Fit to fly after a hospital stay abroad: how airline medical clearance (MEDIF) works

What "fit to fly" means

Fit to fly is not a single certificate that works everywhere. It is the treating doctor's view that the patient can manage the planned journey, accepted by the airline that will carry them. Airlines look at the effects of the cabin: lower air pressure and less oxygen than on the ground, long periods of sitting, and the fact that cabin crew cannot give personal or ongoing medical care. The decision is always medical and individual; this page is general information only.

When an airline asks for a MEDIF

Each airline sets its own rules, but published airline guidance commonly asks for a MEDIF when a passenger:

• needs oxygen, a stretcher, a medical escort or medical equipment on board;
• has a condition that could get worse during the flight or be affected by the cabin environment;
• cannot look after themselves independently during the journey;
• has an uncertain fitness to travel after recent illness, treatment or surgery.

Passengers who only need wheelchair assistance at the airport often do not need a MEDIF. If you are unsure, the airline's special assistance or medical desk decides.

Who fills in the MEDIF

The form usually has two parts:

• Part 1: completed by the passenger or by the family on their behalf (name, flight details, the help needed at the airport and on board).
• Part 2: completed and signed by the treating doctor (diagnosis, current condition, stability, and whether oxygen, a stretcher or an escort is needed).

The airline's medical team then reviews the form. It may approve, ask for more information, set conditions such as an escort or oxygen, or decline.

Timing: plan for the airline's deadline

Many airlines ask for the completed MEDIF at least 48 hours before departure, and some require the form to describe the patient's condition within a set period before travel. Stretcher requests need more lead time, because seats have to be removed and the space confirmed. If the patient's condition changes before the flight, the airline must be told. In practice we build the plan around the airline's own deadline and only confirm the booking once clearance is in.

Seat, stretcher or air ambulance?

The medical assessment points to the type of transfer:

• A regular seat, sometimes with a doctor or nurse escort, for a stable patient who can sit upright for take-off and landing.
• A stretcher on a commercial flight for a stable patient who needs to lie flat.
• An air ambulance when the airline does not clear the patient or the doctors want intensive care on board.

We can arrange any of these, including the ground ambulance at both ends and a bed-to-bed handover.

What the family can prepare

• A recent medical report from the treating hospital, in English if possible.
• The patient's passport and the travel insurance policy or case number, if there is one.
• The name and phone number of the treating doctor.
• The destination: the receiving hospital or home address, and a contact there.
• A list of current medication, carried in hand luggage in the original packaging.
• Whether a family member wants to travel on the same flight.

If there is travel insurance, contact the insurer's assistance line early. See working with your travel insurer.

How we coordinate it

1. We receive the medical report and discuss the travel options with the treating doctor.
2. You receive a written quote before anything is booked.
3. We identify a suitable flight and prepare the MEDIF with the family and the treating doctor.
4. We submit it to the airline and follow up until clearance is in.
5. We arrange the escort if needed, ground transfers at both ends and the handover at the destination.

Why families and insurers contact us

• Available 24/7 by phone and WhatsApp
• Worldwide: transfers between any two countries, coordinated from our Antalya base
• We arrange everything from bed to bed, 24/7.
• One coordinator for each case, from first contact to handover
• Written quote before booking
• We can work with your insurer's assistance team and send case reports to insurers and assistance companies
• Direct contact in English, Dutch, German, Turkish and Russian

Frequently asked questions

What does "fit to fly" mean?

It means the treating doctor considers the patient well enough for the planned flight, and the airline has accepted that assessment. For many patients after a hospital stay, the airline asks for it in writing on a MEDIF.

What is a MEDIF?

A medical information form used by airlines. Part 1 is completed by the passenger or the family, Part 2 by the treating doctor, and the airline's medical team decides whether and on what conditions the patient can fly.

When does an airline need a MEDIF?

Typically when the patient needs oxygen, a stretcher, a medical escort or medical equipment on board, or when fitness to travel is uncertain after recent illness, treatment or surgery. Each airline publishes its own rules.

How far in advance must the MEDIF be sent?

Many airlines ask for the completed form at least 48 hours before departure, and some require it to reflect the patient's condition within a set period before travel. Check the specific airline's page.

Who decides whether the patient can fly?

The treating doctor assesses the patient and the airline's medical team gives the clearance. We do not make medical decisions; we coordinate the paperwork, the flight and the transfers around those decisions.

What if the airline does not clear the patient?

Other options can be discussed with the doctors, such as waiting until the condition is stable, a stretcher on a scheduled flight, or an air ambulance. You receive a written quote for the options before anything is booked.