SkyMed paid all of the medical evac costs directly, we didn't pay a dime out of pocket. That included the ambulance from Marigot to the airport, and in Milwaukee from the airport to our hospital. There was a period of some negotiations with SkyMed, but that was entirely handled by the Marigot hospital facilitator. For example, at one point they suggested that I might go on a commercial flight accompanied by a doctor, but the doctor in Marigot said that would be unacceptable and SkyMed immediately agreed.

We have other bills that we're dealing with, but they had nothing to do with the evac flight... e.g., the 2 day stay in the Marigot hospital (emergency room and intensive care) came to about $4,000, which we gladly paid with a credit card (no 1:1 for cash <img src="http://www.traveltalkonline.com/forums/images/graemlins/Grin.gif" alt="" />). We're only at the beginning stages of filing claims with our health insurance for that, but expect that some of it will be reimbursed.

And yes, I'll now tell anyone who will listen that specific med evac insurance is essential for foreign trips, particularly if you're going somewhere with limited medical facilities. I just hope I can get coverage on our next trip, given my history!