or any of the New York Insurance Plans.

If the staff member is unable to complete and/or sign the form, the staff member’s spouse or an adult family member may complete and sign the form on his/her behalf. If attempts to contact the staff member’s spouse or an adult family member have failed, the UNDP RR, Country Director or OIC may sign on the staff member’s behalf. This measure should only be taken under circumstances where there is supporting documentation to show that efforts to contact the staff member’s spouse or adult family member were unsuccessful and where further delay could jeopardize the staff member’s well-being. When using this measure, the UNDP decision maker is responsible for communicating all medical information to the staff member until such time as a spouse or adult family member is contacted.

Steps

Approve the application for hospitalization and direct billing;
Forward Letter of Guarantee to the hospital/clinic

Responsible Party

Template/Guideline

Explanatory Notes

Insurance Company Cigna, MIP or any of the New York Insurance Plans

For local staff covered under MIP, please refer to MIP Rules. 

For international staff covered under UN WWP (Cigna), please refer to UN  Worldwide Medical Insurance Plan.

Steps

Take MET

Responsible Party

Staff member,

Dependent

Template/Guideline

Explanatory Notes

For local staff covered under MIP, please refer to MIP Rules.

For international staff covered under the UN WWP (Cigna),, please refer to UN  Worldwide Medical Insurance Plan

Steps

For a patient covered under MIP, sign and forward the GMC Prior Agreement form completed by the doctor to GMC.

Responsible Party

Staff member,

Dependent

Template/Guideline

Explanatory Notes

For local staff covered under MIP, please refer to MIP Rules. 

For international staff covered under Vanbreda, please refer to UN  Worldwide Medical Insurance Plan.

Steps

Request completion of ‘Medical Evacuation’ form (MS.39) by the attending physician at the place of evacuation, together with a complete medical report to the Medical Service through the attending physician at the staff member’s duty station within two weeks of the evacuee’s return to the duty station

Responsible Party

Staff member,

Dependent

Template/Guideline

Explanatory Notes

Steps

Forward the ‘Medical Evacuation’ form (MS.39) and the medical report from the attending physician to the UN Medical Director when the staff member returns from MET

Responsible Party

Physician

Template/Guideline

Explanatory Notes

The local Medical Officer of the Regional Commission or 
the UN Dispensary Physician or 
local UN Examining Physician

A complete medical report delivered by the attending physician at the place of evacuation should be forwarded to the Medical Service within two weeks of the evacuee’s return to the duty station. 

The record will include all supporting documentation that may have been submitted to justify a request for MET in excess of 45 days.

Steps

Maintain a complete record of the MET;
Forward the data on MET to the UN Medical Director each quarter

Responsible Party

Template/Guideline

Explanatory Notes

A written record must be kept by the local HR/Operations Manager of each MET, setting out the following information (which should be forwarded to UNMS):
- the name of the staff member, index number, name of the organization, whether locally or internationally recruited; 
​ - the name of the dependant and his/her relation to the staff member, if the evacuee was not the staff member; 
- the name of the Head of Office who authorized the evacuation; 
- the place of evacuation authorized by the Head of Office; 
- the actual place of evacuation; 
- the total cost of the MET, including travel expenses and DSA; and 
- the total medical costs during MET.

Steps

Repatriation of mortal remains

Responsible Party

Template/Guideline

Explanatory Notes

The funding source for the authorized expenses related to the preparation and transportation of mortal remains is the same funding source against which the staff member’s salary is charged. Please be guided by Annex D. 

All expenses related to the staff member’s medical treatment are charged to MIP in accordance with the rules. 

Expenses related to the MET (e.g. staff member’s air ticket, nurse’s air ticket, DSA, ambulances etc.) are charged to the same funding source against which the staff member’s salary is charged.