air travel medical certificate

Please note: Due to increased travel demand, appointments are limited.

Schedule your test as soon as possible to ensure availability.

Fit-To-Fly Medical Certificates

Many Passport Health locations are offering Fit-To-Fly medical certificates , including select clinics in the following states:

Arkansas , Arizona , California , Colorado , Connecticut , Delaware , Florida , Georgia , Iowa , Illinois , Indiana , Kansas , Kentucky , Louisiana , Massachusetts , Maryland , Michigan , Minnesota , North Carolina , New Jersey , New Mexico , Nevada , New York , Ohio , Oklahoma , Pennsylvania , South Carolina , Tennessee , Texas , Utah , Virginia , Washington , Washington D.C.

Fit-to-Fly medical certificates and Fit-To-Travel health forms are required by many airlines and countries in their efforts to keep others from getting infected as operations and economies slowly reopen. These documents provide travelers with proof they received a negative COVID-19 test that was reviewed by a medical professional prior to travel. In most cases, travelers are required to take the COVID-19 test within 72 to 96 hours of departure, depending on the airline or destination.

Call a local Passport Health location today or continue reading to learn more.

What Is a Fit-to-Fly Certificate?

COVID-19 Fit-To-Fly medical certificates certify that the holder of the travel health form has tested negative recently for COVID-19.

Fit-to-Fly medical certification generally requires travelers to show proof of negative COVID-19 RT-PCR test results up to 72 hours before departure. This can vary by destination.

Some countries do require a minimal physical as well which can include listening to the lungs or similar non-invasive procedure.

Check with your airline or your destination’s governing health or entry agency for specific requirements.

Who Needs a Fit-to-Fly Certificate?

Fit-to-Fly certificates are required for entry to some U.S. states and foreign countries. Check with your airline before departure to see if a valid certificate will be required to board your plane.

Not all airlines are requiring proof for travel, but your destination may require proof on arrival. Check our domestic and international COVID-19 travel restrictions pages for more information. The State Department also has a variety of resources for travelers.

How Can I Get a Fit-to-Fly Certificate?

Fit-to-Fly certificates require a negative COVID-19 test and possibly other minor requirements like a healthcare professional listening to your lungs. Various Passport Health facilities throughout the country are offering this service. Be sure to check with your local Passport Health to see if testing is available in your area.

Does a Fit-To-Fly Certificate Require a COVID-19 Test?

Yes, most Fit-to-Fly certificates require a COVID-19 test . Some may only require an antibody test while others require a full PCR test used to diagnose an active infection. Be sure to check the requirements of your destination before receiving testing. As PCR testing can take additional time to process, be sure to reach out to your local Passport Health about availability to fit your destination’s time requirements.

Which Test Do Countries Require for a Fit-to-Fly Certificate?

It can depend. But the most common test required is a RT-PCR test that identifies three different genes in the disease. The RT-PCR is widely viewed as the most comprehensive, currently available test today. To learn more about COVID-19 testing, please visit our COVID-19 testing page .

How Much Does a Fit-to-Fly Certificate Cost?

Fit-to-Fly certificate costs can vary based on the type of test needed and if any additional services, like vital checks, are required. Contact your local Passport Health to learn more about pricing in your area.

Where Can I Get a Fit-to-Fly Certificate?

Fit-to-Fly certificates are available from many Passport Health locations across the United States. Contact your local Passport Health to see if Fit-to-Fly certification and COVID-19 testing are available near you.

On This Page: What Is a Fit-to-Fly Certificate? Who Needs a Fit-to-Fly Certificate? How Can I Get a Fit-to-Fly Certificate? Does a Fit-To-Fly Certificate Require a COVID-19 Test? Which Test Do Countries Require for a Fit-to-Fly Certificate? How Much Does a Fit-to-Fly Certificate Cost? Where Can I Get a Fit-to-Fly Certificate?

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Flight information, infinity mileagelands, business travel, please select your country / region of residence, medical conditions, stretcher assistance.

An EVA Medical Information sheet (MEDIF) certifying fitness to travel must be forwarded to our reservations office and approved by an EVA physician before any passenger requiring this service can be transported.

The passenger using the stretcher must be accompanied by at least one medical doctor or nurse if medical treatment will be required during the flight. A stretcher surcharge equal to 6 full standard fares in the highest applicable adult Y class must also be paid. For detailed information about the stretcher assistance surcharge, please contact an EVA ticketing office.

Carriage is limited to 1 stretcher passenger on each flight segment in Economy Class of some specific aircraft types only. Please contact your EVA Air reservations office at least 48 hours (two working days) before your scheduled flight departure to request stretcher service.

On-board Medical Oxygen

The built-in oxygen supply systems on our aircraft are strictly designed for emergency situations. If a passenger anticipates that they will need oxygen during a normal flight, EVA Air will provide a supply for that individual when the request is made at least 48 hours prior to the flight.

An EVA Medical Information sheet(MEDIF) certifying the passenger's fitness for air travel must be forwarded to our reservations office and approved by an EVA physician at least 48 hours (two working days) before your scheduled flight departure.

A passenger who needs oxygen must be accompanied by at least one medical doctor or nurse if medical treatment is required during the flight. An oxygen bottle and seat surcharge must also be paid. There is a US$200 charge per one oxygen bottle and for the seat surcharge fare. Please contact an EVA ticketing office or travel agent. Excluding oxygen needs on the ground, EVA will make every effort to provide the requested oxygen supply onboard your flight.

Portable Oxygen Concentrators (POC) and Medical Portable Equipment Devices (MPED)

The passenger who would require medical attention and/or special equipment (MPED) to maintain their health during the flight shall follow EVA General Conditions of Carriage to apply and obtain the medical clearance at least 48 hours prior to the flight.

Please note that inflight electrical power is not guaranteed to be available or operative on all flights and every seat. In the event that power supply is necessary for your portable electronic devices, you should bring a sufficient number of fully charged batteries (to power the device for 150% of the expected maximum flight duration) which are in compliance with ICAO instructions. Spare batteries must be individually protected to prevent short circuit or damage and carried in carry-on baggage only.

EVA AIR is not liable for any injury or harm to the passenger caused by a passenger attempting to use the power supplies for medical portable electronic devices by the failure of onboard power supplies or any other reasons in connection therewith. Passengers use power supplies at their own risk.

Portable Oxygen Concentrators (POC) :Passenger may bring and use Portable Oxygen Concentrator (POC) devices on board. The POC needs to be approved by EVA and comply with carry- on baggage weight and dimensions limitations. The POC must be stowed under the front passenger's seat; otherwise passenger may pay for an extra seat to tie-down the POC.

Please advise EVA in advance at least 48 hours prior to the flight departure date and inform reservation staff of the intended use of the POC and the model of POC to be used.

Passenger who plans to use a Portable Oxygen Concentrator (POC) must provide a medical certificate (MEDIF) from their physician that is issued not more than 10 days prior to departure of the flight.

The passenger must check in and arrive at the departure gate no less than 60 minutes prior to departure. Prior to boarding, the handling staff will verify the POC model, medical certificate, number and packaging of batteries. The device must have a label attached indicating that it has been approved for use in aircraft. For more information, please contact EVA AIR reservation staff.

The following POCs are allowed on board:

• Invacare Corporation's XPO2/XPO100
• Invacare Solo 2
• Delphi RS-00400/Oxus RS00400
• AirSep Lifestyle
• AirSep Freestyle
• AirSep Freestyle 5
• AirSep Focus
• (Caire) SeQual eQuinox / Oxywell (mdel 4000)
• SeQual Eclipse
• SeQual SAROS
• Respironics Inc,EverGo
• Respironics SimplyGo
• DeVilbiss Healthcare's iGo
• International Biophysics Corporation's LifeChoice / Inoval Labs LifeChoice
• Inogen One G2
• Inogen One G3
• Inova Labs LifeChoice Activox
• Oxylife's Independence Oxygen Conentrtor
• Precision Medical EasyPulse
• VBox Trooper

Other Medical-Portable Electrical Devices except POC may be carried and used on board flights should follow Regultions Governing The Use of Electrical Device.

Medical Information Sheet (MEDIF)

Please pass the following forms to your attending physician and fill them in depending on your health conditions, so that our Aviation Medicine Office can determine if special safety measures or medical services are required. It is prohibited to operate of any electrical medical device during emergency evacuation.

• MEDIF English download file
• MEDIF Traditional Chinese download file
• Passengers with disabilities who are departing from a US airport should check with the  TSA website (Open in new window)  for information on screening and other procedures for passengers with disabilities. TSA also provides pre-arranged assistance in some cases for passengers with disabilities. Please refer to the  Travel Information web page of Transportation Security Administration (Open in new window)  for details of the TSA Cares program.
• Passengers who are traveling with medications should always carry their medications in their carry-on baggage and not place them in their checked baggage. If there are any questions about the amount of medication, especially liquids, please refer to the TSA regulations on their website.
• Portable Dialysis Machines are permitted on flights to/from the U.S.A. but may not be used during the flight. Please contact EVA Reservations in advance of your flight to advise the dimensions (length + width + height) and the weight of your machine so we can advise you about its carriage. 
• Personal Oxygen Bottles are never permitted on EVA flights either as carry-on or as checked baggage.This is due to US and international dangerous goods and safety regulations. If you require oxygen during the flight, please refer to the section about On Board Medical Oxygen.
• Passengers with reduced mobility who are departing from UK airport. If you have any question or need special assistance, please contact our UK reservation office 20-73808300.

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Home » Information hub » Living with a lung condition » Air travel » Get your medical certificate

Get your medical certificate

If you need additional oxygen on board a plane, you will be asked to provide a medical certificate. Find out how to get one on this page.

If you need additional oxygen on board the plane, your airline will ask for a medical certificate, commonly referred to as a Fit to Fly Certificate or MEDIF (Medical Information Form). These certificates show that you are healthy enough to fly.

All medical certificates are usually composed of two parts to be completed by:

• the passenger or their carer (usually part one)
• a doctor (usually part two)

Passengers are usually responsible for signing and sending the form. Always read the instructions on how to complete it, and when and who to send it to.

You will need to give the date or booking reference of your flight on the form.

Where to find it

Each airline has its own form which can be downloaded from their website – usually on the special assistance pages. If it is not online, you will have to contact the special assistance department of the airline (see the airline index for airline contact information).

How to complete it

Only some of the information requested in fit to fly and MEDIF certificates may be relevant for you. These certificates are designed to cover different temporary or long-term conditions, including heart problems, recent surgeries and injuries.

In most medical forms you will find the following sections that are relevant if you have a lung condition:

Escorts or accompanying persons

If you wish to travel with someone, it is important to give details of this person so that you can sit next to each other during your journey.

Oxygen supply

You should indicate the oxygen flow rate you will need on board the plane as prescribed by your doctor.

The information includes:

• rates in litres per minute
• flow type (continuous or pulse)

Medical equipment

Portable oxygen concentrators.

Most airlines now allow passengers to use their own portable oxygen concentrators (POCs), although only specific models may be allowed.

POCs can provide 1–5 litres of 90% oxygen per minute and have batteries.

Airlines should tell you how many extra batteries you will need to take. This is because you need to have access to oxygen even if your flight is delayed or it lasts longer than expected.

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• Section 3 - Travelers with Disabilities
• Section 3 - Highly Allergic Travelers

Travelers with Chronic Illnesses

Cdc yellow book 2024.

Author(s): Noreen Hynes

Although traveling abroad can be relaxing and rewarding, the physical demands of travel can be stressful, particularly for travelers with underlying chronic illnesses. With adequate preparation, however, these travelers can have safe and enjoyable trips. For more detailed information on assisting immunocompromised travelers , travelers with disabilities , highly allergic travelers , and travelers with substance use disorders prepare for international travel, see the respective chapters in this section.

Patients should see their established health care providers well in advance of travel to ensure that all chronic conditions are controlled, and management is optimized. Clinicians should encourage patients to seek pretravel consultation prior to paying for nonrefundable trips, and at least 4–6 weeks before departure to ensure adequate time to respond to immunizations, try new medications before travel, or redefine the itinerary based upon pretravel consultation recommendations.

General Approach

Advising travelers.

Adequate preparation for patients with chronic illnesses for international travel requires the active participation of both the traveler and the travel health provider. Box 3-03 includes a checklist of pretravel activities for travelers with chronic illnesses.

Box 3-03 A checklist for travelers with chronic illnesses preparing for international travel

☐ Carry copies of all prescriptions.

☐ Check with the foreign embassy or consulate for your destination country in the United States to clarify whether any medication restrictions exist. Some countries do not allow visitors to bring certain medications into the country, especially narcotics and psychotropic medications.

☐ Favor travel to destinations that have access to quality care for your condition (see Sec. 6, Ch. 2, Obtaining Health Care Abroad )

☐ Obtain an established provider letter. The letter should be on office letterhead stationery and outline existing medical conditions, medications prescribed (including generic names), and any equipment required to manage the condition. By law, some states do not permit a travel health specialist to furnish such a letter if the specialist is not also the primary care provider or established provider of record.

☐ Pack a travel health kit (see Sec. 2, Ch. 10, Travel Health Kits ). Take health kits on board as carry-on luggage, and bring all necessary medications and medical supplies (e.g., pouching for ostomies) in their original containers.

☐ Select a medical assistance company that allows you to store your medical history so it can be accessed worldwide.

☐ Sign up for the Smart Traveler Enrollment Program , a free service of the US Department of State to US citizens and permanent residents, to receive destination-specific travel and security updates. This service also allows the Department of State to contact international travelers during emergencies.

☐ Stay hydrated, wear loose-fitting clothing, and walk and stretch at regular intervals during long-distance travel (see Sec. 8, Ch. 3, Deep Vein Thrombosis & Pulmonary Embolism ).

☐ Wear a medical alert bracelet or carry medical information on your person. Various brands of jewelry or tags, even electronic ones, are available.

Health Care Provider Roles & Responsibilities

Health care providers play a critical role in helping patients with chronic underlying conditions travel safely. Ask patients about previous health-related issues encountered during travel (e.g., complications during air travel). In addition to sharing the advice found in  Box 3-03 , ensure the traveler has sufficient medication (and proper storage conditions) for the entire trip, plus extra in case of unexpected delays. Because medications should be taken based on elapsed time and not time of day, offering travelers guidance on scheduling when to take medications during and after crossing time zones might be needed. Educate travelers on possible drug interactions (see Sec. 2, Ch. 4, Interactions Between Travel Vaccines & Drugs ). Some medications used to treat chronic medical illnesses (e.g., warfarin) can interact with prescribed self-treatment for travelers’ diarrhea or malaria chemoprophylaxis. Discuss all medications patients use, including medications taken daily, those taken on an as-needed basis, and dietary supplements or herbal products. In addition, discuss supplemental insurance options for travelers, including policies that cover trip cancellation in the event of illness, supplemental medical insurance, and medical evacuation insurance. Supplemental medical insurance can reimburse travelers for money paid for health care abroad; most medical insurance policies do not cover the cost of health care received in other countries. Medical evacuation insurance covers moving the person from the place of illness or injury to a place where they can receive definitive care. Travelers might need assistance to identify supplemental insurance plans that will cover costs for preexisting conditions (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

Help patients devise a Personal Travel Health Plan. This plan should give instructions for managing minor problems or exacerbations of underlying illnesses and should include information about medical facilities available in the destination country (see Sec. 6, Ch. 2, Obtaining Health Care Abroad ).

Specific Chronic Medical Conditions

Chronic illness or acute illness affecting underlying chronic disease might affect the recommendations clinicians make to a traveler after completing the risk assessment conducted as part of the pretravel consultation (see Sec. 2, Ch. 1, The Pretravel Consultation ). Some online resources for travelers who have ≥1 chronic medical conditions can be found in Table 3-05 (in Sec. 3, Ch. 2, Travelers with Disabilities ) and Table 3-07 .

Chronic conditions include those affecting the cardiovascular, endocrine, gastrointestinal, genitourinary, hematological, hepatic, neurologic, and respiratory systems. Table 3-08 addresses issues and recommendations related to specific chronic medical illnesses and should be used in conjunction with the other recommendations given throughout this book.

Travelers also might want to investigate international health care accreditation agencies to identify health care facilities at the travel destination that have received recognition or accreditation for high care standards and good patient safety records. If travelers or their health care providers have concerns about fitness for air travel or the need to obtain a medical certificate before travel, the medical unit affiliated with the specific airline is a valuable source for information.

Travelers who require service animals, including emotional support animals, should check with the airline and the destination country to ensure both the air carrier and the country will allow the animal; documentation and permits might also be required (see Sec. 7, Ch. 6, Traveling with Pets & Service Animals ). Travelers planning to use supplemental oxygen on the aircraft or needing other equipment (e.g., a wheelchair) must inform the airline far in advance of planned travel. The Transportation Security Administration (TSA) Cares Helpline (toll-free at 855-787-2227) or TSA Cares online assistance also can provide information on how to prepare for the airport security screening process for a particular disability or medical condition.

Table 3-07 Online resources for travelers with chronic illnesses: disease & condition-specific

DISEASE / CONDITION

ORGANIZATION / SOURCE

ANTICOAGULATION

Anticoagulation Forum

Centers of Excellence Resource Center

American Cancer Society

Eat Right and Stay Active while Traveling

CELIAC DISEASE

National Celiac Association

Eating GF when traveling abroad

CHRONIC PAIN

International Pain Foundation

Top Tips for Traveling Abroad with Chronic Pain

American Diabetes Association

Air Travel and Diabetes

Epilepsy Foundation

Travel and Holidays

Epilepsy Society (UK)

Travel and holidays for people with epilepsy

HEART CONDITIONS

American Heart Association

Healthy Travel

INFLAMMATORY BOWEL DISEASE

Crohn’s & Colitis Foundation

Traveling with IBD

KIDNEY DISEASE

American Association of Kidney Patients (AAKP)

International Travel while on Dialysis

National Kidney Foundation

Foreign Travel Tips for Dialysis Patients

Global Dialysis (UK)

Travel Advice

LUNGS & CHEST

American Lung Association

Traveling with Oxygen

MULTIPLE SCLEROSIS

Multiple Sclerosis Foundation

Tips for Traveling Abroad with MS

SLEEP APNEA

American Sleep Association

Travel: CPAP Machines

American Sleep Apnea Association

US Travel Tips for CPAP Users

Table 3-08 Special considerations for travelers with chronic illnesses

Abbreviations: AAKP, American Association of Kidney Patients; AICD, automatic implantable cardioverter defibrillator; CABG, coronary artery bypass graft; CHF, congestive heart failure; CKD, chronic kidney disease; CNS, central nervous system; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease; CrCl, creatinine clearance; CVA, cerebrovascular accident; DVT, deep vein thrombosis; ECG, electrocardiogram; FSBG, fingerstick blood glucose; GI, gastrointestinal; Hgb, hemoglobin; HIV, human immunodeficiency virus; IGRA, interferon-γ release assay; INR, international normalized ratio; PNS, peripheral nervous system; PPIs, proton-pump inhibitors; PTX, pneumothorax; TD, travelers’ diarrhea; TIA, transient ischemic attack; TNF, tumor necrosis factor; TST, tuberculin skin test; YF, yellow fever.

a There is a spectrum of airline travel–related risk that depends on the cardiovascular disorder, the defined risk group within the disorder, and the time since the acute event (if applicable). Evidence basis for recommendations is suboptimal, however.

b See Sec. 5, Part 3, Ch. 16, Malaria , for additional details.

The following authors contributed to the previous version of this chapter: Deborah Nicolls Barbeau, Gail A. Rosselot, Sue Ann McDevitt

Bibliography

Aisporna C, Erickson-Hurt C. End-of-life travel: A bucket list desire for patients with life limiting illnesses. J Hospice Pall Nursing. 2019;21(5):397–403.

Furuto Y, Kawamura M, Namikawa A, Takahashi H, Shibuya Y. Health risk of travel for chronic kidney disease patients. J Res Med Sci. 2020;25:22.

Heng S, Hughes B, Hibbert M, Khasraw M, Lwin Z. Traveling with cancer: A guide for oncologists in the modern world. J Glob Oncol. 2019;5:1–10.

International Air Transport Association. Medical manual, 12th edition; July 2020. Available from: www.iata.org/en/publications/medical-manual .

Josephs LK, Coker RK, Thomas M; British Thoracic Society Air Travel Working Group. Managing patients with stable respiratory disease planning air travel: a primary care summary of the British Thoracic Society recommendations. Prim Care Respir J. 2013;22(2):234–8.

McCarthy AE, Burchard GD. The travelers with pre-existing disease. In: Keystone JS, Kozarsky PE, Connor BA, Nothdurft HD, Mendelson M, Leder K, editors. Travel medicine, 4th edition. Philadelphia: Saunders Elsevier; 2018. pp. 263–6.

Pinsker JE, Becker E, Mahnke CB, Ching M, Larson NS, Roy D. Extensive clinical experience: a simple guide to basal insulin adjustments for long-distance travel. J Diabetes Metab Disord. 2013;12(1):59.

Ringwald J, Strobel J, Eckstein R. Travel and oral anticoagulation. J Travel Med. 2009;16(4):276–83.

Smith D, Toff W, Joy M, Dowdall N, Johnston R, Clark L, et al. Fitness to fly for passengers with cardiovascular disease. Heart. 2010;96(Suppl_2):ii1–16.

US Department of Justice. Exemption from import or export requirements for personal medical use. Title 21 CFR §1301.26. 2004 Sep 14. Available from: www.deadiversion.usdoj.gov/fed_regs/rules/2004/fr0914.htm .

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Medical Certification - Get a Medical Certificate

To obtain a medical certificate you must be examined by an FAA-designated Aviation Medical Examiner (AME). As the airman you should follow these steps to apply for and obtain your medical certificate:

• Use MedXPress , to complete the initial portion of the application.
• Schedule an appointment with an Aviation Medical Examiner ( AME ) in your area.
• If you have any medical conditions or take any mediation, ask the AME office what records you need to bring to your appointment.

At your scheduled appointment, the AME will complete your medical examination and the remainder of the FAA application form. If you meet the required medical standards, the AME will issue you a medical certificate.

Flying with Prescribed Drugs: How-to Pack, Tips & More! [Ultimate Travel Guide]

• July 6, 2023
• Lauren Stuttaford

Are you a frequent traveler who relies on prescribed medications to maintain your well-being? Or perhaps you’re a first-time flyer with concerns about how to navigate the skies with your essential drugs. Don’t panic – we’ve got you covered with our ultimate guide on how to pack prescription meds for air travel.

In this guide, we’ll explore the ins and outs of flying with prescribed drugs, from understanding airline regulations to organizing your medications and navigating security screenings.

Wondering, “How do I pack my prescriptions for air travel”?

We’ll equip you with the knowledge and confidence to embark on your travels with ease. So, let’s dive in and discover how to pack like a pro, ensuring your medications are as ready for takeoff as you are!

Prescription Medicine and Air Travel: Can You Fly with Medication?

The good news is that you can fly with your medication. Airlines and airport authorities understand the importance of carrying necessary medications during air travel. However, there are a few essential considerations to keep in mind to ensure a seamless journey. We cover everything you need to know about international air travel with prescription medication below!

Understanding Airline & Airport Regulations for Flying with Prescribed Drugs

When you’re flying with prescribed drugs, it’s important to be familiar with the rules and regulations governing air travel so you can ensure everything is in order when packing prescription medication for air travel. Also, keep in mind that different airlines and countries may have specific guidelines, so you should do your own research on each destination to avoid any unnecessary hassles or delays.

Here’s what you need to know about air travel with prescription drugs:

Carrying prescribed drugs on flights:

• Passengers are generally allowed to carry prescribed medications both in their carry-on luggage and checked bags. But when packing prescriptions for air travel, it’s strongly recommended to keep your essential medications in your carry-on to ensure immediate access during the flight.
• Avoid packing medications in unmarked containers or plastic bags. Instead, use their original pharmacy-labeled packaging whenever possible.

Proper documentation and identification:

• Carrying proper documentation is crucial when you’re planning air travel with prescriptions. Make sure to bring your original prescription labels with your name, medication details, and prescribing doctor’s information clearly printed.
• If you’re traveling with injectable medications or medical devices like syringes, carry a doctor’s note or medical certificate stating their necessity.

Specific restrictions and limitations:

• Liquids and gels: If you’re not sure how to pack prescription meds for travel, you should know, the TSA’s 3-1-1 rule applies to liquid medications as well. You can carry medications in liquid or gel form, but they must be in containers of 3.4 ounces (100 milliliters) or less and fit into a clear quart-sized bag. Medications are exempt from the 3-1-1 rule but be prepared for additional screening if needed.
• Controlled substances: When it comes to air travel and prescription drugs, you should do extra research if your prescribed drugs fall under controlled substances, such as certain pain medications or anxiety drugs. Check the specific regulations of the destination country and obtain any necessary permits or approvals in advance.

TSA regulations:

The Transportation Security Administration (TSA) is a federal agency that is responsible for security at airports and other transportation hubs in the United States. The TSA has regulations on flying with prescribed medicines in order to ensure the safety of passengers and crew members.

These regulations are important because they help to prevent the illegal transportation of controlled substances and other dangerous materials. They also help to ensure that passengers have access to their essential medications in case of an emergency and that they adhere to regulations on packing prescription drugs for air travel.

The full TSA regulations on flying with prescribed medicines can be found on the TSA website . However, here are some key points to keep in mind:

• You can bring your prescribed medications in your carry-on luggage or your checked luggage.
• Liquid medications must be in containers of 3.4 ounces (100 milliliters) or less and must fit in a clear quart-sized bag.
• You may need to declare controlled substances to the TSA.
• Be prepared to show documentation for your medication, such as your prescription or a doctor’s note.

If you are traveling with a large quantity of medication, you may need to declare it to the TSA. You can request a private screening if you prefer not to disclose personal medical information in public.

Always check the official websites of your airline, the TSA, and the destination country’s aviation or transportation authority for the most up-to-date information on air travel regulations prescription drugs and more information on how to pack prescription meds for air travel. Remember, it’s better to be over-prepared than to be caught unaware, so take the time to understand and follow these regulations to make your journey as smooth as possible.

Consult with Your Healthcare Provider

Before you travel (and learn how to pack prescription meds for air travel), it’s important to consult with your healthcare provider to discuss your medication needs. They can help you adjust your medication schedule, ensure you have an adequate supply, and advise you on how to store your medications safely.

Here are some things to discuss with your healthcare provider:

• Your travel plans, including the duration of your trip, the destinations you’ll be visiting, and any potential challenges or concerns you anticipate.
• Any changes in your medication schedule that may be necessary due to time zone changes or disruptions to your regular routine.
• The need for additional prescriptions to cover the entire period of travel.
• How to store your medications safely, especially if they have specific storage requirements or are sensitive to temperature changes.
• Emergency contact information, including the number of your healthcare provider and the nearest hospital or clinic at your destination.

By consulting with your healthcare provider, you can ensure that your medications are well-managed during your travels and get info on how to pack prescription meds for air travel. This will help you stay on top of your health and enjoy your trip with peace of mind.

Organizing Medications

It’s important to know how to pack prescription meds for airline travel with prescription drugs, since proper organization of your medications is essential for easy access, safety, and convenience while traveling. Here are some tips:

• Use pill organizers to keep your medications neatly sorted and easily accessible.
• Label your medication containers clearly with your name, the name of the medication, dosage instructions, and any other relevant information.
• Keep your medications in their original packaging, especially for prescription medications.
• Separate medications by type to avoid confusion.
• Carry extra medications in case of unexpected delays or changes to your itinerary.
• Place liquid medications in sealable, clear plastic bags to comply with TSA regulations and prevent leaks.
• Carry your medications in your carry-on luggage for easy access.

By following these tips, you can ensure that your medications are well-organized and easily accessible while traveling.

How to Pack Prescription Meds for Air Travel : Carry-On or Checked Luggage

When packing prescription medications for air travel, it is generally recommended to keep them in your carry-on luggage. This ensures that you have immediate access to them during your flight and reduces the risk of lost or delayed luggage.

If you do choose to pack your medications in your checked luggage, be sure to pack extra medication in case of unforeseen circumstances. It is also important to check the specific regulations and guidelines of your airline regarding carrying prescription medications to ensure compliance and a smooth travel experience.

Here are some of the pros and cons of each option:

Carry-On Luggage

• Immediate access to medications
• Mitigates the risk of lost or delayed luggage
• Liquid restrictions (3-1-1 rule)

Checked Luggage

• Convenience
• Ease of travel
• Risk of lost or delayed luggage
• Limited access to medications during security screenings

Following these tips helps ensure that your prescription medications are safe and accessible during your flight.

Documentation and Labeling

When it comes to international air travel with prescription drugs, it is important to carry proper documentation and ensure clear labeling. This will help you verify the legitimacy of your medications, expedite security clearance, and comply with international travel requirements.

For documentation, carry the original prescription labels or packaging provided by the pharmacy. These labels should include your name, the medication’s name, prescribing doctor’s information, and the dosage instructions. Additionally, consider obtaining a letter or note from your healthcare provider explaining the necessity of your prescribed medications, especially for controlled substances or injectable medications.

For labeling, you can use adhesive labels or waterproof markers to write your name, dosage, and any other relevant information directly on the medication packaging. Alternatively, you can attach removable labels or use medication-specific labeling systems designed for this purpose.

Clearly labeling your medications will help you identify them easily, stay organized, and maintain medication adherence. It will also help prevent mix-ups or accidental ingestion of the wrong medication.

By carrying proper documentation and labeling your medications clearly, you can enhance safety, facilitate security screenings, and demonstrate compliance with regulations. It will also help you manage your medications effectively while traveling, ensuring a worry-free and well-organized journey.

How to Pack Prescription Meds for Air Travel: Security Screening and Airport Procedures

When going through security at the airport, it’s important to be prepared and aware of how it may affect your prescribed medications. Here are some tips to help you navigate the process smoothly:

• Medication Screening: Prescription medications are allowed through security checkpoints, but they may be subject to additional screening procedures. Be ready to present your medications separately for inspection if requested.
• X-ray Scanning: Medications, including pills and inhalers, can typically go through X-ray scanners without any issues. However, you can request a manual inspection instead if you prefer that your medications are not X-rayed.

Communicating with Security Personnel:

• Inform Security Officers: Advise the security officers that you are carrying prescribed medications and have them readily accessible for inspection. Clear communication from the start helps prevent any misunderstandings and ensures a smoother process.
• Carry Documentation: Carry your prescriptions or doctor’s notes with you and present them if requested. Proper documentation strengthens the legitimacy of your medications and can expedite the screening process.

Private Screening Option:

• Request Privacy: If you feel uncomfortable or prefer additional privacy during the screening process, you have the right to request a private screening. This allows you to discuss your medications confidentially and address any concerns or questions you may have.

Remember, security personnel are trained to handle situations involving prescription medications and medical needs. By cooperating, communicating clearly, and being prepared, you can navigate the security screening process with ease and ensure the safety and accessibility of your prescribed drugs.

Other Tips for a Smooth Journey

In addition to the tips mentioned earlier, here are some additional things you can do to ensure your air travel with prescription meds goes smoothly:

• Carry extra medication. This is especially important if you are traveling internationally, as there is a higher risk of luggage delays or loss. You should also carry extra medication if you have a chronic condition that requires you to take medication on a regular basis.
• Adjust your medication schedule for time zone changes. This can be done by gradually moving your medication times forward or backward by a few hours each day. If you are traveling across multiple time zones, you may need to adjust your medication schedule multiple times.
• Research local regulations. This is an important step to take before traveling to any country, as the regulations regarding prescribed medications can vary from country to country. You can usually find this information on the website of the country’s embassy or consulate.

What To Do If You Lose Your Medications?

If you happen to lose your prescribed medications while traveling, take the following steps to address the situation:

Losing your medications can be distressing but try to remain calm and composed. Panicking will make it harder to think clearly and find a solution.

Contact Your Healthcare Provider:

Reach out to your healthcare provider as soon as possible. Explain the situation and ask for guidance on what to do next. They may be able to provide advice, suggest alternatives, or assist with obtaining replacement medications.

Seek Medical Assistance:

If you require immediate medical attention or your condition is critical, seek medical help at a local healthcare facility or contact emergency services. Explain the situation and provide any relevant medical history to ensure proper care.

Locate the Nearest Embassy or Consulate:

If you are in a foreign country and need assistance, contact the nearest embassy or consulate. They can provide guidance, help facilitate communication with local healthcare providers, and assist in obtaining replacement medications if necessary.

File a Report:

If your medications were lost or stolen in a public place, consider filing a report with local law enforcement. This documentation may be required for insurance purposes or to facilitate any necessary legal processes.

Explore Local Healthcare Options:

Depending on your destination, there may be local healthcare facilities or pharmacies where you can seek assistance. Contact them and explain your situation to see if they can help provide replacement medications or suggest alternatives.

Arrange for Prescription Refills:

If you have travel insurance, check if it covers the cost of prescription refills in case of loss or theft. Contact your insurance provider to understand the process for obtaining replacement medications.

Consider Prescription Transfer:

If it is feasible, inquire about the possibility of transferring your prescription from your home pharmacy to a local pharmacy. This may require coordination between your healthcare provider, home pharmacy, and the local pharmacy.

Take Preventive Measures:

To minimize the risk of future medication loss, consider keeping medications in your carry-on luggage, ensuring proper labeling and documentation, and utilizing pill organizers to stay organized.

Remember, it is essential to consult with healthcare professionals and follow their advice in situations involving lost medications. They can provide the most accurate and appropriate guidance based on your specific circumstances.

How Air Doctor Can Help You Fill Prescriptions Abroad

Traveling abroad can be an amazing experience, but it can also be stressful. One of the biggest stressors is figuring out how to fill prescriptions if you get sick. In many countries, there are different healthcare regulations and it can also be difficult to find a doctor who speaks your language. This is where Air Doctor can help.

Air Doctor is an app that connects travelers to trusted, local doctors abroad. With Air Doctor, you can find a doctor who speaks your language and who is familiar with the local healthcare system. You can also get local, valid prescriptions.

Here are some of the benefits of using Air Doctor to fill prescriptions abroad:

• You can find a doctor who speaks your language.
• You can filter doctors according to other preferences.
• You can book clinic, at-home (hotel), or video consultations.
• You can get 24/7 multi-lingual support from the Air Doctor team.
• No lengthy claims processes.
• We’re partnered with insurance providers worldwide.
• Find trusted medical care, anywhere, anytime.

If you’re planning on traveling abroad, be sure to download the Air Doctor app so you can have peace of mind knowing that you’ll be able to get the medical care you need if you get sick.

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Jenny Cohen Derfler

Air dr ceo & co-founder.

Jenny is the CEO and one of the Co-Founders at Air Doctor. She spent more than 20 years at Intel, most recently as general manager of its manufacturing facility in Israel and before that in various engineering and manufacturing roles in Silicon Valley. Air Doctor is her second startup having previously founded electric vehicle company ElectRoad.

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Information on how to stay safe and healthy abroad. About us.

• General Travel Health Advice

Air Travel 

Introduction, airline restrictions on flying.

• Consideration of security measures

Health considerations when flying

Potential in-flight health problems.

Air travel can expose you to a number of factors that can impact your health and well-being.  Although most travellers won't notice any adverse effects to their health during a flight, the effects from flying may present challenges if you have certain underlying health conditions .

The airline you plan to fly with needs to make sure it is medically safe for you to fly, so you might need to tell them about any health condition you have.  Airlines might not let you travel with them:

• if they are concerned that you have a medical condition that might get worse during a flight
• if you have an illness that could infect other passengers

Restrictions and rules can vary between airlines, so if you are in any doubt, you should seek advice from the medical department of the airline. Most airlines have a medical advisory service, details of which can usually be found on their website.

If you think your health might be affected by flying, you should contact your GP or specialist before you book a flight.

Travel by air is not normally advised in the following cases (this list is not exhaustive):

• infants less than 48 hours old (longer after premature births)
• women after the 36th week of pregnancy or 32nd week for multiple pregnancy
• if you suffer from or have had:
• angina or chest pain at rest
• an infectious disease (e.g. chickenpox, flu), including COVID-19
• decompression sickness after diving (sometimes called 'the bends')
• increased pressure in the brain (due to bleeding, injury or infection)
• infection of your ears or sinuses
• recent heart attack
• recent stroke
• recent operation or injury where trapped air or gas may be present in the body (e.g. stomach ,bowel, eyes, face, brain)
• severe long term diseases that affect your breathing
• breathlessness at rest
• unresolved pneumothorax (punctured lung)
• sickle cell anaemia
• unstable mental health or psychotic illness

Consideration of security measures 

Security restrictions on the type of equipment and fluids which can be taken into the aircraft cabin might affect what medical equipment or medication you can bring with you for use during a flight.

• Please see the Travelling with Medicines advice page for further details.

If you have been fitted with any metal devices such as an artificial joint, a pacemaker or internal automatic defibrillator, then you should:

• carry a medical alert letter from your doctor
• alert the security staff that you have a medical device fitted before passing through any screening equipment

High Altitude

High altitude is generally considered to be 2,400 metres (8000 feet) and above. Aircraft cabins are kept at a pressure approximately equivalent to between 1,800 to 2,400 metres; developing symptoms due to high altitude ( altitude sickness ) is not usual during flights for most people. However, if you have a lung or heart condition, you might need to use oxygen during a flight because of the higher altitude.

If you fly in to an airport that is above 2,400 metres, for example in the Andes and Himalayas, you might get signs of altitude sickness. 

• For further information on the effects of altitude, see the Altitude and Travel advice page.

Using oxygen whilst flying

If you have a lung or heart (cardiac) condition, your symptoms might become worse during or after a flight, particularly if you become dehydrated or have over exerted yourself. You may need oxygen during the flight, even if you do not usually need it:

• If you use your own home oxygen, you must still contact the airline in advance to discuss if you are able to use it on the flight.
• You will need to contact your GP or specialist as they may need to provide medical information to the airline.

If you are healthy and your pregnancy has been straightforward, then air travel is generally considered safe. However, some pregnant women with underlying risk factors might be at increased risk of complications such as deep vein thrombosis (DVT) from flying.

• You should get advice from your midwife or obstetrician before booking any flights.

Airlines request a medical certificate from pregnant travellers if travelling after 28 weeks of pregnancy:

• most airlines won't allow air travel after 36 weeks for a single pregnancy, and 32 weeks for multiple pregnancies
• the medical certificate should detail your estimated delivery date and confirm that your pregnancy is uncomplicated and progressing normally

You must ensure you have travel insurance which covers both yourself and your unborn baby (in the event you need to give birth unexpectedly during your trip).

• See the Advice for Pregnant Travellers page for more details.

Flying with a disability

Navigating an airport and flying can at times be stressful, cause anxiety and be physically exhausting.  Many airports offer assistance services for those who have physical or hidden disabilities but these may need to be booked in advance.  Cabin crew are not allowed to assist passengers who are unable to look after their own physical needs (such as using the toilet, assistance with meals or mobility) during a flight.

• It is important that you make the airline aware of any special requirements you may need during the flight as soon as possible.

You should contact your airline well in advance of travel to check what assistance might be available to you for:

• your journey through your departure airport
• boarding the aircraft and during the flight
• disembarking the aircraft
• transferring between flights
• travelling through your destination airport

If you use an electric mobility aid such as an electric scooter or wheelchair, you will need to provide your airline with details of your equipment (such as make, model, size or weight) well in advance of your flight to enable the airline to check they can safely load and stow your equipment and undertake a fire risk of electrical equipment.

• If you use a wheelchair and wish to remain in your own chair to the aircraft door rather than transfer to an airline wheelchair at check-in, you should inform your airline of your particular needs as soon as you can.
• Showing airline crew your equipment’s operating manual may be helpful, especially if they have any issues loading, disassembling or reassembling your equipment into the aircraft hold.

Infectious Diseases

To reduce the potential risk of passing on infections to others on board an aircraft, you should postpone travel if you are actively unwell, especially if you have a fever, until you have fully recovered.

The quality of aircraft cabin air is carefully controlled and research has shown that there is a very low risk of infectious diseases being transmitted on board. The risk is no different from being sat close to someone on other forms of transport such as a bus or train. When transmission of infection does occur between passengers, usually as a result of a cough or sneeze or by touching surfaces which have been contaminated, they are usually seated in the same area of an aircraft.

An airline can deny boarding of any passenger who looks unwell, especially if they suspect the passenger might be infectious (infect other passengers). 

• If you have recently recovered from an infectious disease, but are still showing physical signs of being unwell, for example crusted spots following chicken pox, then you should carry a letter from a GP confirming that you are no longer infectious.

If someone has already travelled and is then found to have a serious infectious illness (such as measles or COVID-19 ) which could be a potential risk to other passengers, then contact tracing of passengers will be carried out by local public health authorities.

Coronavirus (COVID-19)

You should not fly if you have experienced recent symptoms of COVID-19 or have been identified as being a close contact of someone who has experienced COVID-19.

You should check the latest UK advice on the length of time you must self-isolate for after symptoms develop or being identified as a close contact, before deciding on travel:

• Scotland – NHSinform
• England – NHS UK
• Northern Ireland: NIdirect.gov.uk
• Wales: GOV.Wales

Further information on reducing your risk of exposure to coronavirus (COVID-19) during travel is available on the COVID-19: Health Considerations for Travel advice page.

Dehydration

The circulating air inside aircraft cabins is very dry and can affect your skin, lips, nose and eyes. Discomfort can be reduced by using:

• skin moisturisers
• saline nasal sprays
• glasses instead of contact lenses, which may cause irritation

Alcohol and caffeine containing drinks can make you pee more which can lead to dehydration:

• you should try to drink plenty of clear fluids, such as water, during long flights and limit how much alcohol and caffeine you drink

Deep Vein Thrombosis (DVT)

The cramped conditions and long periods of being less active on a flight can cause pain, stiffness or swelling of your legs. Being less active can lead to slow blood flow in your veins which increases your risk of developing a blood clot, known as deep vein thrombosis (DVT). DVTs most commonly form in the legs. Part of the clot may break off and travel to the lungs, causing a pulmonary embolism (PE) which is potentially life threatening.

• See the Deep Vein Thrombosis advice page for further information and advice on reducing your risk of DVT during travel.

Ear nose, throat and dental conditions

It is common to experience a 'popping' sensation in your ears during take-off and landing. This is caused by the air pressure changes that occur during a flight mean that during take-off air moves out of your middle ear and sinuses and during landing it flows back into your sinuses and middle ears.

 If you experience any discomfort, simple measures usually relieve symptoms such as:

• using a pacifier (dummy) in infants (as it mimics swallowing)

If you are suffering from an ear or sinus infection you may experience intense pain during take-off and landing.

• You should discuss this with a doctor prior to flying as it may potentially cause an injury within your ear.

General dental treatment, such as dental fillings, are not usually a contraindication for flying. However, some dental conditions or treatment can result in pockets of trapped gas (for example, unfinished root canal treatment, dental decay or abscesses) which may cause pain and discomfort when flying. You should seek advice from your dentist before flying in this instance.

Flying after diving

Flying too soon after diving might lead to you developing complications such as decompression sickness (more commonly called “the bends”). The general rule is to avoid flying until 12 -24 hours after your last dive. If in any doubt, you should seek specialist advice from your diving school before flying.

Jet lag is the term used for when your normal sleep pattern is disrupted due to crossing multiple time zones.

Jet lag can cause:

• difficulty sleeping at night
• wanting to sleep during the day
• difficulties in concentration and remembering things
• changes to your mood
• changes to your appetite
• nausea (feeling sick), indigestion and constipation

Effects of jet lag gradually wear off as your body adapts to the new time zone.

To minimise the effects of jet lag, you can consider the following measures:

• Try to begin adjusting your body to the new time few days before travel by going to bed 1 to 2 hours later if travelling westward, or earlier if travelling eastward.
• Change your sleep schedule to your new time zone as soon as possible after arrival.
• If you take medication that needs to be taken at a specific time (for example antibiotics or insulin), you should speak to your GP or specialist to plan an altered schedule for taking your medication which takes time zone differences into consideration.
• On long haul flights, you should:
• stretch and walk in the cabin when you can
• drink plenty of water
• avoid excess alcohol or caffeine
• try to sleep on the plane during an overnight flight
• Once at your destination:
• spend plenty of time outdoors in the natural daylight
• try to eat meals and go to bed according to local times
• If you are tired during the day, try taking a short nap (approximately 20-30 minutes) as this is unlikely to affect your ability to sleep at night.
• Avoid heavy commitments on the first day after travelling:
• be prepared for tiredness in the evenings and early waking, which can last up to 5 days or more

Motion sickness

It is uncommon to experience motion sickness during flying unless there is severe turbulence. If you are known to suffer from motion sickness in flight, you should:

• choose a seat in the mid-section of the aircraft
• keep motion sickness bags nearby
• avoid alcohol during and for 24 hours before a flight
• discuss with your GP medications to manage your symptoms if they can be severe

Fear of Flying

Fear of flying is a common phobia to have.  If you suffer from fear of flying, the following tips might be useful:

• A visit to your doctor prior to travel can provide you with reassurance about your general fitness for air travel:
• in severe cases, your doctor may be able to refer you for cognitive behavioural therapy in order to learn different ways to overcome your fears
• Tell the cabin crew:
• reassurance about routine aircraft sounds and inflight activities can help reassure you
• On a flight, try distracting yourself by talking with other passengers, watching a film, listening to music or reading.

A number of airlines run courses aimed at alleviating fear of flying. Some of these are listed here:

• British Airways Flying with Confidence
• Virgin Atlantic Flying without Fear
• Easyjet Fearless Flyer

This term is used to describe threatening behaviour or violence occurring on an aircraft, usually provoked or worsened by stress and frustration.  Airlines will, when necessary, divert aircraft to offload disruptive passengers and legal action taken against those involved.

Minimising the triggers causing air rage involves:

• avoiding excess alcohol and substance misuse
• remaining calm when dealing with stressful situation such as crowding, delays and lack of information
• using nicotine gum or patches to avoid the agitation of nicotine withdrawal when smoking is not allowed in airport buildings and during the flight

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• Disease Prevention Advice

The 2024 Guide to Fit-to-Fly Certificates

Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.

In the last 20 years, the number of global flights has been increasing steadily, reaching 38.9 million in 2019, with 4.4 billion people taking air trips in 2018. In 2020, courtesy of the COVID-19 pandemic, the number of flights dropped to 16.4 million.

But by 2022, despite the war in Ukraine and the Omicron variant of COVID-19, travel had bounced back – in Europe alone, 2 billion passengers took 9.3 million flights, back to 83% of pre-pandemic levels. By 2023 we were back to 94.1% of pre-pandemic flights – a 37% increase on 2022.

After almost three years of (sometimes complete) restrictions on flying, millions of Brits have shown how much holidays abroad mean to them. But while pretty much all COVID-19 formal requirements are gone, that doesn’t mean all entry requirements for medical conditions have.

Just as before the pandemic, you may require a certificate from your doctor if you have certain medical conditions. So it’s well worth knowing the regulations for the country or countries you’re planning to visit before you book.

Do I need proof I'm fit to fly if I have a medical condition?

If you have a health condition, you’ll want to ensure that you’re fit to fly before travelling abroad.

While you might feel well enough within yourself to tackle the journey, it’s always worth checking in with your doctor or nurse so that they can get a better understanding of your condition before you commit to flying. 

However, beyond a routine chat with your doctor, you might find that there are circumstances where you might need an official fit-to-fly certificate.

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General restrictions on flying

There are certain long-term medical conditions that can flare up from time to time. As well as making you feel generally unwell, a flare-up of some conditions (including  asthma ,  COPD ,  Crohn’s disease  and ulcerative colitis) can make travelling riskier.

There are other medical conditions where the severity of symptoms varies widely. For instance, many people with  Parkinson’s  disease have only mild issues with mobility; and many people with  multiple sclerosis  feel entirely well between attacks. But others may need major modifications to their travel plans or have very limited mobility.

So if you have a long-term medical condition, you should always check with your travel agent or airline whether you’ll need a fit-to-fly certificate or medical letter confirming you’re currently fit to fly.

Time-limited restrictions on flying

There are certain situations where flying on passenger planes is not allowed. However, in most circumstances, these restrictions are:

• Time-limited (e.g. after stroke, heart attack, or surgery); or
• Depending on the severity of your symptoms (for instance, you can usually fly if you have angina, but not if you’re getting symptoms at rest).

You can find out more details in our article on  Flying with Medical Conditions .

When do you need a fit-to-fly certificate?

A fit to fly certificate is needed to be granted medical clearance by your airline. 

If your condition is stable, it’s very unlikely that you will be asked for medical clearance - but a fit-to-fly certificate may still be required if: 

• You’ve recently been discharged from the hospital
• You’re in recovery from an operation
• You’re more than 28 weeks pregnant
• You’re actually travelling for medical reasons (i.e. you’re going for some treatment)

Of course, whether you need a fit to fly certificate is at the discretion of your chosen airline, so you should always carefully check their individual guidelines to find out their specific requirements. 

Travelling with medicines or medical equipment

Travelling with medication

You’ll often need a letter from your doctor if you need to take medication abroad. In addition, some countries have restrictions on certain medicines (and even ban certain medicines, including some available in the UK without prescription, such as codeine-containing medicines).

You can find out exactly what you need to do to avoid any issues with your medication from our article on  taking medication abroad .

Travelling with oxygen

One of the major issues in relation to fitness to fly is the fact that oxygen pressure in a plane is lower than on the ground. That means conditions affecting your heart and lungs, which can reduce your body's ability to carry oxygen around your body, can lead to new or worsening symptoms during flight.

In some situations, you may be able to fly if you have access to oxygen onto the plane – speak to your doctor about arranging this if needed. You will definitely need a letter from your doctor detailing:

• All your medical conditions.
• Why you need to travel with oxygen.
• That your condition is stable and that you are fit to fly with oxygen.

Remember that all airlines have different rules about travelling on a plane with oxygen: some supply it on board for free, while others charge for it. You’ll need to contact your airline well in advance to make arrangements. You’ll also need to make arrangements to access oxygen at your destination. You can find out more details in our  travel guide .

Flying with a pacemaker or implantable defibrillator (ICD)

Having a pacemaker shouldn’t cause problems for travelling by air, but you will need your device identification card. It’s a sensible precaution to get a doctor’s letter, too.

Recent research suggests it’s usually safe to go through airport scanners with a pacemaker or ICD. But you can ask for a hand-held metal detector check instead – see our guide to  travelling with a heart condition  for more details.

Travelling with a plaster cast

Because of the risk of swelling inside a cast, many airlines choose to restrict flying during the first 24-48 hours after a cast has been fitted. If you do decide to travel before that period has elapsed you can expect the airline to require your cast to be split along the full length. This will prevent any pressure build-up from impacting your circulation. Having a letter containing the date & time the cast was fitted will be helpful.

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How much does it cost to get a fit-to-fly certificate?

This depends on how much your GP surgery charges - but typically this cost ranges from £20-£40. 

You can find a list of  suggested fees  from The British Medical Association if you want a more comprehensive idea of the different costs and fees you might expect.

When will my fit-to-fly certificate expire?

Again, there is no clear-cut answer to this. But at the very least, your certificate should indicate that you’re fit to fly at the exact time of your trip. 

So, if you have a letter from months ago, the likelihood is that this won’t be suitable for your airline today. 

If you have a recurring, or more permanent medical issue, you should probably speak to your doctor or specialist nurse about getting a fit-to-fly certificate every time you travel - just to be on the safe side.

Single Trip insurance is for one-off, individual trips and will cover your specified travel dates. This is usually up to 45 days; however, some insurance providers can cover up to 94 days. If you’re not a frequent traveller, single trip cover is a great option and will likely be cheaper than an annual multi-trip cover .

If you travel 2 or more times a year, annual trip cover may very well save you money. The maximum duration of any trip will always be specified and will vary by provider. But don't worry, when you get a quote, we'll ask you what your maximum trip length is and only show you quotes that match!

A pre-existing is any medical condition for which medical advice, diagnosis, care, or treatment was recommended or received before applying for a travel insurance policy. For some conditions, we'll need to know if they have ever been present, whilst for others if they occurred within a certain period.

A pre-existing condition is a diagnosed medical condition that existed before taking out a policy. We'll ask a series of questions about the medical history for you and any travellers on your quote. If you answer yes to any of these, you will need to tell us about the traveller's conditions. This could be a condition that a traveller has now or has had in the past. If you are not sure what conditions you need to declare, we have online support available to help you 24/7!

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Medical clearance

In most cases, medical clearance is not required for travel with Air France.

While medical clearance is not always necessary, Air France recommends contacting your primary care physician to determine whether you are fit for air travel in the following cases:

• Recent surgery,
• An appendage in a cast.

Medical clearance delivered by Air France's Medical Service is mandatory only in the following cases:

• You are traveling with a stretcher or incubator,
• You need oxygen therapy at a rate exceeding 2 liters/minute,
• You may need extraordinary medical assistance during the flight due to your state of health*,
• You have a contagious disease*.

* In these cases, recent medical clearance from your physician or a certificate from the airport physician is accepted.

If one of the following cases concerns you, please consult your primary care physician before traveling. To obtain an Air France Medical Service clearance, please download forms A and B:

• Form A "Passengers requiring special assistance".  To complete this form, please request assistance from our Saphir service, your booking agent or your travel agency.
• Form B "Passengers requiring medical clearance"  to be completed by your primary care physician. You must submit both completed forms to Air France no later than 48 hours before your departure.

They must also be sent to an Air France physician whose contact details will be sent to you by our Saphir service, your booking agent or your travel agency. Air France Medical Service determines if you are fit to travel (or not), and if so, issues your medical clearance.

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Unable to Fly Due to Medical Reasons: Avoid Cancellation Fees with a Doctor’s Note

Christine Sarkis

There's a 95 percent chance Senior Editor Christine Sarkis is thinking about travel right now. Follow her on Instagram @postcartography and Twitter @ChristineSarkis .

Christine Sarkis is an SATW-award-winning journalist and executive editor at SmarterTravel. Her stories have also appeared on USA Today, Conde Nast Traveler, Huffington Post, and Business Insider. Her advice has been featured in dozens of print and online publications including The New York Times , Conde Nast Traveler , and People magazine. She has also shared travel tips on television and radio shows including Good Morning America, Marketplace, and Here & Now. Her work has been published in the anthologies Spain from a Backpack and The Best Women's Travel Writing 2008 . She is currently working on a travel memoir.

The Handy Item I Always Pack : The Trtl Pillow . It's easy to pack and comfortable, and makes it so I can actually sleep on flights.

Ultimate Bucket List Experience : Seeing the Aurora Borealis from the comfort of somewhere warm, like a glass igloo or hot spring.

Travel Motto : Curiosity is an amazing compass.

Aisle, Window, or Middle Seat : Aisle all the way.

Email Christine Sarkis at [email protected] .

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I consider myself a nonrefundable ticket sort of person. There are very few circumstances in which I’m willing to shell out significantly more to book a more flexible ticket, and until recently I had never been unable to fly due to medical reasons. The cost is simply too high. I’d rather cross my fingers and hope no complicating factors arise. And usually, that works.

But sometimes, it doesn’t. Like the time I got very ill a few days before a trip, and as the illness progressed, it became clear that I would be unable to fly due to illness. I could barely stand, let alone traipse halfway across the globe. I needed to cancel, but I wanted to avoid a stiff penalty if at all possible.

Unable to Fly Due to Medical Reasons? Get a Letter from a Doctor

Enter the doctor’s note. The cost to cancel my ticket would be $200, but the airline was among those that would waive the fee if I could provide a doctor’s note.

I had the fortune/misfortune of a trip to the emergency room and multiple consultations with two different doctors, so I had a paper trail to back up my claim that I was unable to fly due to illness. The airline asked for a doctor’s note, on the doctor’s letterhead, which included some kind of statement regarding my inability to fly for medical reasons plus my name and confirmation number.

Flight-Cancellation Rights: The Ultimate Guide

Because of some tight timing (and the fact that I wasn’t up to making all those phone calls in one day), I first had to cancel the flight and incur the $200 fee, then ask the doctor to fax a note to the airline confirming I was unable to fly due to medical reasons, at which point the $200 was credited back to my account. In my case, the money now sits as credits to be used on a future flight, but since I plan on traveling with the airline in the next year, that’s just fine with me.

How to Ask for a Cancellation Fee Waiver with a Doctor’s Note

If you need to cancel a flight due to a medical reason and are hoping to avoid cancellation fees:

• Read the fine print or contact your airline to assess whether or not a documented medical emergency is enough reason to waive a cancellation fee.
• Be in touch with your doctor so that he or she can vouch for you.
• Cancel more than 24 hours in advance.
• Ask your doctor (or a nurse or someone at the front desk) politely, and make it as easy for them as possible to provide a doctor’s note.
• Provide the airline with as much information as possible about your medical condition, ask nicely, and follow up to check on the process of your cancellation fee waiver claim.

It’s also worth mentioning that Southwest is the only U.S. airline that doesn’t charge cancellation fees.

How to Get a Refund on a Nonrefundable Flight

How to Know If You’re Too Sick to Fly

If you’re wondering if you’re too ill to fly, you’re probably too ill to fly. Need more concrete advice? The CDC has answers: Its Before You Travel Tips page is packed with specific advice about symptoms and special considerations. For instance, if you have a temperature of 100.4 degrees Fahrenheit, a sinus infection, or any disease (including flu) that can spread easily, you should cancel your travel plans. At that point, you can reach out to the airline and reach out to your doctor to see what you can do about trying to get that cancellation fee waived.

More from SmarterTravel:

• Healthcare Abroad: How to Find an English-Speaking Doctor or Clinic
• Airline Fees: The Ultimate Guide
• How to Avoid Foreign Transaction Fees

Editor’s note: This story was originally published in 2013. It has been updated to reflect the most current information.

We hand-pick everything we recommend and select items through testing and reviews. Some products are sent to us free of charge with no incentive to offer a favorable review. We offer our unbiased opinions and do not accept compensation to review products. All items are in stock and prices are accurate at the time of publication. If you buy something through our links, we may earn a commission.

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• Medical Information Form (MEDIF)

MEDIF Part 1

To be filled in by the passenger, or on behalf of the passenger.

MEDIF Part 2

Once Part 1 has been submitted, we’ll send Part 2 to the passenger’s doctor to complete.

Part 2 will then be forwarded to the passenger.

Final Submission

The final submission (Part 1 and Part 2) must be reviewed and confirmed by the passenger, before submitting it to us.

Please submit the completed forms at least 48 hours before the flight, so we can check and process the request.

Start my MEDIF form

Important information.

The MEDIF should be completed based on the passenger's condition within one month from the planned date of travel, and submitted at least 48 hours before the flight.

Emirates Medical Services might request further information or clarification before approving your MEDIF. You should also let us know immediately about any change in the passenger’s condition PRIOR to departure.

If you are submitting a MEDIF form on behalf on an infant , please download the MEDIF PDF (Opens a PDF in a new tab)  and send a completed copy to [email protected] .

General guidance

Passengers travelling with any of the following conditions should complete a medif when making a booking:.

• Passengers whose medical condition requires a supply of oxygen, a stretcher, a medical escort or treatment whilst on the flight.
• Passengers who may need to use medical equipment or instruments on the flight.
• Passengers whose fitness for air travel is in doubt, whether because of recent instability, disease, treatment or surgery.
• Passengers who aren’t usually accepted for travel, or suffer from serious or unstable illnesses or injuries.

There are two main factors we consider when assessing a patient’s fitness for air travel:

• Reduced atmospheric pressure: cabin air pressure changes greatly during 15-30 minutes after take-off and before landing, and gas expansion and contraction can cause pain and pressure effects.
• Reduction in oxygen tension: the cabin is at a pressure equivalent to an altitude of 6,000ft to 8,000ft and oxygen partial pressure is approximately 20% less than on the ground.

Any medical condition that would render a passenger unable to complete the flight safely, without requiring extraordinary medical assistance during the flight, is considered unacceptable for air travel.

Conditions usually considered unacceptable for air travel

We assess each individual case on its own merits, and take into account whether the passenger is accompanied by a medical escort. However, as a general guide the following conditions are usually considered unacceptable for air travel:

• Severe cases of anaemia.
• Severe cases of either middle ear infections (otitis media) or sinusitis.
• Acute, contagious or communicable diseases.
• Those suffering from congestive cardiac failure or other cyanotic conditions which aren’t fully controlled.
• Uncomplicated myocardial infarctions (MI) within two weeks of onset, or complicated MIs within six weeks of onset.
• Those suffering from severe respiratory diseases or recent pneumothorax.
• Those with gastrointestinal lesions which may cause hematemesis, melaena or intestinal obstruction.
• Within 10 days of simple abdominal operations
• Within 21 days of chest or invasive eye surgery (not including laser surgery).
• Jaw or jawbone fractures with fixed wiring of the jaw (unless medically escorted).
• Unstable mental illnesses without escort and suitable medication for the journey.
• Uncontrolled seizures (unless medically escorted).
• Uncomplicated single pregnancies beyond the end of the 36th week or multiple pregnancies beyond end of the 32nd week.
• Infants within seven days of birth.
• Those who have introduced air to body cavities for diagnostic or therapeutic purposes within the previous seven days.

Notes on other conditions

• Food allergies: passengers don’t need to complete this form to request a dietary meal for their flight. Please note we can’t guarantee peanut-free meals. However if the passenger has a life threatening food allergy that may require treatment in-flight – particularly if they react to the presence of traces of food in the air – this form should be completed.
• Asthma: medication for asthma must be carried in cabin baggage. As nebulisers require their own power source, spacer devices used with an inhaler are an effective onboard alternative.
• Escorts: medical escorts should ensure that they have all appropriate items for the proper care of their patient, and are responsible for attending to all aspects of their patient’s needs. Due to food handling regulations, cabin staff can’t assist with these needs.
• Fractures: all new long bone fractures and full leg casts require a medical certificate. Casts must be at least 48 hours old. Plasters should be split for fresh injuries (48 hours or less), which could swell inside the cast on a long flight. Unfortunately extra legroom for leg elevation isn’t possible in Economy Class; however, an aisle seat can be reserved. Please state whether the injury is on the passenger’s left or right.
• Inflight care: please note we don’t provide nursing attendants; our cabin crew are only trained in first aid.
• Lung or heart disease: cardiopulmonary disease which causes dyspnoea on walking more than 100m on a flat surface, or has required oxygen in hospital or at home (or in flight previously) may require supplementary oxygen. The aircraft oxygen is for emergency use only. Serious cardiopulmonary cases as well as those requesting continuous oxygen, a stretcher, or an incubator should enclose a recent detailed medical report with the medical certificate. (A copy of a specialist or hospital referral should be sufficient.)
• Physical disabilities: if the passenger only requires a wheelchair as far as the aircraft door there is no need to complete this form. Note: Civil Aviation Rules require all passengers to be able to use the aircraft seat with the seatback in the upright position.
• Dietary meals: Special diets for religious or other medical reasons can be ordered by managing your booking online , or directly through a travel agent if you booked with one.
• Terminal illnesses: passengers in the advanced stages of terminal illness will normally require a medical or nursing escort.

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Medical Needs and Clearance

Medical needs and clearance requirements.

Do you require medical assistance on your upcoming flight with us? We have got you covered. Learn more about what to do if a passenger requires medical assistance or has special needs and requires mobility aid to be taken onboard.

Care in the air

Although rare, a medical incident in the air is always a possibility. As your safety is our priority, our cabin crew is trained in advanced first aid and life support. Our medical kits are recognised and approved as per international medical guidelines, which can be administered by our cabin crew and by a doctor or nurse who may be on board and willing to assist if the situation demands. 

Medical clearance

Most passengers with a medical condition can fly with us. All you need to do is fill out the  Medical Information Form (MEDIF)  while booking your flight with us. 

The cabin air is pressurised on the flight, and the passengers must take precautions if they have a respiratory or cardiac condition. Medical clearance is required if

• The passenger's fitness to travel is doubtful due to recent illness, hospitalisation, injury or surgery.
• The passenger has an existing medical condition. 
• The passenger needs special services such as oxygen or medical equipment on board. 
• The passenger is flying for medical reasons or treatment. 

Are you flying internationally?

When planning to fly internationally, it is recommended that you:

• Check on any vaccination requirements at least six weeks before your departure. 
• Carry adequate travel insurance to cover any medical costs incurred abroad. If you still need to get travel insurance, you can head to the  TATA AIG Travel Insurance page for more information.
• Although most medical cases are straightforward, some may require individual assessment. 
• You may be asked to travel with a medical escort or supplementary oxygen. 
• Your fitness to fly is based on internationally accepted criteria to ensure a safe, comfortable, and uneventful journey with us. 

If you have a prevailing condition that may affect you in flight, we request you to complete the formalities that include:

• Filling out the MEDIF form. 
• Getting adequate medical clearance for your travel. 
• To ensure we have all the arrangements in place for your smooth journey, please submit the MEDIF form at least 14 days prior to departure to the nearest Air India office . 

Cabin pressure

The cabin air pressure could cause a drop in oxygen levels in the blood. As a result, this could affect a passenger with respiratory problems (such as chronic bronchitis, emphysema, or Chronic Obstructive Pulmonary Disease (COPD)) who may need to book supplementary oxygen.  

A request for supplementary oxygen needs to be made while booking your flight. 

Post-operative care

Flying after an operation or a severe illness can be stressful. It is recommended not to travel during this period. However, if you need to travel post-surgery, please keep in mind the points below:

• It is advisable to carry the medication with the prescription in your cabin baggage that you may need during the flight.  
• Medication cannot be refrigerated on board. Please carry a cool bag or vacuum flask if your medicines must be kept cool. Kindly discuss options with your pharmacist.  
• If you're travelling with medical equipment, please inform us in advance, as clearance will depend on the type of equipment.  
• Medical clearance is required for most medical equipment, including nebulisers and ventilators.  
• The equipment must be capable of being battery-operated. We cannot guarantee a power supply onboard our aircraft.  
• You will not be allowed to use authorised medical equipment during taxi, take-off, approach, and landing.  

Nebulisers and oxygen masks

Only battery-operated nebulisers can be used in flight. You will not be allowed to utilise the devices during take-off and landing. 

Passengers travelling with a medical requirement for an oxygen mask and cylinder will be charged separately.

• Oxygen mask per unit: USD 275 (all-inclusive charges). The cost is for the mask only. Masks are for single use, so for passengers who require a mask change, an additional charge will apply.
• Oxygen bottles are not included with an oxygen mask. They are available separately.
• Oxygen cylinder per bottle: USD 50 (all-inclusive charges).

Portable Oxygen Concentrator (POC)

A passenger diagnosed with sleep apnea is permitted to use an FAA/EASA-approved Portable Oxygen Concentrator (POC) machine or Continuous Positive Airway Pressure (CPAP) machine ,provided the following conditions are met:

• The person using the equipment has a medical need to use it. This must be evidenced by a written statement in that passenger's possession. 
• A licenced physician must sign a statement specifying how much oxygen is needed every hour and its flow rate under normal operating conditions.
• Due to the limited aircraft electrical power supply, we strongly recommend carrying charged batteries for a period equivalent to 150% of the expected flight time.
• You must inform the flight commander when the machine is brought onboard. Also, notify the cabin crew before and while operating the equipment.
• Warning lights and audio alerts will be made when the aircraft is on the move (on the surface, take-off and landing). Please ensure the POC is placed underneath the seat in front of the passenger using the machine during such times.
• No passenger operating a POC is permitted to occupy an exit seat.
• The equipment and a bag with additional batteries required to charge it during the flight are considered assistive devices and will not be considered part of the cabin baggage allowance.
• When connecting to or from any other airline, including codeshare flights not operated by us, passengers are advised to make independent arrangements directly with the other airline.
• The unit should display the manufacturer's label indicating that the device meets FAA safety requirements regarding M-PED (Medical Portable Electronic Devices).
• All POCs meeting the requirements but not recognised by Special Federal Aviation Regulations (SFAR 106) must bear a red label stating: 'The manufacturer of this POC has determined this device conforms to all applicable FAA acceptance criteria for POC carriage and use on board aircraft.'
• The machine must be operated by a dry-cell battery that is leakproof and doesn't have any spillage. Spare batteries must be protected from damage and short circuits.

Critical guests requiring ventilator support

We do not allow critically ill cases to fly using our commercial aircraft.

However, we may consider making an exception on a case-by-case basis after thoroughly examining the guest's condition. In such exceptional cases, medical, engineering, and security clearances will be required.

The following equipment criteria must be fulfilled:

• It should be FAA (Federal Aviation Administration) approved.
• The equipment must be battery-operated and portable.
• Passengers should carry enough spare non-spillable batteries (at least 1.5 times the entire flight duration) to last the whole flight duration.  
• Please note we do not provide any equipment for stable cases requiring ventilation with air.

If a guest with such a condition needs to travel, they must be accompanied by a physician experienced in aeromedical transportation. The physician/intensivist must submit a self-declaration regarding their capability to handle such cases.

In-flight seating

Safety regulations stipulate that passengers with medical needs should not be seated near emergency exits or in cross aisles that are a part of the emergency exit routes. Only suitable seats will be allocated to such passengers. 

Wheelchair request

In accordance with air safety regulations, passengers requiring wheelchair assistance must follow specific guidelines when flying with us.

• Please ensure that your request for a wheelchair is made at the time of booking and confirmed before you travel with us so that we can provide the required assistance throughout your journey. 
• Wheelchair and buggy car assistance are available at airports upon request and are subject to availability. Passengers with confirmed wheelchair requests made during booking will be assisted on priority. 
• Certain airports levy charges for providing wheelchairs, so kindly check the applicable charges with the airport authorities before your travel.

If you're travelling with your wheelchair:

• We can arrange to carry your wheelchair or mobility aid on your flight. Please let us know your requirements at the time of booking. 
• If there is space, we will store collapsible wheelchairs and mobility aids in the aircraft cabin. They will be carried in the hold if we cannot take them due to weight or size.
• One mobility aid, e.g., a wheelchair, will be carried free of charge in addition to the applicable checked baggage allowance.
• Special permission must be requested when bookings are made for mobility aids over 30 kg/66 lbs due to weight and space restrictions.
• If you have a battery-powered wheelchair, you must take certain safeguards before travelling. Please get in touch with our nearest office for more details. At some airports, we may have to check in wheelchairs or mobility aids into the aircraft hold and return them once we land at our destination. In such cases, we will transport you from the check-in counter to the aircraft in another wheelchair and, upon arrival, from the plane to your wheelchair or mobility aid. 

Passengers who require a stretcher

Air India can accommodate passengers who need to use a stretcher on its domestic and international flights with prior information and advanced planning. Stretcher bookings are accepted only after clearance from our medical services department and the chief medical officer.  Learn more  about carrying a stretcher onboard.  

Flying with a Service Dog

Service dogs that are trained to assist passengers with special needs are permitted to fly in the cabin for free, provided they meet all requirements and regulations of the individual country.  Learn more  about the travel requirements and behaviour guidelines for service dogs aboard our flights and in other countries.

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Acclimation certificates/statements

Comment on this policy

Acclimation certificates/statements are used to allow airlines to ship dogs and cats when the airline cannot guarantee compliance with existing requirements as stated in the federal Animal Welfare Act regulations, Part 3, Subpart A – Specifications of the Humane Handling, Care, Treatment, and Transportation of Dogs and Cats (9 CFR § 3.13[e]) and, specifically the minimum temperature allowed by the regulations. Veterinarians may advise clients not to ship animals with transporters or airlines that cannot guarantee compliance with animal welfare regulations. In accordance with the requirements of the Animal Welfare Act, regardless of the temperature range suggested by the owner/authorized agent or veterinarian, ambient temperatures listed in the acclimation certificate/statement cannot be higher than 85° F for more than four consecutive hours while in animal holding areas of airport terminals or for more than 45 minutes while transferring the animal between the aircraft and the animal holding area. Veterinarians should exercise sound professional judgment when asked to make declarative statements about the safety or risks that arise from shipping specific animals outside of the provisions of the AWA.

Carriers or intermediate handlers whose facilities fail to meet the minimum temperature allowed by the standards may accept for transportation or transport, in commerce, any live animal if the consignor furnishes to the carrier or intermediate handler a certificate executed by an accredited veterinarian stating that such live animal is acclimated to air temperatures lower than those prescribed in the CFR (45° F).

Acclimation certificates/statements issued in accordance with 9 CFR section 3 no more than 10 days prior to delivery of the animal(s) for transportation should only be provided as a statement attached to a Certificate of Veterinary Inspection and shall include at least the following information:

• Name and address of consignor
• The number and identification of animals in the shipment
• An acclimation certificate/statement
• The signature of the USDA accredited veterinarian, accreditation number, and date

Veterinarians who sign acclimation certificates/statements for the transportation of pet animals that may be exposed to adverse temperatures, should word their certifying statement as follows:

"The animal(s) in this shipment appear healthy for transport but need(s) to be maintained at a range of ambient temperatures (in Fahrenheit) to which the animal(s) has/have been acclimated, as determined in consultation with the owner/authorized agent to be no lower than (W degrees) for (X) minutes and no higher than (Y degrees not to exceed 85° F) for no longer than (Z) minutes."