Anecdotes do not good statistical analyses make. However, DS works in Tanzania and at 38 had a spontaneous pneumothorax, aka collapsed lung. He has all sorts of insurance through work, but it was a hassle dealing with them regarding evacs. After a week in hospital in Dar es Salaam, TZ, they weren't able to get the lung reinflated. He had just put his pregnant wife on plane to return her to US for delivery. Would they send him there? No, it was off to South Africa (where his care was excellent, a 4 hour special medivac plane ride w a doctor). Before he got there they were expecting surgery, so DW and I flew there since his wife was no longer allowed to fly because of pregnancy. We never thought anyone would pay for it, but the company's special medical insurance covered one of us and his company chipped in for the other (Thanks!).
Once lung inflated and healed, they needed to fly him to states for delivery. At this point it was all in the hands of the special insurance company. Next thing he knew he was in business class to Chicago, with his own accompanying physician, who delivered him to his wife's parents home where she was staying. Two tix business class from Joberg to Chicago with an MD escort (and return). I'd guess that alone was $20-30k easily. The medivac from TZ to Joberg likely that much as it was a special plane, medical equip, and staff, all just for him. All in I'd guess the adventure was at least $75k.
Yeah, most travel is to more medically equipped places than Tanzania, but that experience has us inclined to buy the medical for visits to such places as TZ. With an acute life threatening incident in the middle of the third world, you can't just hope to make it home to the US in time on your own. Well, you can hope to I suppose.
May have posted this before, but when seen by US Dr. was told, oh, you can have this again (had been told by Dr. in South Africa, who incidentally had been Mandela's personal physician for 6 years) and you must not fly again and should always be within an 1/2-1 hour of a good hospital. WTF? He was freaking out as international engineering is his career. Called the South Africa Dr. and he just said, pshaw, that's just US medicine covering its legal ass. You work in Africa and expose yourself to far greater danger so just live your life. It's been three years and no repeat. Besides, while pretty painful and scary, I'd guess he could live through another one even a day away from a hospital. And I do believe airplanes come equipped w O2 to assist stressed folks. Keep Calm and Carry On!