I have carefully studied several of these insurance contracts and have concluded they are not worth the money. You have to be virtually near death before you’ll get a real medivac benefit. Most countries you go to have better medical facilities than in most of the USA, and if you have health insurance here, it will probably pay for out of country medical costs if there was an emergency, which, I assume, it would be your case. I have used local doctors in Indonesia and Canada. In Indonesia, the costs were so small I just paid them. In Canada, my insurance company was billed and paid the claim.